NB Latin America refers to those countries as defined by the World Atlas. (1)
Background to COVID-19 in Latin America Latin America has some of the highest COVID-19 death rates in the world. Whilst accounting for just 8% of the world's population, Latin America accounts for more than 20% of COVID-19 cases and over 30% of all COVID-19 deaths. (2)
Despite the region as a whole having some of the world's longest lockdowns, COVID-19 continues to surge through many Latin American countries, most notably Brazil, Peru, Chile, Argentina and Mexico. Brazil is registering up to 75,000 new cases and 2,000 deaths per day from COVID-19 and their rates are continuing to increase. (3)
From the early days of the pandemic the Pan American Health Organization (PAHO) cautioned the different governments of Latin America about the virus and made clear that restrictive measures to curb its spread were needed. Whilst most countries heeded the call, the PAHO expressed frustration that Brazil and Mexico did not. (4)
In terms of total deaths Brazil and Mexico rank second and third after the USA. (5)
Both the Brazilian president, Jair Bolsonaro, and Mexico's president, Andrés Manuel López Obrador, have been widely criticised for playing down the threat of COVID-19 and refusing to instigate measures such as national lockdowns or the wearing of face masks in public.
(6) (7)
Despite the stance of their president, a poll in Mexico showed that the majority of the population were very much in favour of wearing masks. (8)
And in Brazil, the president has now declared that he will refuse a COVID-19 vaccine. (9)
Why has Latin America been badly hit? There are many factors that have contributed to the high COVID-19 figures across the continent. Poverty, crowded slums and poor living conditions, corruption and a lack of healthcare infrastructure all provide ideal conditions for a pandemic.
Around 231 million people in Latin America were living in poverty by the end of 2020 and more than half the workforce is employed on a casual basis with no state regulations or safety nets over income. Locking down and staying home is not a viable option when it means no income. Informal workers also have less access to health care. (10)
Obesity, a known risk factor for COVID-19, is also prevalent across Latin America with 72.5% of all adults classed as overweight or obese. For the poorest people their diets include a lot of processed foods with few nutrients but many calories. A more healthy diet is simply not affordable. (11)
Although some countries in Latin America have universal health-care systems, notably Brazil, many of the populations have difficulty in accessing health care. The wealthier are able to use the private sector whilst the public system goes underfunded and under-resourced. (12)
On 28 October 2020, at the 38th UN session of the Economic Commission for Latin America and the Caribbean, 33 countries in the region signed an agreement on a strategy for recovery from COVID-19 but how this will translate into action remains to be seen. Global investment is needed to reduce inequalities but global health experts warn that Latin America is often neglected. (13)
In September 2020, the British Medical Journal focused on the fight against COVID-19 in Latin America. (14) Whilst noting Brazil and Mexico as having some of the worst outbreaks in the world, some countries were faring better. Many countries were quick to follow the WHO recommendations. Bolivia, Colombia, Ecuador, and Peru began locking down in March 2020 and have had some of the longest and strictest lockdowns in the world.
Colombia increased its intensive care capacity by 40% and is seeing sustained decreases in both its case and death numbers. (15)
Bolivia likewise is seeing falling numbers as is Uruguay. (16) (17)
Uruguay has benefited from its implementation of a swift lockdown and border closures and the fact it has a robust healthcare system. It also encouraged, rather than enforced, its lockdown restrictions which reaped a better end result than that seen in other countries who used their armed forces to try and enforce lockdowns amongst populations already familiar with this as a tool of political unrest and uprisings. (18)
COVID-19 Vaccination Rollout in Latin America
Cuba has been developing its own COVID-19 vaccine, named Soberana 2, at its Finlay Institute of Vaccines in Havana. Testing on volunteers is currently being rolled out after initial trials were described as "encouraging" by the institute's director Dr Vicente Vérez Bencomo. The hope is that every Cuban citizen will be vaccinated during 2021 and that Cuba will also make the vaccine commercially available to other countries in the region. Cuba has experience in the field of vaccination and immunology and was the first country to develop a vaccine against meningitis B. (19)
Cuba will need some outside assistance if it is to meet its goal of supplying vaccines to other countries and it is highly unlikely such help will come from its near neighbour the USA given the history between the two nations. Help will most likely come from Europe and/or Canada.
The PAHO are optimistic that Cuba will become the first Latin American country to produce its own vaccine which would also help the island re-open to tourism, an important source of revenue. (20)
The PAHO has helped countries access vaccines via COVAX - a WHO-backed international agreement whereby richer countries have pledged funding to help lower income countries buy vaccines. Twenty-two Latin American countries have signed agreements to access vaccines through COVAX. Some individual countries have also made direct agreements with vaccine companies including those in Russia and China. (21)
Argentina and Bolivia have struck deals with Russia to buy its Sputnik V vaccine. The first deliveries arrived in January 2021 amidst reports that many countries in Latin America are facing difficulties securing adequate vaccine supplies from companies such as Pfizer and AstraZeneca and are finding it easier to negotiate with Russia. There are concerns however that the Russian vaccine may not be as effective against recently discovered virus variants one of which is in wide circulation in Brazil.
When they were contacted by Reuters, Pfizer confirmed it had agreements with eight countries in Latin America and AstraZeneca reported deals with ten countries.
Bolivia has also procured 5 million doses of the AstraZeneca vaccine via the COVAX scheme but they are not expected to be delivered until April 2021.
For some countries in Latin America the low temperature storage requirements of the Pfizer vaccine (it has to be stored at -70'C) means it is not a viable option to import. (22)
The US company Johnson & Johnson carried out trials of its one dose vaccine in six Latin American countries during 2020 but anger is growing that it is yet to reach any supply agreements with Latin American countries. (23)
Elsewhere there has been an outcry in Peru when the former president, MartÃn Vizcarra, and his wife received early vaccinations in October 2020 ahead of those in front of them in the priority queue. Mr Vizcarra was impeached and removed as president by parliament over unrelated corruption allegations in November 2020. It is thought he received the vaccine made by the Chinese firm Sinopharm. Peru's official vaccination rollout only began last month (February 2021) starting with healthcare workers. (24)
There are also fears that COVID vaccines will be targeted by criminals keen to profit from selling them. A truck of flu vaccines was hijacked in Mexico in December 2020 with the intent of selling them on the black market. This does not bode well for the roll out of the COVID vaccines. Interpol has issued a global alert saying organized crime networks are targeting Covid-19 vaccines, both physically and online, around the world with Latin America seen as one of the most vulnerable regions. (25) The world will not recover from the pandemic until mass vaccinations have taken place across the globe. High income countries who are likely to find themselves in the luxurious position of having too many vaccines for their populations need to be planning now how to redistribute them. The fact that the latest variant of concern appeared in Brazil should perhaps focus the mind on just why this is so important.
