March 19, 2020
In this series of articles, I will focus on the challenges that countries in Latin America and the Caribbean (LAC) face on diagnosis, surveillance, and treatment of different diseases. I highlight the potential adaptation of technologies, services, and policies to solve these public health issues. Estimating the burden of these health issues is necessary, not only for determining priorities for future research but also for health systems to take actions to reduce them.
Currently, the world keeps an eye on what is happening about the pandemic caused by the new coronavirus. Millions of people could die, especially in poor countries, if it is allowed to spread uncontrollably. Up to now, the LAC region undergoes the beginning of the outbreak curve. Soon, we will see whether the transmission mimics that in Asian and European countries.
The fatality rate in Latin America and the Caribbean might be intensified by local health challenges. Including lack of hospital beds, intensive care units close to collapse, centralised diagnosis and a dozen of accompanying neglected infectious diseases.
Yet, the LAC region has had a different experience confronting infectious diseases compared to EU and the USA, such as chikungunya (2016), zika (2017) and measles (2018-2019). Besides, policymakers had time to reflect on successful measures in some eastern countries to contain COVID-19, in contrast to the slow implementation in EU and the USA. At this point, we have learned the following:
The main policymakers go in the right direction surrounding themselves with expert epidemiologists. They seek to privilege the health of citizens. The major offensive is quarantine, which deprives many of the livelihood activities. But it seeks to mitigate the burden of the healthcare system. The latter, in many cases in the LAC region was on the edge of collapsing before the arrival of the pandemic.
The fundamental role that science and technology fulfil to attend emergencies. Both are vital to studying infectious agents, developing better diagnostic methods and controlling outbreaks. Scientific evidence guides governments to make the best decisions. Under quarantine, intended to slow down infection rates, science and technology enable people to continue doing their jobs from home and allow care takers to tele-monitor their patients.
The power of education and media to value the contribution of science and technology in solving vital problems. We need to strengthen the exchange of knowledge between the experts and society at large. Bringing discussions about current health issues, their origin, implications and the ways to improve it. A better educated population is aware about the importance of adopting the required measures.
Bringing discussions about what would happen in countries that are privatising health for decades. In this case, the absence of robust public health systems impacts not only the least favoured but the entire population. The French president expressed recently: ‘what this pandemic is showing, is that free health care, without regard to income, or profession, our welfare state, these are not costs or burdens, but precious assets (…) these are goods and services which must be protected from the laws of the market’.
What is coming next?
Ideally, effective political decisions will lead to control not only COVID-19, but also endemic infectious diseases. Regularly found among people in certain areas, these diseases, such as dengue and malaria, have received noticeable attention. Only from dengue, the economic burden in the Americas could be around $4 billion US dollars per year. Importantly, from 2019, more than 120 countries undergo the largest outbreak of dengue ever reported. But the losses of lives has been around a tolerable rate in the past decade due to an upsurge in research, development and strategies that positively impact the management of the disease. Thus, the new pandemic might be intensified by endemic infectious diseases, but governmental determination is key to decrease the losses of lives, the burden and to contribute to the progress of medical sciences.
Promoting and quickly embracing innovation could arise solutions in diagnosis, surveillance and therapeutics of a dozen of neglected infectious diseases. These diseases do not receive as much attention as other, yet they affect more than one billion people and cost billions of dollars every year in 149 tropical and subtropical countries. Solving this problem requires a new economic model in which each country contributes to the costs and provide an economic basis for these developments.
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