[This post has been written by Carolina Batista, ISGlobal Latin America and the Caribbean Strategic Focal Point, and Leire Pajín, ISGlobal Director of Global Development.]
Gabriela1 is a young black woman who lives in Mangueira, a favela in Rio de Janeiro. She got pregnant with her first child when she was 16 years old. After Gabriela was diagnosed with hypertension during her pregnancy, a psychologist from the public health centre recommended that she make an appointment at the referral maternity hospital. However, although it seems like a simple task, several barriers hindered Gabriela’s access to proper health care.
According to PAHO, one third of the Latin American population faces obstacles to accessing health care, and the region remains the most unequal place in the world
At first, the fear of suffering some kind of obstetric violence from health care workers who are often insensitive to the health issues of vulnerable populations prevented Gabriela from seeking proper care. Moreover, she had no one to take her to the maternity hospital: her boyfriend works all day at an informal job and relies on daily earnings to make a living. Her parents suffer from a severe alcoholism problem and cannot provide any support. Finally, she did not have money for transportation and was deeply ashamed of this. Today, even after the baby was born, she still cannot afford to go to the health centre for paediatric consultations or vaccinations.
Despite Latin America’s technical capacity and recognised public health excellence, a significant part of the population is trapped in a vicious cycle of poverty and disease due to unmet medical needs
Unfortunately, stories like Gabriela’s are common across Latin America. Such examples demonstrate that socioeconomic, institutional, racial and gender-based barriers reinforce other problems and hamper access to health care. According to Pan American Health Organization (PAHO), one third of the Latin American population faces obstacles to accessing health care, and the region remains the most unequal place in the world. Despite Latin America’s technical capacity and recognised public health excellence, a significant part of the population is trapped in a vicious cycle of poverty and disease due to unmet medical needs.
Cienfuegos Cuba. Adam Cohn / Fickr
Latin America’s Public Health Challenges and Local Capacity
Since the onset of the COVID-19 pandemic, most of the world’s health systems and social protection mechanisms have been strained and some have collapsed. Most Latin American countries have had difficulty responding to the sustained pressures caused by the pandemic. This alarming scenario has deepened pre-existing inequalities in the region and highlighted the challenges faced daily by its population. According to the World Bank, poverty rates have increased for the first time in two decades and, by the end of 2021, contemporary problems such as the COVID-19 pandemic, climate change, armed conflicts and the global economic recession will push millions of people into extreme poverty, posing additional challenges to achieving the Sustainable Development Goals (SDGs) by 2030.
COVID-19 is considered a syndemic, the result of overlapping pre-existing socioeconomic and health problems that have been compounded by the pandemic. In Latin America, health inequalities, the overlap of non-communicable diseases with infectious conditions, emerging vector-borne diseases, migration issues, unplanned urbanisation, climate change and violence now represent the leading health problems and pose urgent challenges that require the design and implementation of policies for strengthening, and in some cases redesigning, local health systems (PAHO, 2017).
In Latin America, health inequalities, the overlap of non-communicable diseases with infectious conditions, emerging vector-borne diseases, migration issues, unplanned urbanisation, climate change and violence now represent the leading health problems
Latin America’s public health expertise is broadly recognized. This translates into inclusive health policies, strong community engagement, locally driven Research and Development, successful scale up of access to of HIV and tuberculosis care and innovative responses to endemic vector-borne outbreaks. These factors, along with a successful international cooperation agenda, strategically position the region to leverage on collaborations and bridge the gap between its population and global health progress.
Beneficiaries of Brazil’s Bolsa Família programme in Novo Cruzeiro. Leonardo LaraAldeia / Flickr
ISGlobal in Latin America: Past, Present and Future Opportunities
Building on previous successful experiences, existing collaborations and ongoing research in the region, and guided by a belief in international cooperation as a means to achieve global health impact, ISGlobal decided to scale up its investment in Latin America. With a comprehensive focus on regional excellence and unmet needs, ISGlobal seeks to consolidate and expand strategic partnerships, build a common research agenda and pave the way to advance public health to achieve the SDGs. ISGlobal’s regional presence started in Bolivia in 2009 with a focus on Chagas disease.
