UNDP: Pandemic could give boost to underfunded LatAm public health systems

By Alvaro Mellizo

Lima, Apr 28 (efe-epa).- Although the Covid-19 crisis in Latin America carries serious health risks and economic consequences, one potential silver lining is that it is raising awareness about the poor state of the region’s public health systems and the need to take corrective measures, a Mexican economist and senior official with the United Nations Development Programme told Efe.

The regional director of the UNDP for Latin America, Luis Felipe Lopez-Calva, also said in the interview that there is an opportunity with the pandemic for countries to emerge with a stronger social fabric and greater trust in government.

Question: Will there be a push toward a strong public health system?

Answer: In Latin America we’ve had a fragmented social contract: those with income demand private services and they don’t have an incentive to fiscally support health systems … That creates a gap between an expensive private system financed by the middle and upper classes and a public system without financing that has a lot of problems and leaves the majority of the population unprotected.

Now with this crisis people who previously were opposed (to a strong public health system) realize that we all benefit by having something strong. And that’s an opportunity because the crisis is redistributing the ability to block reforms, the power and the influence, and it’s changing the collective perception of some public goods.

It seems we’re in agreement that an inclusive, high-quality system is something that benefits all of us, and we’re willing to contribute to it.

And that goes a step further. For example, to what we economists call automatic stabilizers like unemployment insurance, which are very small in Latin America.

Fiscal weakness and political problems mean we face a shock with profound inequalities. This crisis is an opportunity to realize that social stabilizers are highly valuable.

Q: So is the image of the state, which was very low in the region, being rehabilitated?

A: Prior to Covid-19, it was bad and trust in government institutions had been falling … They said the government existed to protect those who have the most and trust in government had been falling … But now there are cases, like Peru and other places, where people are seeing that institutions are responding and that’s a positive sign.

That can be an opportunity to see that in times like these the state can have a major impact on our lives, can recover its credibility even when there are excessive measures like confinement, which is perceived as negative.

In general, the (response to the) Covid-19 crisis has been characterized as positive, and that creates an opportunity. There’s also greater trust in others. We see how connected we are, and it’s a positive thing to strengthen connections and community solidarity. There a chance to come out of this with an improved social fabric and greater trust in the state.

Q: What then are the keys for Latin America to actually respond positively to this crisis and improve its governability?

A: Communication and transparency in decision-making and the reasons why (decisions) are being made … where there’s greater transparency and explanation there’s better compliance and a better relationship between the government and the citizenry.

There also needs to be a clear idea of the fiscal commitment to the most vulnerable and that a collective agreement is a way to appropriately respond to the crisis. There needs to be a realization that inclusion benefits all of us.

That message must be made clear, and in so doing the citizen actors, those affected, have to be involved in making decisions about how to get out of the crisis. We’re talking here about the legitimacy of the processes leading up to the decisions. (Citizens) have to contribute to designing the exit (strategy).

Trying to sustain those emerging coalitions for (the purpose of) community solidarity, private contributions to public resources and trust in governments … It’s not easy but there are ways of working on this. EFE-EPA


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