ECLAC and PAHO call for prioritizing investment in health to reduce inequality and achieve the SDGs in Latin America and the Caribbean – PAHO/WHO

The third joint report was presented today by José Manuel Salazar-Xirinachs, Executive Secretary of ECLAC, and Jarbas Barbosa, Director of PAHO.

Santiago de Chile/Washington, DC, October 21, 2024 (ECLAC/PAHO) – The Economic Commission for Latin America and the Caribbean (ECLAC) and the Pan American Health Organization (PAHO) today urged the countries of the region to Do not leave health aside on the public agenda during the current post-pandemic period. Investment in this sector must be a priority, both due to the duty to guarantee the population’s right to health and due to its fundamental role in achieving inclusive social development in Latin America and the Caribbean, they stated in a new joint report.

Six years before the deadline to fulfill the 2030 Agenda for Sustainable Development, ECLAC and PAHO presented the policy document The urgency of investing in health systems in Latin America and the Caribbean to reduce inequality and achieve the Sustainable Development Goals (SDGs). ), in which they point out that the COVID-19 pandemic, added to the development crisis in Latin America and the Caribbean, has created a situation that threatens the achievement of the SDGs in the region.

“Inequalities in access to health, gaps in the quality of care received and the population’s high out-of-pocket expenses not only underline the urgency of increasing public spending on health, together with efficient management of resources, but also reveal the need to advance the financial sustainability of investments to strengthen the resilience of health systems,” say ECLAC and PAHO. To achieve this, it is essential that countries move forward with social agreements backed by strong fiscal pacts.

Although public health spending in Latin America and the Caribbean increased by 25% between 2000 and 2014, average spending was 4.5% of GDP in 2021, still below the goal of at least 6.0% of GDP proposed by PAHO/WHO.

In 2021, only 61% of the region’s total health spending corresponded to public spending, which highlights the important role that private spending still plays in countries, with out-of-pocket spending being the main component. On average, the report says, households in the region had to cover more than 28% of total health spending with out-of-pocket payments in 2021, and in 11 countries out-of-pocket spending was even higher than 35%. This figure is concerning, as out-of-pocket expenses perpetuate inequalities in access and quality of care and can result in catastrophic or impoverishing expenses.

The document was presented by José Manuel Salazar-Xirinachs, Executive Secretary of ECLAC, and Jarbas Barbosa, Director of PAHO, with comments from Ximena Aguilera, Minister of Health of Chile.

«Today, Latin America and the Caribbean faces a development crisis and the region is trapped in three traps: low capacity for growth, high inequality and low mobility and social cohesion, and low institutional capacity and ineffective governance. In the health sector , chronic problems «Defunding, fragmentation and segmentation of health systems persist. Now, more than ever, essential transformations are required in the region’s development models, with health being key to expanding social protection and moving towards more productive, inclusive and sustainable development», José Manuel. Said Salazar-Xirinachs, Secretary ECLAC Executive.

PAHO Director Jarbas Barbosa stressed that “overcoming barriers to access to care, which today mean that almost 3 in 10 people have unmet health care needs in the region, is essential to making the right a reality.” to health and achieve universal health coverage.” He also emphasized that “countries must invest more and better, ensure the financial protection of the population and reduce out-of-pocket and catastrophic expenses to improve health, as well as address inequities and poverty. The pandemic has taught us that we need stronger and more resilient health systems, as well as social protection systems to safeguard the health and well-being of the population.”

ECLAC’s latest projections indicate that only 22% of the SDG targets will be achieved by 2030, while 46% of them require faster progress to be achieved on time, and 32% will not be achieved.

The setback in achieving the SDGs due to the pandemic and cascading crises “is evident in key health indicators, such as maternal mortality, immunization coverage and others associated with malnutrition and mental health,” the document states. set.

The high inequality resulting from the social determinants of health in the region is reflected, for example, in the fact that the lowest income quintile has a maternal mortality rate more than seven times higher than that of the highest income quintile. . The same is true for under-five mortality: the most disadvantaged income group has around 4.5 times the risk of dying compared to the most economically advantaged group.

Again, the same applies to chronic non-communicable diseases: the most disadvantaged group has a 46% higher risk of dying between the ages of 30 and 69 from these diseases compared to the most advantaged group. Finally, data from 2019 indicates that the mortality rate attributable to contaminated water, poor sanitation and lack of hygiene is almost six times higher in the lowest income quintile, highlighting the impact of living conditions. life in people’s health.

Both ECLAC and PAHO highlight the relevance of the primary health care strategy, considering its three components – integrated services and essential public health functions, multisectoral action and social participation – as part of the transformation of health systems to reduce inequalities and addressing economic setbacks. implementation of the 2030 Agenda. A comprehensive and intersectoral approach that coordinates health and the other components of social protection makes it possible to address the social determinants of health.

“It is crucial to consolidate universal, comprehensive, sustainable and resilient health systems that ensure universal access and coverage, provide timely and quality care to the entire population regardless of their ability to pay, and have supportive and supportive financing and adaptability mechanisms.” sustainable. to changes and crises,” the document concludes.

The report presented today is the third publication prepared jointly by the two institutions, after the 2020 and 2021 documents dedicated to analyzing the impacts of the COVID-19 pandemic.

Press contacts:

• ECLAC Public Information Unit in Santiago, Chile. Email: press@cepal.org; telephone: (56 2) 2210 2040.
• PAHO Public Affairs Unit in Washington, DC Email: mediateam@paho.org; phone: Ashley Baldwin, +1 202 340-4025; Sebastian Oliel, +1 202 316-5679.