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Latin America has seen a significant increase in infectious disease outbreaks since the beginning of the 21st century. Dengue outbreaks have been affecting the region since the beginning of the century and have continued to worsen over time. By the end of March 2024, the region had reported more than 4 million dengue-related cases and 1,240 deaths. In 2009, we were hit by influenza A (H1N1), which continued until 2010. Then in 2013, we tried Zika and Chikungunya viruses, culminating in the COVID-19 pandemic in 2020.
The COVID-19 pandemic has shown us the extreme vulnerability of our region. Despite having 8.2% of the global population, our region has reported 80 million cases (10% of the global total) and 1.7 million deaths (25% of the global total). Latin America has experienced the greatest loss in life expectancy at birth in 2021 compared to 2019. During the pandemic, there has been limited technical and logistical cooperation between the different countries of Latin America, and even in our Central American subregion, the diplomatic attitude of children trying to stand up as “better” has had a negative impact on this poor cooperation, to the detriment of the people of the respective affected countries.
Knowing the extent of the region’s vulnerability to infectious diseases, what can we do as a region to prevent a recurrence of disasters like the one that occurred during the COVID-19 pandemic?
The work of the Pan American Health Organization (PAHO), a regional body of the World Health Organization (WHO), and its action plan to guide member states in combating emerging and re-emerging infectious diseases, has not been as successful as it could have been, based on the information provided above. One of the main obstacles facing the organization’s work in the field of infectious diseases is that it is limited to individual governments, which limits cooperation between two or more countries in the region. Even sub-regional platforms such as the Central American Integration System (SICA), which includes Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Belize and the Dominican Republic; have proven to be completely incapable of effectively and efficiently promoting cooperation between member states in times of health emergencies. I have always wondered what it costs member states to maintain SICA as it fails to demonstrate its achievements over time.
Our countries face structural weaknesses related to political instability, ideological divisions and polarization, extreme economic inequalities, and, in many countries, large amounts of informal employment. All of these are social determinants of health, which in many cases combine to increase the vulnerabilities associated with weak and incapable health systems.
A group of public health and infectious disease experts in the region have proposed the creation of a structure similar to the Africa CDC for our region. The Latin America-CDC would form a regional technical cooperation platform that is free from political interference. The group of experts proposed that the main objectives of the platform include promoting collaboration, sharing resources, strengthening manufacturing capacity, collectively negotiating supplies, and acting as a regional unit to rapidly respond to outbreaks in member countries by leveraging existing capacities in countries and minimizing duplication.
Latin America – The main functions of the CDC include training of public health professionals, standardization of pandemic prevention, preparedness and response practices, improvement of data collection capacity, data repository function and risk analysis, real-time regional disease surveillance and use of technologies such as genomic sequencing. The governance of such a structure should include academic institutions, international organizations, the private sector and civil society; similar to the governance of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has been so successful. It goes without saying that the formation and survival of such a regional institution must exclude politicians and ideologues.
It is undoubtedly a difficult task, but if we want to strengthen our health systems and reduce our vulnerability to infectious diseases, I see no other way.
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