Deepening Cooperation and Coordination on Health Policy in the Americas
On July 28, 2021, the Inter-American Dialogue hosted the online event “Deepening Cooperation on Health Policy in the Americas.” The panel discussed a new report published by the Inter-American Health Task Force, which analyzed the response to Covid-19 in the Western Hemisphere and identified recommendations to improve cooperation and coordination in health policies across the Americas. The event was moderated by Michael Shifter, president of the Inter-American Dialogue. Julio Frenk, president of the University of Miami and former Minister of Health of Mexico, and Helene Gayle, president and CEO of the Chicago Community Trust, both co-chairs of the Inter-American Health Task Force, introduced the key recommendations of the report, followed by commentaries from Carlos Felipe Jaramillo, World Bank vice president for the Latin America and the Caribbean Region, and Ramiro Guerrero, dean of economics and finances at Universidad Icesi, in Calí, Colombia.
Shifter began the session by describing the motivation behind the report, noting how Western Hemisphere countries failed to take advantage of opportunities for regional collaboration to address the challenges of the Covid-19 pandemic. Frenk and Gayle outlined five areas for which the report made recommendations to improve coordination and cooperation in regional health policy: promoting leadership and better governance in regional health emergencies, accessing and sharing of high-quality data, strengthening regional health security by investing in national preparedness, ensuring equitable access to Covid-19 health services and products, and controlling and managing the spread of misinformation, disinformation, and conspiracy theories. The challenges and lessons learned during the pandemic in these five areas were examined through the lens of six stakeholder groups: governments, multilateral organizations, international financial institutions, the private sector, scientific and academic institutions, and civil society organizations. Frenk and Gayle noted that the report provides actionable recommendations for each of those six stakeholder groups in each of the areas.
Both Frenk and Gayle presented a summary of the report findings. Frenk pointed out how strong global responses require strong national responses due to the interconnectedness of the local with the global. Therefore, good national leadership requires the need for governments to make data-informed decisions, which can only happen if there is increased access to reliable and high-quality data. Gayle highlighted how the pandemic underscored the long-standing challenges within the region to be able to meet the core capabilities required under International Health Regulations (IHRs), making it necessary to strengthen IHR in the Americas. In addition, Gayle pointed out how the worst examples of collaboration during the pandemic have been through regional access initiatives to vaccines and other health products such as COVAX, which presents the urgent need to ensure equitable access to Covid-19 health services and products.
The online event moved on to commentary on the information and recommendations provided by the report. Jaramillo emphasized how the lack of coordination at different levels within countries has been the key factor behind the region’s inability to develop an effective response to the pandemic. The distribution of vaccines and medical equipment have been mainly based on the “power of the income of countries” rather than on the country’s needs, making it difficult for lower and middle-income countries to counter the challenges developed by the pandemic. In addition, Jaramillo noted that the lack of investment in reliable routine information systems has been the major impediment towards a more effective response. Therefore, innovations are needed to “enable countries to make better decisions in an emergency” and to better understand the performance of their health care systems.
Guerrero noted that even within countries an uneven distribution exists regarding capacities for surveillance, and there has been a lack of transparency by some governments regarding the data of the pandemic such as infection and transmission rates. Therefore, “highly competent and technical institutes within countries” need to be created in order to strengthen the surveillance capacities of “every corner of the country.” Guerrero also added that there is a lack of understanding of how misinformation and disinformation spread. It is necessary for countries to invest in and understand the science of information spreading and information flows to develop better policy prescriptions for the problem.
The event concluded with a Q&A session. When asked whether disinformation has gotten worse over the years, Gayle stated rates of disinformation escalated because the vehicle and the number of ways people have been able to access information have increased, allowing people to selectively use information to reinforce their positions. To counter misinformation and disinformation, there needs to be an understanding of “what are the right messages and who are the right messengers” that can do a better job at disseminating good and reliable information. Frenk addressed a question on the role of the private sector and the health sector by stating that public function needs to be carried out by both public and private actors, since “no country in the world has a purely public and private system”. The best performance systems are the ones that get the right mix of public and private. As stated earlier by Gayle, everyone has “a part to play whether its government, health authorities, and media” if the region wants to successfully counter the effects of the pandemic and future health emergencies.
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