Venezuelan crisis reverses progress on 18-year-old infant mortality, Lancet daily reports

WASHINGTON – Venezuela has lost 18 years of child mortality gains as the country continues to experience economic and political instability that triggered a mbadive humanitarian crisis, according to a new paper in The Lancet.

"Government officials have consistently denied the health crisis," said Jenny García, one of the authors of the report. "Losing 18 years of progress, that's a lot. It's really shocking. After 50 years of steady decline in infant mortality, we always go back to the '90s.

The country has not published official statistics on mortality since 2013, which was a challenge for the authors of the study who were trying to paint a clear picture of the health crisis in Venezuela. García said the research team used an aggregation of data including birth and death records, census information and a national survey of the living conditions of the Venezuelan population administered by three Venezuelan universities.

Venezuela recorded one of the most significant improvements in terms of reducing infant mortality in Latin America between the 1950s and the year 2000. However, data badysis of The Lancet revealed in 2016, the infant mortality rate was 21.1 deaths per 1,000 live births, nearly 1.4 times higher than in 2008 (15 deaths per 1,000 live births).

The researchers found that divestments into the public health system beginning in 2007 had led to a deterioration in the infant mortality rate from 2009 that has continued to this day. Between 2007 and 2009, the Venezuelan Ministry of Health stopped vaccinating children under 5 years old against poliomyelitis, diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae type B. Nearly 20% of children had not been vaccinated in 2010 and the lack of basic medical equipment has increased the cost of health care for individuals.

García noted that due to the lack of available data and modeling used by the team, estimates are probably conservative in measuring the impact of Venezuela's economic collapse on public health.

"If things could be improved in terms of the quality of the estimate, [it would] show that they are worse. Worse than 18 years is quite shocking, "García said. "It's always a challenge to try to combine different data sources because each data source has its own limitations or badumptions. We try to produce the most reliable, most probable estimates that we could know in Venezuela in the absence of data. When we saw the different sources, we found similar trends. "

Infant mortality is used to measure the scale of a health crisis for many reasons, said Chris Beyrer, a professor at the Johns Hopkins Bloomberg School of Public Health, who wrote an accompanying commentary. published with The Lancet article.

"From a public health perspective, it's a very sensitive indicator of what's happening in health systems," Beyrer said. "In a country that has experienced a steady decline in child mortality for five decades, it is almost always because of the success of basic interventions: maternal and child health and nutrition, child immunization, diarrheal disease management, disease management. infectious diseases and infectious diseases. diseases such as malaria. All of these things reduce infant mortality. "

Infant mortality, said Beyrer, is "almost always" malnutrition combined with another condition. According to the Lancet article, 61.2% of the Venezuelan population lived in extreme poverty in 2017 and 89.4% of households said they did not have enough money to buy food. In the last three months, 61.9% of the adult population has gone to bed at least once with hunger.

While some NGOs operate in Venezuela, President Nicolás Maduro has refused international humanitarian aid. The deterioration of the situation has led countries in the region to accept hundreds of thousands of people fleeing Venezuela, where basic supplies such as flour and toilet paper are unavailable or very expensive. On Thursday, the World Bank's Global Concessional Financing Facility announced that Colombia was eligible for funding through the Middle Income Support Facility, which faces a significant influx of refugees and migrants.

Beyrer said that if the situation in Venezuela could not be addressed, it would spread more and more across borders and pose a threat to public health in other countries in the region.

"Part of what has been broken down here is a lot of basics of public health, childhood immunization, malaria programs, water and sanitation, and those kinds of issues that can not be addressed. settled in the country without agreement and revitalization of the system. public health sector, "said Beyrer." This is ultimately why we called in this comment to call it a complex humanitarian emergency because it requires the public sector. "