COVID-19 Pandemic
Assessment of four South American countries’ COVID-19 pandemic preparedness, responses, and lessons learned Andrea Ramirez Varela* Andrea Ramirez Varela Michael Touchton J. Jaime Miranda Juliana Mejía Grueso Rachid Laajaj Gabriel Carrasquilla Martha Vives Florez Ana María Vesga Gaviria Ana María Ortiz Hoyos Alejandra Velásquez Morales Nubia Velasco Silvia Restrepo Restrepo
Background: The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world’s hardest hit by the pandemic, accounting for 10·1% of total cases and 20·1% of global deaths. This study aims to explore how pandemic PPR were affected by political, socioeconomic, and health system contexts. We explore how PPR may have shaped pandemic outcomes in Argentina, Brazil, Colombia, and Peru, lessons learned and advance an agenda for improving PPR capacity at regional and national levels. Methods: Mixed-methods sequential explanatory study in four South American countries based on structured interviews and focus groups with elite policy makers. Findings: Structural and contextual barriers limiting PPR activities were identified at the political, social, economic levels, and health care system. The perception was that top-level government officials had insufficient political will for prioritizing pandemic PPR and post-COVID-19 recovery programs in their countries’ health agendas. Interpretation: To place pandemic PPR at the highest level of South American national public health agendas, we recommend the development of a regional task force on COVID-19, post-pandemic recovery, and emerging disease threats in the next two years, social and economic protection for vulnerable groups, improved primary health care and surveillance systems, and investing in risk communication strategies and community engagement. Funding: Open Society University Network OSUN Fellowship, Queen Elizabeth II Academy for Leadership in International Affairs, Chatham House, UK; Universidad de los Andes, Fundación Santo Domingo, and Asociación Nacional de Empresarios, Colombia.