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Thursday, December 01, 2022

What’s Behind Chile’s Vaccination Success?

The deadly impact of COVID-19 has been felt in every corner of the globe. On February 22, the United States reached a tragic landmark of 500,000 deaths. Across the Atlantic, nine of the top 10 nations in deaths per million are in Europe, with tiny enclaves of Gibraltar and San Marino topping the tables. The list of countries that have dealt with the pandemic relatively well is much shorter. Almost a year ago, I wrote about how leaders in Brazil and Mexico were slow in taking tougher action to prevent the spread of the virus. I falsely predicted that Latin America is unlikely to witness the death rates seen in Europe. Unfortunately, the effects of the pandemic were equally devastating in the region, if not worse.

Images of mass graves in the Amazonian town of Manaus and the dead bodies left in coffins in the streets of Guayaquil, Ecuador, have spread worldwide. More than 260,000 Brazilians and nearly 190,000 Mexicans died because of the virus, placing the two countries second and third in absolute numbers of fatalities. Peru registered 1,421 deaths per million and Panama 1,352 on March 4 — numbers that show the devastation caused by the virus in the region so far. Chile has also experienced a significant death rate of 1,084 per million.


Why Are Mexico and Brazil So Slow in Reacting to COVID-19?


The big difference in Chile was that authorities mobilized in advance to secure vaccines, hedging bets on various suppliers in different stages of development. In September last year, President Sebastian Pinera announced the purchase of 10 million doses of Pfizer-BioNtech vaccine. Deliveries commenced on December 24, making Chile the first Latin American nation to start its vaccination program. The country has ordered some 90 million doses, more than enough to immunize its 19 million citizens. By March 4, more than 20% of its population received at least one shot, placing Chile fifth in the world when it comes to vaccination rates, just behind Israel, United Arab Emirates, the United Kingdom and the United States.

Political Conflict

On December 29, Argentinians started to receive the Russian Sputnik V vaccine. The pace of immunization in Argentina has been much slower than expected, with several complaints of those not in priority groups receiving the jab before health workers and the elderly. The “VIP vaccination” scandal has caused the resignation of the health minister, drawing protesters onto the streets and generating criticism against President Alberto Fernandez. So far, Argentina has vaccinated only 2.61% of its 45 million citizens. The slower pace seems to be standard in the region, with most nations unable to vaccinate even 1% of their citizens. The cause is not only the shortage of vaccines but lack of planning and, more significantly, internal political conflict. 

In Brazil, president Jair Bolsonaro has made several statements that undermined efforts to slow the pandemic. In a national broadcast on March 24, 2020, he criticized the restrictive measures adopted by governors and mayors, urging people to return to work and referring to COVID-19 as a “little flu.” The president also highly publicized the unproven anti-malarian drug chloroquine as being effective against the virus, ordering the Ministry of Health to produce four million doses. His insistence on the use of the drug caused the loss of two health ministers, Dr. Henrique Mandetta, fired by Bolsonaro last April, and Dr. Nelson Teich, who resigned less than a month after taking over. Since then, the position has been filled by an army general specializing in logistics, with neither medical education nor experience.

Over the course of the pandemic, Bolsonaro has been exchanging public barbs with the state governments, such as over lockdown measures adopted by individual governors last month. On March 1, 16 of the country’s 26 governors, including three Bolsonaro allies, signed a letter criticizing the government and accusing the president of misleading the public about federal pandemic relief funds. Sao Paulo’s governor, Joao Doria, a former ally in the 2018 elections and a potential competitor in 2022, has been the president’s most vociferous antagonist over the handling of the pandemic.

At the center of the dispute is the Butantan Institute, one of the most prestigious health centers in Latin America, situated in the state of Sao Paolo. Back in June, Butantan signed a partnership with the Chinese laboratory Sinovac Biotech to produce the CoronaVac vaccine. Initially, Bolsonaro has signaled that Brazil would not purchase the Chinese vaccine, questioning its efficiency, but in January, the Ministry of Health added the vaccine to the national immunization plan following approval by the health regulator, Anvisa. Last month, Doria announced a deal for a further 20 million doses of CoronaVac to complement the 100 million already secured by Butantan.

Last August, Pfizer said it offered 70 million batches of its vaccine to Brazil, with a delivery scheduled for December. However, with Brazil dissatisfied with the terms of the contract, the deal is still being negotiated. Health Minister Eduardo Pazuello hopes to secure 100 million doses from Pfizer and 38 million from a pharmaceutical subsidiary of Johnson & Johnson, Janssen, to start deliveries in May and August respectively. Due to this lack of urgency and an absence of a unified policy between the federal and state governments, Brazil has so far vaccinated just 3,67% of its population.

Crisis Management

Chile has also faced political unrest. Since 2019, the country experienced several mass protests calling for education and pension reforms. In a televised address, President Pinera declared a state of emergency, granting powers to restrain freedom of movement and assembly. The measure resulted in violence that cost 18 lives in five days, leading the UN to examine possible human rights abuses. As a result, Pinera’s approval rating fell to just 7%. In 2020, amid the ongoing political crisis, COVID-19 hit the country hard, provoking the resignation of the health minister, Jaime Manalich.

However, Pinera managed to turn the situation around. With a degree in commercial engineering from the Catholic University of Chile and a PhD in economics from Harvard, the president is a billionaire businessman, with an estimated net worth of $2,9 billion. He has already led the country once, between 2010 and 2014, earning crucial government nous. Pinera made several concessions to the protesters and supported the calls for a new constitution in an attempt to turn down the political temperature.  

A referendum on October 25 saw 78% of the population approve a new constitution that will substitute the current one created in 1980 under General Augusto Pinochet. The new Magna Carta will be written by a 155-strong body also elected through a popular vote and with an equal number of men and women. The document will then be confirmed by a popular vote before being implemented.

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To assuage popular discontent caused by the initial handling of the pandemic in combination with other historical grievances relating to health care, education and pensions, Pinera focused his negotiation abilities to mediate the purchase of million doses of vaccine from different laboratories and suppliers. While most developing nations have been struggling with a lack of supplies, Chile is among the top three countries, along with Canada and the UK, when it comes to the number of doses ordered per capita. Back in September, just before the peak of protests, Pinera announced partnerships on the development and clinical trials between the Catholic University of Chile and Sinovac; the University of Chile, Janssen/Johnson & Johnson and AstraZeneca; as well as the University of Frontera and another Chinese laboratory, CanSino Biologics. More than that, purchases were agreed with Pfizer, Covax, Sinovac and AstraZeneca.

But despite perceived goodwill from an unpopular right-wing government, the president still faces an uphill climb when it comes to popularity. By March 1, 83% of the Chileans deemed the massive vaccination as good or very good, 58% asses the general management of the pandemic as positive, but Pinera’s personal approval is still only at 24%.

The successful vaccination has already yielded positive outcomes. According to Chile’s Health Ministry, the number of new COVID-19 cases has decreased in six of the country’s 16 regions in the last seven days and in eight the last 14 days. Chile hopes to vaccinate at least 15 million people in the first semester, which would allow the country to immunize its entire population by the end of June. These numbers would put Chile way ahead in the vaccination game not only in Latin America but worldwide, suggesting that resolute leadership is as important for the nation’s well-being as a robust medical system.

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