In recent years, ISGlobal has significantly expanded the scope of its activities, having successfully contributed to tackling public health challenges such as malaria, zika virus, maternal health, environmental health and other transversal issues. These initiatives have connected ISGlobal with an increasing number of collaborators and generated research and publications with a significant policy impact.
ISGlobal seeks to consolidate and expand strategic partnerships, build a common research agenda and pave the way to advance public health to achieve the SDGs
Following a scoping exercise to identify high-impact opportunities, ISGlobal’s regional strategic priority areas include the following: neglected tropical diseases with a special focus on Chagas, malaria, arboviruses, non-communicable diseases antimicrobial resistance, maternal health, urban health, tuberculosis, HIV/AIDS, social determinants of health, health impact assessment, environmental health, COVID-19, migration, implementation of the 2030 Agenda, and learning and development.
Lo Valledor Market, Chile during the COVID19 pandemic. Max Valencia (FAO)
ISGlobal’s successful work and collaborations in various parts of the world, including Latin America, have demonstrated its ability to engage with a wide range of organisations over the long term , ranging from academia, researchers and policy makers to civil society groups. This ability provides a strategic advantage for ISGlobal to engage in further collaboration with Latin American groups.
Projects underway to advance the health and development agenda in the region include the following:
- During a virtual ceremony held on 20 April, ISGlobal formalised a partnership with Fiocruz (Brazil). ISGlobal and Fiocruz have already collaborated on various joint research projects and scientific publications in recent years, which provides a strategic advantage and the legitimacy to formalise a cooperation agreement and advance the public health agenda.
- In light of the current migration crisis in Latin America, ISGlobal, Lancet Migration, PAHO and the Ibero-American General Secretariat (SEBIG) organised a webinar to discuss the challenges and responses on migration, COVID-19 and the right to health in Latin America. As keynote speaker, UN High Commissioner for Human Rights Michelle Bachelet called for a human-rights approach around migrants and people on the move. Moreover, the event brought together representatives from the WHO, European Union – Latin America and Caribbean Foundation (EU-LAC), MSF, Lancet Migration Latin America, ISGlobal and regional political leaders. About 150 participants from different countries attended the webinar. The webinar was a part of the Ibero-American Summit of Andorra. In keeping with the main goal of the event, the recommendations made by the authorities are expected to influence the responses of governments and institutions to this challenge.
- Joint coordination with the Spanish Agency for International Development Cooperation (AECID) and regional institutions, including PAHO, the Pasteur Institute in Uruguay and others, to build an Ibero-American centre for prevention, surveillance and epidemic response.
- Strategic partnership with AECID and Global Health Innovative Technology Fund (GHIT) to support Chagas disease research and scaling up in the Gran Chaco region.
- Ongoing negotiations to implement a multilateral collaboration with Latin American universities and think tanks to work together on public health initiatives and tackle issues around social determinants of health, impact assessment, environmental health, AMR and endemic infectious diseases.
- Along with the United Nations Development Programme (UNDP), ISGlobal has provided technical consultancy on managing the COVID-19 response and economic recovery in the Caribbean region.
In a context where health challenges have gone global, it has become evident that national responses alone will not be enough to contain the global health emergency
In a context where health challenges have gone global
, it has become evident that national responses alone will not be enough to contain the global health emergency. Proper recovery will demand collaboration and solidarity. International cooperation and strategic partnerships are urgently needed to foster coordination among countries and develop joint actions that complement the measures carried out by various organisations. ISGlobal has demonstrated that working alongside researchers and policy makers in different parts of the world and building sustainable capacity to co-design tailored responses that link global health and human development is not only possible but can be a real success.
Latin America is experiencing a historical moment when old challenges are meeting new opportunities and initiatives to advance towards more equitable health access, public health progress and a political commitment to address obstacles to the implementation of the SDG agenda, posing a unique opportunity for ISGlobal to consolidate and strengthen its regional presence to achieve a greater impact on public health and cooperation.
1.Fictitious name. Case shared by a psychologist from the public health centre in Rio de Janeiro, Brazil.