1. NEEDS AND CHALLENGES
The first cases of COVID-19 were reported in Latin America between February and early March 2020, and as of March 15 almost all countries took strict measures to control the pandemic.
According to the model adopted at a global level for the reduction of infections, the main measure in the region has also been the confinement of the population. However, the results have not been as expected and in May 2020 WHO declared that the region was the new epicentre of the pandemic.
In fact, by September of this year, the number of confirmed cases had reached 8 million, while 248,000 people had died.
At the health management level, COVID-19 has exceeded the capacities of the precarious and segmented health systems in all the countries of the region, although the degree of affectation varies between countries and areas. In indigenous communities, rural areas or particularly isolated areas (such as the Amazon) there is extremely limited access to health services; while in all territories the availability of intensive care beds is limited and diagnostic capacities have been rapidly overwhelmed, both possibly because of budgetary reasons and difficult access to important segments of the population (for example due to security issues or logistical difficulties), which suggests that the real number of infections and deaths is much higher than officially recorded.
This fragility of the systems has generated a high level of mistrust and uncertainty among citizens, in addition to directly affecting the attention to other key areas such as maternal and child health or undernutrition. In Guatemala, for example, health services have suspended regular programmes, including maternal and child health care and other essential services, while funds for these programmes have been redirected to the national response of COVID-19, which has again had a very negative impact on the most vulnerable populations. This suspension and cutbacks have further increased the gaps and structural deficiencies of services, particularly at the first level of care, evidenced in the low capacity for active search of cases of acute malnutrition during the seasonal period of hunger, despite the fact that so far this year there have been more than 21,000 children with acute malnutrition, doubling the cases of the same period in 2019.