Latin America faces hurdles with vaccine
Concerns are mounting about shortages, corruption and public skepticism.
MEXICO CITY — In Latin America, a region hit hard by poverty and f lawed healthcare systems, many experts fear that large- scale COVID- 19 immunization could prove a logistical nightmare, even as vaccinations are set to begin.
Home to 8.4% of the global population, Latin America and the Caribbean account for 30% of the world’s 1.6 million COVID- 19 deaths and 19% of the 76 million coronavirus infections, according to data from Johns Hopkins University and the World Bank.
Mexico and Chile plan to begin inoculating health workers this month with the vaccine developed by U. S.based Pfizer Inc. and its German partner, BioNTech. Other Latin American countries are unveiling ambitious plans for large- scale immunization campaigns employing a variety of vaccines, most still in the testing stage and virtually all developed in the U. S., Europe or Asia.
But healthcare analysts fear that Latin America’s largely ineffective response to the virus could worsen during the massive undertaking of vaccinating hundreds of millions of people. Plagued by severe income inequality, healthcare woes and pervasive corruption, the region appears as ill- prepared now as it was when the virus first struck.
“The management of the pandemic has been so bad that we are not optimistic about how the vaccine is going to be managed,” said Dr. Francisco Moreno, head of the COVID- 19 unit of Mexico City’s private ABC Medical Center, which, like most hospitals in the capital, has no more available beds for COVID- 19 patients. “The people at the top are not doing what has to be done.”
Amid soaring case numbers, officials Friday declared the Mexico City metropolitan area — home to more than 20 million people — a “red” zone, shutting down nonessential activities and silencing streets. Meanwhile, complaints of inadequate equipment, insufficient drugs and other essential items have escalated.
“We are living in a catastrophe right now — we have patients sharing one tank of oxygen, and there is a shortage of everything: ventilators, beds, medicines, safety gear, medical personnel,” said Claudia, a doctor at a public hospital in Mexico City who asked that her surname be withheld, fearing reprisals. “I have faith in the effectiveness of the vaccine. But I have no faith in the abilities of authorities to handle the logistics of vaccination, because they have demonstrated that they are not capable.”
With so much uncertainty, officials across the region are moving to dampen expectations of a quick f ix. Many people may have to wait until 2022 for vaccines.
“We must be patient and remain realistic that COVID- 19 will be among us for some time — so our work to control it cannot and must not stop,” Carissa F. Etienne, director of the Pan American Health Organization, told reporters last week in Washington.
Mexican officials anticipate an initial delivery of 250,000 doses of the PfizerBioNTech formula this week. They plan to begin inoculating 6,000 people a day, starting with medical workers. The vaccine’s requirements — two shots per patient, three weeks apart, and storage at minus 76 degrees — pose a challenge; Mexico intends to use military personnel and facilities for its vaccine launch.
Further complicating matters, Mexico and other nations have committed to purchasing multiple vaccine formulas, with varying storage, dilution and dosage guidelines and produced in different parts of the world.
Relatively well- off countries like Mexico, Brazil and Chile have earmarked billions of dollars to cut bilateral deals with manufacturers. To help score vaccines, some Latin American nations have been serving up volunteers to international pharmaceutical giants for late- stage trials.
“This was my way of helping out,” said Johana Ramírez Cuevas, 34, one of more than 6,000 Mexicans who received experimental doses from China’s CanSino Biologics, with which Mexico has a pre- purchase deal to buy shots for 35 million people. “I was very nervous.… But I feel well. I’ve had no after- effects.”
Some impoverished countries — including Bolivia, El Salvador, Honduras and Nicaragua — are counting on free vaccines via Covax, an international consortium backed by the World Health Organization. But there are doubts that Covax will have enough funding to ensure equitable dissemination of vaccines.
The British drugmaker AstraZeneca has cut production deals with Brazil, Argentina and Mexico, including a cooperative project with Carlos Slim, the Mexican billionaire. But the AstraZeneca injection, developed by researchers at Oxford University, remains in the clinical trial stage.
Graft is another problem. Investigations in the region have uncovered evidence of price gouging for purchases of test kits, ventilators, medicines and other essential equipment — along with lucrative contracts and kickbacks for politically connected COVID- 19 scammers.
“We think what has happened with tests, with ventilators, with medications will happen again with vaccines,” said Dr. Suyapa Figueroa, president of the Medical College of Honduras. “The consequence will be more deaths.”
In addition, Interpol issued a global alert this month about organized criminal efforts worldwide to hijack vaccine shipments or traffic in false cures.
Even before the inoculation stage, vaccine policy was embroiled in regional politics.
Argentine President Alberto Fernández has come under fire for turning to Russia’s Sputnik V vaccine to inoculate 10 million people. The president vowed to be the first vaccinated, “so that no one need to be afraid.”
Brazilian President Jair Bolsonaro, a right- wing populist and coronavirus skeptic, has said he has no intention of getting vaccinated — though Brazil ranks second worldwide in COVID- 19 deaths, after the U. S.
Bolsonaro, who tested positive for the virus in July but has continued to downplay its risks, assailed a health ministry decision to purchase 46 million doses of the CoronaVac vaccine from China’s Sinovac Biotech, saying he doesn’t trust Chinese remedies. Last week, he publicly ridiculed the PfizerBioNTech vaccine, joking that it could turn people into alligators, cause women to grow beards and cause men to speak effeminately.
Many fear that Bolsonaro’s scorn could bolster the anti- vaccine movement in Brazil and elsewhere. There is already considerable public skepticism: Almost half of respondents to a poll this month in Mexico’s El Financiero newspaper said they had little or no faith in the vaccines.
But for many, the prospects of a vaccine are stirring fresh hopes. Karla Salgado, 35, a single mother of two, was among more than 100 people waiting for free COVID- 19 tests in the central plaza of Iztapalapa, a densely populated swath of Mexico City. A cashier at a grocery store, she had recently experienced headaches, a cough and fever.
“I’m concerned about infecting my family, but also about losing income — I can’t afford not to work,” Salgado said. “As soon as the vaccine arrives, I’m signing up for it — that’s the best thing that could happen.”
As Mexico’s caseload soars, hospitals, cemeteries and crematoria are jammed.
At Iztapalapa’s St. Nicholas of Tolentine cemetery, Rosalía Benhuema, 55, awaited the arrival of the remains of her niece, Rubí Benhuema, 27. There was no room in the cemetery in her hometown of Chalco, 25 miles away. The niece, a hairdresser, had a son, Amir, 4.
“We came because we are family,” her aunt said. “We want to tell the parents of Rubí and grandparents of Amir that we love them, and we are here for them at this most difficult moment.”