Roadmap Health and Medicine

Latin America begins to buckle under weight of pandemic

In an online discussion, two Latin American policy experts explained how the pandemic is exacerbating glaring inequalities and endemic poverty in the region.
Institute for Advanced Study of the Americas to host webinar on COVID-19 in the Americas

In the latest segment of the “COVID-19 in the Americas” series, Jorge Castañeda, professor of politics and Latin American and Caribbean Studies at New York University, and Salomón Chertorivski Woldenberg, professor and researcher at Mexico’s Center for Research and Teaching of Economics (CIDE), concurred that Latin American governments’ “erratic and confusing response” have opened the door for catastrophe as the coronavirus turns its misery south.

Felicia Knaul, director of the University of Miami’s Institute for Advanced Study of the Americas, co-moderated the interactive session on April 23 to explore the policy implications related to what she referenced as “the greatest global policy science failure in a generation.”

“Mexico was the epicenter for the H1N1 virus [2009-10]—we were supposed to learn from that crisis and be better prepared,” said Chertorivski. “And, in the case of COVID-19, we had three months [notice] in advance of other regions; we had that advantage. What did we learn from other countries? How did we prepare?

“How the health authority gives instructions, their transparency, how a government communicates to its citizens what they should expect, and how leaders act and react—these are all fundamental to see how countries work through a crisis,” he said.

Chertorivski noted that Mexico’s universal health system, which University of Miami President Julio Frenk helped implement when he served as minister of health of Mexico, “was imperfect but robust.” But it has been weakened over the past few years, creating a situation for an economic implosion.

“Unlike in Western Europe or the United States, there is no welfare state in most Latin American countries, and certainly not in Mexico,” pointed out Castañeda, a 2016 commencement speaker at the University. “If you lose your job, you get nothing—and most of the time you lose your health care coverage, too,” he added.

“We are rapidly going to find ourselves in a situation with an enormous number of people who have lost their jobs, lost their income, and who have no direct help from the government,” said Castañeda, who noted that millions have been laid off in Mexico already.

From 14 to 45 percent of residents in most Latin American countries, with the lone exception of Chile, continue to live in poverty—with devasting social consequence, he said.

And, women will bear the brunt of the economic, social, and even physical pain, both policy specialists agreed.

“Women will be disproportionately affected for several reasons. One, they have a higher participation in the informal sector, and this sector will be the hardest hit. Two, because schools have been shut down and inevitably, because of machismo and the realities of Mexican life, the burden of dealing with the children at home falls on women. And third, unfortunately—because people are sheltered at home in small houses—we are seeing signs of increased domestic violence,” Castañeda stated.

Knaul, who is spearheading a Lancet Commission on gender-based violence and maltreatment of young people, echoed the findings in Mexico.

“All of the evidence that we have from around the world is that there has been an increase of domestic violence accompanying the spread of the pandemic,” she said.

In response to a question about the potential impact of President Donald Trump’s announcement this week to suspend green cards and immigration into the United States, Castañeda said that as many as 100,000 Latin Americans could be affected and “normally half of those who seek green cards, who get work visas, tend to be Mexicans.”

He said that already the U.S. decision to conduct expedited deportations without hearings is causing woes for Mexico in particular.

“Some being sent back are infected with the virus, and they’re being sent back to Mexico regardless of whether they’re Mexican or not,” Castañeda said. “This is placing a great strain on the system there.”

Castañeda pointed out the potential for cooperation between the United States, Mexico, and Canada in terms of supply chains, especially the car industry. A letter from the North American Manufacturing Council representing 320 U.S. companies directed to Mexican President Andrés Manuel López Obrador urged him to keep factories open in Mexico that supply car parts to factories in the United States.

“They’re asking, reasonably enough, to have the definition for ‘essential’ and ‘non-essential’ be the same—let’s do this in mirror fashion,” Castañeda said.

The two specialists, both collaborators with the institute, were asked if Latin American governments might follow a historic trend in the region and resort to hardline tactics to maintain their power in the face of crisis and popular discontent.

Both agreed that regimes have used tough talk, but, as yet, have not taken actions that suspend democratic rights.  

“With currently 1,000 deaths in Mexico, the country has yet to reach its peak in terms of the health impact of the crisis,” Castañeda said. “But what’s going to happen next week, or two weeks from now, if the hospitals become saturated, people are not able to find ventilators, not able to go to the hospital or even to bury those who pass away? That is where it might get tricky in terms of authoritarianism.”