COVID-19 in Latin America: What Does it Take to Go From a Highly-Vulnerable Region to a Pandemic-ready Region?

This is the eighteenth document in a series of discussion notes addressing fundamental questions about the COVID-19 crisis and response strategies. These documents are based on the best scientific information available and may be updated as new information comes to light

Written by Carolina Batista (Latin America and the Caribbean Strategic Focal Point at ISGlobal) and Leire Pajín Iraola (Global Development Director at ISGlobal), the document offers a brief overview of the current impact of the crisis in Latin America, comments on some positive examples, goes on to highlight five specific weaknesses and makes recommendations on ways to reduce these vulnerabilities.

We are the victims and the witnesses of the unprecedented impact of the COVID-19 pandemic across the globe. Countries with robust health systems and social protection mechanisms have seen their structures collapse trying to cope with overwhelming numbers of infected cases and deaths. Since the World Health Organisation (WHO) declared the pandemic in March 11, the virus has spread to countries in every continent and by July 22 close to 15 million cases had been reported worldwide and more than 616,000 people had lost their lives due to COVID-19.

But the situation has disproportionately affected regions with weaker health systems, large pockets of vulnerable populations and socioeconomic conditions that make confinement measures more difficult. This is the case of Latin America, a region of 650 million people where coronavirus is exacerbating existing inequalities and punishing individuals and communities with a long history of vulnerabilities, such as women, migrants and indigenous populations.

Until effective vaccines and treatments are developed and made available to all who need them, the epidemiological risk will persist. However, there are actions that can be taken in the meantime to mitigate the impact of the coronavirus on the region’s health and socioeconomic systems, as the successful example of some Latin American countries has shown.

Social, Economic and Health Impact of COVID-19 in Latin America

According to the United Nations Development Programme (UNDP), about 142 million people, almost one-quarter of the population of the Latin American region, are currently at risk of contracting COVID-19. The region has seen an exponential increase in cases since the first imported case was detected in Brazil on February 26 and the first death was reported in Argentina on March 7. In early June, the WHO declared Latin America the new epicentre of the pandemic. With more than 3.5 million infected people and nearly 152,000 deaths, the region now accounts for one in every four COVID-19 cases worldwide.

The countries most affected as of the third week of July 2020, according to Johns Hopkins University, are: Brazil, Peru, Chile and Mexico. Together, these four countries have reported over 2.8 million cases. Other countries in the region, such as Colombia, Argentina and Ecuador, are also struggling to contain major outbreaks.

The real impact of COVID-19 on local economies has yet to be seen, but preliminary analysis points to the likelihood of a major depression. And any exacerbation of this debt by the COVID-19 pandemic could trigger an unprecedented financial crisis.

COVID-19 has exposed the inequalities and weaknesses of Latin American health systems caused by a chronic lack of investment. Barriers to services are multidimensional. According to PAHO (Pan American Health Organization, the regional division of the WHO), 30% of the population cannot afford healthcare and 21% are excluded due to geographic factors. This means that many of the region’s most vulnerable populations are trapped in a vicious cycle of poverty, exclusion and disease.

Pandemic Response: Five Vulnerabilities in Latin America

The COVID-19 pandemic is shining a light on underlying vulnerabilities and limitations that will hamper the response to the epidemic in the region and the subsequent recovery. The following are five major challenges:

1. Lack of Political Leadership and Misalignment of Public Health Recommendations.
2. Labour informality. According to the International Labor Organization, approximately 54% of workers in Latin America rely on day-to-day work to ensure a basic income to supply their families’ needs. They cannot comply with social distancing or lockdown measures, have limited cash reserves and no access to social safety nets. On the other hand, only 26% of workers in formal employment can work remotely and only 20% of the 154 million children and youngsters living in the region have access to the technologies they need to support remote education.
3. Gender Inequality. The COVID-19 pandemic put many women in a more vulnerable and precarious situation.
4. The ‘Curse’ of Being a Middle-income Country and the Global Response. Most of the region still falls into the category of middle or low-middle income countries. In a context in which the richest economies are already making their own arrangements and the poorest ones may benefit from enhanced aid schemes, large sections of the planet’s population living in middle-income countries could be left behind. 
5. The  Greater Vulnerability of Certain Social Groups. Indigenous people and afro-descendants are among the most vulnerable groups in Latin America. 

Success Stories in Latin America: From Government-led Responses to Strong Community Engagement

Although the pandemic is posing enormous challenges throughout the region, some countries are emerging as leaders in driving successful responses. Measures implemented in Paraguay, Uruguay and Cuba, for instance, have kept the number of cases and deaths significantly lower in those countries than elsewhere in the region. International groups have ranked those three countries as deploying some of the 45 best practices for COVID-19 prevention and control.

According to Johns Hopkins University, by mid-July the number of reported cases was just over 3,200 in Paraguay and 1,000 in Uruguay, and the two countries had reported only 56 COVID-related deaths—a result that stands out in contrast to the very high numbers reported in the region as a whole. Mathematical models suggest that, in Paraguay alone, the national COVID-19 response has averted around 15,000 deaths

The Way Forward: Opportunities to Build a More Resilient and Inclusive Post-COVID Region

The crisis triggered by COVID-19 demands a swift, ambitious and equitable response from the Latin American countries and the international community supporting them. But it also represents an opportunity to reassess some of the economic, social and environmental policies that have increased the vulnerability of Latin Americans during this crisis. Despite the recent shock—or perhaps because of it— the region’s commitment to the 2030 Agenda is more important than ever. Latin American leaders can choose whether this crisis will jeopardise progress towards sustainable development or whether it will serve as a catalyst for reducing underlying inequalities and bringing about far-reaching transformations.

These are key actions that national and regional authorities could take in response to COVID-19, as recommended by international bodies such as PAHO, UNDP, ECLAC, and OECD. Many of these recommendation have already been included in the current national strategies and some depend on the commitment of the international community.

Health Dimension 

• Scale up access to testing and care for all who need it, with special attention to the most vulnerable populations.
• Build isolation sites and boost ICU bed capacity.
• Improve countries’ contact tracing capacity.
• Ensure PPE supply, in particular for all health personnel

Socioeconomic & Political Dimension 

• Ensure access to basic humanitarian aid to those living in extreme poverty and to the most vulnerable groups.
• Create a specific emergency basic income equivalent to one poverty line for six months, available  to all those living in poverty in 2020 (215 million, 34.7% of the population).
• Provide anti-hunger grants for those living in extreme poverty.
• Ensure income and employment protection for those in formal employment.
• Extend access to unemployment benefits to low-skilled and informal workers.

Mid-term & Recovery Recommendations 

• Tap into existing multilateral platforms to ensure that Latin American and Caribbean middle-income countries are included in ongoing multilateral emergency responses.
• Approve tax moratoriums in LAC countries.
• Design and implement public policies to address stigma and protect marginalised groups from discrimination.Incorporate a gender perspective in response plans by ensuring the meaningful participation of women to avoid gender bias.
• Build a development recovery plan with a specific focus on indigenous communities and marginalised groups in urban areas.