How can we increase Latin American healthcare system resilience?
What would be the most effective way to measure the resilience of a healthcare system? Undoubtedly, facing a sudden health crisis of considerable proportions. In other words, a pandemic like COVID-19. The chaos caused by the pandemic exposed the shortcomings of many healthcare systems around the world, but it also made it possible to detect which ones responded best to the crisis and why.
Let’s start with the basics and then draw a parallel to what happened in Europe and Latin America in the face of the pandemic. What does it mean for a healthcare system to be resilient? Broadly speaking, resilience can be defined as the ability of a system to cope with crisis situations, respond to them effectively and reorganize itself, based on lessons learned, to return to providing necessary services for the benefit of patients and their families.
An eye-opening study
Latin America was among the regions hardest hit by the pandemic. The crisis was the result of several factors such as inefficiencies in healthcare systems and low public healthcare spending, lower than that of European countries and OECD members. This became even clearer in the FIFARMA study “COVID-19 Policy Environment and the Importance of Health Economics in Latam,” prepared by WifOR, a German research institute. The study analyzed the situation generated by the pandemic in the healthcare systems of Brazil, Argentina, Peru, Chile, Mexico and Colombia as compared to European countries.
The pandemic exposed our shortcomings, with painful results for life and the economy. The time has come to look in the mirror and learn lessons from regions such as Europe, which managed to weather the crisis with good practices
According to the study, while countries such as France have a public expenditure on health of 8.8 % of GDP, the United Kingdom of 8.0 %, Spain of 6.5 % and OECD countries of 5.8 %, in Latin America the best qualified countries are Argentina and Chile with 4.9 %. Colombia accounts for 4.1 %, while Brazil invests 3.8 %, Peru 3.3 % and Mexico 3.1 %.
The pandemic had a different impact in each country in terms of deaths, but very different from Europe. The country with the lowest number of deaths per 100,000 inhabitants was Chile with 232, followed by Mexico (249), Colombia (274), Argentina (282), Brazil (309) and Peru (642). Meanwhile, in Europe, France had 211 deaths per 100,000 inhabitants, Spain 214 and the United Kingdom 240, figures much lower than the Latin American average. The study also showed a low ratio of inhabitants to physicians, nurses, hospitals and ICU beds in most Latin American countries.
Research is healthy
The study exposes the reality of healthcare systems in Latin America. However, instead of criticizing, it is worth asking ourselves: Why did Europe do so well and what lessons can we learn and apply to our region?
I will focus only on those that I consider fundamental. The first one involves extensive work. Europe has been building robust and sustainable healthcare systems for decades. Shifts in government and economic priorities in non-health sectors in Latin America led to short-termism, with temporary and insufficient solutions.
Another important difference is that Latin Americans still believe that health is an expense and not an investment. Accordingly, most of the budget goes to other issues, such as security or infrastructure. Understanding that health is a vital asset for a country’s development, as is the case in most European countries, is key to designing better health ecosystems.
The third reason is research and innovation. Europe has some of the most innovative pharmaceutical companies on the planet. To achieve this, Europe relies on legislation that reduces the time it takes for innovative drugs to reach patients while also safeguarding intellectual property.
Spain is a good example. In 2022, Spain authorized over 900 clinical drug trials, 86 % led by pharmaceutical companies. The USA leads the world in the number of clinical trials (2020 data) with 38.8 %, followed by China with 5.2 % and Spain with 4.8 %, Japan with 4.1 % and Germany with 4.0 %. The top Latin American country on the list is Brazil, with 1.7 %, followed by Argentina, with 1 %, followed by Mexico, with 0.7 %.
Argentina’s case is also striking, because it has boosted the growth of clinical research in recent years, and is reaping the benefits, such as an improvement in employment due to a greater demand for professionals and specialists, reduction in the cost of care for patients who are treated in clinical trials, paid for by pharmaceutical companies and patient access to innovative drugs and treatments at levels of more developed countries.
In conclusion, now is an excellent time to work toward building more resilient healthcare systems in Latin America. Some keys to success include teamwork, long-term thinking, thinking of health as an investment for development rather than an expense and beginning to strengthen an innovation environment that promotes clinical research, protection of intellectual property and reduction in access times to innovative drugs for patients.