SANTIAGO, Chile (CMC) — Health authorities participating in an international seminar here say that it’s time to transform the health systems in Latin American and the Caribbean and make progress on universality, comprehensiveness and financial sustainability.

The Economic Commission for Latin American and the Caribbean (ECLAC) said the seminar, titled ‘Challenges to move towards universal, comprehensive, and sustainable health systems — lessons from an international perspective’, featured remarks by Mario Cimoli, acting ECLAC executive secretary; María Begoña Yarza, minister of health of Chile; and Dr Carissa F Etienne, director of the Pan American Health Organisation (PAHO).

In his remarks, Cimoli thanked Chile’s Health Ministry for the trust it has put in ECLAC on requesting technical assistance to support the process of reforming the national health system.

He emphasised that having universal access to health systems is vital for moving towards development with equality in the region.

“Growth with high productivity, global competitiveness, and social inclusion is not possible if the population cannot access quality health care,” Cimoli said. “That is what we are referring to when we talk about the inefficiency of inequality.

“States’ capacity to raise enough resources to finance universal, comprehensive, sustainable and resilient systems is key to carrying out the reforms needed in the region — one of the pillars of which must be strengthening primary health care,” he added.

Begoña Yarza expressed gratitude for the work of the various United Nations organisations that are supporting the reform process in Chile, including ECLAC and PAHO.

“We come to this place, to ECLAC, to ask that you collaborate with the greatest challenge, since the 1952 reform, that Chile has in the health arena,” she said. “And what we obtained was a generous reception from this organisation where development issues are discussed, because we cannot talk about development if we don’t talk about health.”

Dr Etienne said that “The data is clear: The region of the Americas reported the highest number of COVID-19 cases and the highest number of fatalities.

“Our public health infrastructure was not prepared and our health systems fragmented, segmented and under-resourced,” she added, declaring that “the time for substantive transformation of our health systems is now, and such transformation must be guided by extensive analysis of the performance of health systems during the pandemic.

“It must be founded on the principle that everyone in this region has the right to health,” Etienne stressed.

According to ECLAC’s data, public spending on health in Latin America and the Caribbean amounts to 3.8 per cent of gross domestic product (GDP), far below the six per cent of GDP recommended by the World Health Organization (WHO).

Likewise, ECLAC said 32.2 per cent of total spending on health in the region corresponds to out-of-pocket household expenses, compared with 21 per cent in Organisation for Economic Cooperation and Development (OECD) countries.

ECLAC said a third of Latin American and Caribbean countries have out-of-pocket expenses that account for more than 40 per cent of total spending, “which exposes the population to critical situations of financial vulnerability, particularly in light of the multiple crises the region is experiencing (economic, health and social).

“Health and social protection systems must be at the centre of sustainable development strategies, which means that it is critical to consolidate a social compact centred on rights and equality, linked to a progressive fiscal compact that would guarantee the financial sustainability of health systems and that would move towards a welfare state,” ECLAC urged.

It said the seminar was aimed at learning about the experience of distinct regions and countries — such as Canada and Spain — that have “more robust health systems and are characterised by their universality, comprehensiveness, and financial sustainability, as well as the main lessons learned and challenges faced by countries that have recently implemented reforms”.