how to explain the successful model of Chile and the differences with Argentina

The neighborhood, the undeniable cultural bridge and the shared history often give a confused picture of the similarities between Chile and Argentina. The coronavirus vaccination campaign has shot down any illusion of similarity in the inkwell. On the side there, they received nearly 11 million doses. On the side here, a little over a third. On the other hand, nearly 27 vaccines were applied per 100 inhabitants. Here, less than 4. The aggravating factor? The Chilean population is 41% of ours. How do you explain so much difference?

Although comparing yourself to third parties is not the best way to improve (a topic debated when President Alberto Fernández – films in hand – highlighted the local containment of the coronavirus in the face of the health collapse under d ‘ other latitudes), if it is about institutional management, this could be a valid parameter. See an alternative model. Try to integrate it to some extent.

In addition, it is difficult to look west and swallow the toad that Chile has applied coronavirus vaccines to 26% of its population almost at the same time as us. It is difficult to understand that they have already disembarked and stored all the vaccine shipments to complete, at the end of March, the vaccination of all the groups at risk. That’s 32% of the country. It includes people over 18 with co-morbidities and all over 60.

Here we cut our nails while waiting for a flight with a lot, raising hopes of the type “now able to touch me“, Before the high plateau of more than 7,000 people infected per day becomes a real second hello.

Weaknesses

From the differences game with Chile, the question of Communication. While the databases of the Chilean information system SAS offered from day one all the details of the vaccination scenario against Covid (from whom and from which jurisdictions were vaccinated, in the number of doses administered per brand), Argentina incorporated the Public Monitor of Vaccination as a palliative for the scandalous VIP vaccination.

Now alright What is the genesis of the weak vaccination campaign in Argentina, a country respected regionally for its very complete official vaccination schedule? We should go to the first months of the pandemic, when – to use the expression of several sanitary facilities in this pandemic year – “we sleep”.

May was the month when countries like Chile began to enter into pre-purchase agreements with pharmaceutical companies. As explained to this support Paula Daza, Under-Secretary for Public Health of Chile, “everything was prepared well in advance … in May and June conversations began to sign agreements with different laboratories, which made it possible, today, to have this amount of doses. “

The deals involved disbursements of money (no one knows the amounts) to promote developments, in return for companies guaranteeing to prioritize the virtual “investor” when the doses were ready. The Chilean equation was “the more agreements signed, the better“.

Reputation

According to Adolfo Rubinstein, former Minister of Health and Master in Clinical Epidemiology, the government’s difficulty in moving forward in this way has several aspects: “On the one hand, Compared to Chile, Argentina is an unreliable buyer. You can’t get rid of it. A country in default twenty times, which had to reformulate its debt … is not trustworthy for pharmaceutical companies. Plus, while others have purchased in advance, Argentina doesn’t have the dollars, an obvious macroeconomic restriction that puts us at a disadvantage ”.

Rubinstein recalled when Ginés González García (former Minister of Health since February 20) admitted the failure of negotiations with Pfizer – one of the largest pharmaceutical companies in the world – with the justification that they wanted to impose “ unacceptable conditions ”.

A few days ago, sources from the Presidency of the Nation confirmed Bugle the words of the displaced minister: they assured that Pfizer had asked to include excessive guarantees in the contract, in the form of sovereign assets.

A recent report by the Latin American Network of Journalists for Transparency and the Fight against Corruption (PALTA) published by The nation He went deeper into the subject and reported that there were impositions of this tenor from several pharmaceutical companies, in different countries in the region who, to top it off, would have changed their laws to appeal to vaccine developers. Has Chile bowed to these pressures?

Although the contracts are confidential and it is not excluded that the company has sought to impose its rules, reserved sources of the Chilean government have assured Bugle that the final contract with Pfizer did not include clauses of this magnitude.

It follows, therefore, that the difference in treatment “on the here side” and “on the over there side” has to do with the poor Argentinian reputation before international economic organizations.

Pre-purchase

According to Rubinstein, further, “Argentina married the Sputnik V vaccine. When the trade deal with Pfizer started to crumble and AstraZeneca announced that it was so late in production that by the summer there would be no more vaccines, they were very keep the promise of the Gamaleya Center“.

“As for vaccines from China, they haven’t managed them. Slept“He stressed and clarified:” Sinopharm is a much more expensive vaccine, but something could have been agreed earlier. Anyway, although these are all conjectures, one would think that China negotiates hard, in the sense of saying ‘I give you … what do you give me?“. The same, Russia. There is a huge geopolitical component which goes beyond the sanitary “.

Based on data collected by the Center for Innovation in Global Health at Duke University (United States), Chile has four pre-purchase agreements for 34 million doses, enough to cover immunization for the entire population over 16 years of age. And they have agreements in place for 60 million doses for future waves of Covid.

The detail? With Sinovac, they closed at 14 million doses, of which 12 million will have arrived at the end of March. With Oxford-AstraZeneca, 6 million (which, unlike Argentina, would arrive in Chile from South Korea), of which 1,620,000 correspond to the COVAX fund and the rest are private agreements. With Pfizer, 10 million doses, which are expected to arrive in June of this year.

They are also negotiating unit doses with Janssen (4 million) and Cansino (1.2 million), and there is a preliminary dialogue with the Gamaleya center.

To the East

The photo on this side is dark. Duke University recalls that Argentina has committed 47 million doses, a figure short to cover the population over 18 (which would require 60 million), but which would provide more than a toast, if it could be made. At the end of this note, they had arrived in Argentina 4,050,540 doses.

Many have put tokens on Sputnik V, which has pledged 20 million doses, but its production is clearly oversold and only 2.5 million doses arrived (rounded). As for AstraZeneca-Covishield, with the 580,000 that have arrived, we are still far from the 22 million scheduled doses.

In addition, less than a month ago (thanks to a recent purchase agreement) arrived 1 million doses of Sinopharm, which the ANMAT has not authorized – for now, for lack of scientific evidence. – for people over 60 years old. And this Thursday the signing of an agreement for 3 million additional doses was confirmed.

Finally, from the COVAX fund (for the equitable distribution of vaccines), in theory, 9 million doses would come this month. In reality, it will be less than 2 million, before May. The fund is already distributing vaccines to other countries in the region, but has yet to announce when it will do so with Argentina.

Logistics

“Note that we are not worse at all. Regarding complex health systems, Argentina is much better than Chile. The problem is the major devices, which work much better there, ”Rubinstein noted.

Beyond the questions to the tripartite division of Health (national, provincial and municipal spheres) and without counting the offers of these months between the Government and the social and prepaid works, the management of the pandemic, in general, and the plan vaccination, in particular, honored the federal system: they came subject to the organization of the provinces.

Or to your disorganization, as we could see at the end of February in the city of Buenos Aires, with the famous “dysfunctional gap”, and also when this Tuesday took place a terrible demonstration of non-vaccination of people over 80 years old.

In Chile, the vaccination plan neither required nor required registration. There has been no change.

This is how Daza explains: “The government communicates the schedule every week, according to the target groups that have been defined with an external vaccination council at the Ministry of Health. The primary care system allows us to reach all people, even the most distant, since they have experience in previous vaccination programs ”.

In practice, for example, this Monday was the turn of people with comorbidities, aged 58 and 59. Tuesday, with comorbidities, but at 56 and 57 years old. Wednesday, 54 and 55 years old. And so.

The contrasts between Argentina and Chile are endless. There, much of the primary care falls to the municipalities. From this sphere they are sent to the doctor’s office $ 15 per person, each month. The clinics therefore want to add patients, in order to increase the subsidy. It’s a model. The system is looking for people. Not the opposite.

AS