As countries prepare for COVID-19 immunization campaigns, it is equally important to look back at the past months and examine what policy interventions worked in the health sector, what did not work and what can be done better.
Disrupted global supply chains, limited knowledge of the disease, lack of information and weak monitoring systems were some of the reasons health systems were mostly “flying blind” at the onset of the pandemic in March of 2020. But this no longer needs to be the case – understanding what interventions worked in what context may help countries chart a course forward and mitigate future outbreaks of the disease as they roll out vaccine distribution.
In this context, we at the World Bank, in partnership with the North American Observatory on Health Systems and Policies at the University of Toronto and the Korea-World Bank Partnership Facility (KWPF), have undertaken an analysis on how to accelerate mutual learning through the pandemic.
The study collected and analyzed data on COVID-19 policy responses by ten Latin America and Caribbean countries – Argentina, Chile, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Panama, Paraguay, and Trinidad and Tobago – with the goal of identifying successful policy interventions and replicate them when and where possible. To do this, countries were compared with two high performing countries – South Korea and Uruguay.
The analysis focused on three aspects of the pandemic response: emergency preparedness and governance, timeliness and stringency of Covid-19 policy measures, and health sector responses . Data were compiled from the Oxford COVID-19 Government Response Tracker database, government websites, media releases, and Pan-American Health Organization’s pandemic situation reports.
What did we find from benchmarking policy responses to COVID-19?
Compared to South Korea and Uruguay, most countries in the region had similar legislation surrounding public health emergencies, pandemic preparedness plans, and public health surveillance activities . However, few had existing stockpiles of personal protective equipment (PPE).
Although governments were quick to mobilize leadership and allocate funding to fighting COVID-19, one area for improvement had to do with the ability of governments to communicate to the public in a timely, trustworthy and sensitive manner to improve public awareness of the pandemic.
Countries in the region were quick to act to flatten the curve – all countries in the study introduced their strictest closure measures (such as schools, workplace, and public events) earlier than South Korea. Honduras and Trinidad and Tobago, for example, imposed restrictions on internal movement one month before South Korea and Haiti almost two months before.
In contrast, implementation of social protection measures – income support, programs to support food security and expenses – occurred relatively later. Most countries did not apply programs to support citizens’ access to personal protective equipment in a timely manner and many still have not done so.
South Korea and Uruguay stand out in their high rates of public testing of symptomatic and asymptomatic individuals, a key public health tool to respond to the pandemic. South Korea has conducted 109 tests per confirmed case and Uruguay 128, a much higher rate than any other country in Latin America. Few countries reviewed in the study offered similar open public testing with most requiring symptoms or symptoms in addition to criteria such as exposure to a known case. However, governments did take steps to expand Intensive Care Unit (ICU) bed capacity and access to ventilators, and put policies in place to expand the health workforce.
The way forward
The report concludes that governments in Latin America and the Caribbean should consider moving forward:
- Ensuring an adequate supply and distribution of personal protective equipment to health care workers and to the population at large
- Allocating resources in a way that emphasizes prevention and shifts resources to lower cost interventions where possible
- Supporting adherence to public health interventions with supportive emergency safety net measures
- Ensuring appropriate measures for testing and tracing
- Strengthening scientific leadership and clear communication with the public
In the coming months, governments will focus their efforts on preparing for a fair, equitable and efficient distribution of COVID-19 vaccines . Yet, not all populations will have the opportunity to get access to vaccines in 2021, which makes the supply of personal protective equipment, proactive testing at the population level and aggressive contact tracing critical in limiting the death toll of the pandemic and its devastating impact on economies and human capital.
In 2021, keeping on building on rich experiences documented in the study --such as the house-to-house public health surveillance program Detectar in Argentina or the implementation of epidemiological fences in high-infection areas in El Salvador, Panama and Honduras-- will be critical to strengthen health sector responses and reduce the health and economic consequences of the pandemic.
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