Chile began vaccinating against covid-19 on February 3 and this Tuesday, less than 21 days later, more than three million people have already received a dose.
The amount of vaccines available and the speed of the operation, with at least 1,300 centers in the territory, has the South American country as a regional and global example.
Mexico, Colombia, Peru, Uruguay or Paraguay have asked the Chilean authorities for help, according to the Foreign Ministry.
The success of the strategy combines historical and other conjunctural elements: the strength of primary health care since the 1950s, the commercial muscle of one of the most open economies in the world and the negotiating nose of the president himself, Sebastián Piñera, a powerful businessman .
As a result, his Government (2018-2022) hopes to vaccinate 15 million people in this first semester and, with this, achieve immunity for the Chilean population by the end of June.
In May of last year, Piñera ordered the undersecretary of International Economic Relations, the lawyer Rodrigo Yáñez, to dedicate himself exclusively to closing the deals with the laboratories.
Yáñez has since led the negotiations, in direct contact with the president.
Shortly before the arrival of the first doses of China's Sinovac, in late December, for example, Piñera spoke directly with Xi Jinping to rush the bureaucracy.
Although he has had serious political problems in this second government, the Chilean president continues to be recognized for his management capacity, such as the one that allowed the media rescue of the 33 underground miners in 2010.
The center of the Chilean strategy has been pragmatism and the diversity of laboratories with which it has been negotiated in parallel and through different paths.
The management of alternative plans has been especially beneficial, considering the delays in deliveries registered around the world.
The Government has a motto: the perfect is the enemy of the good and agreements need to be reached quickly, because other countries are on the waiting list to seal the negotiations.
In Chile, for example, there were no clinical trials of the American Pfizer, but they were the first 20,000 doses that arrived in the country on December 24.
With them, health officials working in critical patient units (UPC) were vaccinated.
10 million doses were also committed, the delivery of which will be concentrated mainly in the first semester.
Unlike other countries in the region, Chile achieved a good calendar, with exponential growth.
From China to the United States
A different tactic was deployed with Sinovac, because clinical trials carried out by the laboratory in Chile, funded by the South American country, facilitated the availability of the vaccine.
In that case, however, prices and an ambitious schedule were negotiated that will allow the delivery of 60 million doses in three years (although the amount could be increased, depending on Chilean needs).
Two shipments of Sinovac vaccines have already arrived with approximately four million doses.
The collaboration agreement signed by the prestigious Universidad Católica de Chile with the Chinese laboratory was crucial in this process.
“In 2020 we were in an uncertain scenario, because we did not know how each vaccine was going to end.
There were no regulatory approvals and the laboratories were just starting their production chains.
But we try to minimize the risk of the bet, with weekly calls, even daily, to Sinovac, for example, with which we seek close contact ”, says Yáñez.
"Sometimes the bets work and fortunately with Sinovac it was an excellent bet, considering the availability of vaccines at an early stage, which was complemented by Pfizer, which could deliver us earlier, but in a smaller quantity", adds the Undersecretary of Relations International Economics of the Government of Chile.
From Oxford / AstraZeneca, Chile expects some five million vaccines, with a first shipment between April and next May.
In parallel, the Piñera government seeks to expand the contract with the Chinese Sinovac, negotiates with CanSino –a Chinese-Canadian company that also conducts clinical trials in Chile–, and carries out advanced talks with the Russian Sputnik V. With the latter two seeks to reinforce the inoculation process of the second trimester.
According to data from the Ministry of Health, 3,037,063 people had been vaccinated as of Tuesday.
In a single day, Chile has the capacity to inoculate 87,264 people, as happened on the last day, but the pace will accelerate as the age of the groups called, which are large, decreases.
So far, most citizens over 65 have been immunized with the first dose.
From next week, they will begin to receive the second, because 28 days will have elapsed since the first puncture.
Different risk groups have been vaccinated, such as older teachers.
This Wednesday it was announced, meanwhile, that new shipments are arriving from both Sinovac and Pfizer, so that on Friday there will be about nine million doses available.
They will allow progress with the immunization of the 250,000 teachers who educate in Chile, kidney patients who need dialysis (who will be punctured from Friday) and people between 60 and 64 years old.
Then, on March 8, the chronically ill will continue, regardless of their age.
Previous trade agreements
Chile has 30 trade agreements in force with the main countries and blocs in the world.
Therefore, although it is a small country, it is very inserted in the global economic scene and has an oiled foreign trade machinery that was activated in time and almost naturally when it was time to soon negotiate the vaccines against covid-19.
An additional element was crucial in the strategy: despite the problems of a state in need of modernization and the polarized political climate, Chile did not become entangled in the bureaucracy and managed to make decisions quickly.
He did it from the president to technical organizations such as the Public Health Institute (ISP), which has management autonomy for the authorization of medicines and vaccines, among other tasks.
Before approving the Sinovac, for example, its officials traveled to their offices.
The Chilean government has paid special attention to the execution of the contracts, a particularly complicated phase of the process.
In recent weeks, Undersecretary Yáñez has had to manage issues such as import restrictions from the European Union, the interruption of calendars and logistical issues, such as flight permits.
In the shipments that will arrive in Chile in the next few hours with new Chinese vaccines from Sinovac, a container will arrive for Uruguay.
"Cooperation exists exclusively in transportation," Chilean Health Minister Enrique Paris explained Tuesday.
"The Uruguayan Government has acquired these vaccines and we, using the trip, bring them to Santiago and they go immediately to Montevideo."
The negotiations have been especially complex with the European Union and the United States, which are rigid with their clauses.
In the case of the United States, Chile hired the Skaden law firm to mitigate the risks.
For the vaccination process, meanwhile, there was a budget of 200 million dollars, although the Ministry of Foreign Relations estimates that another 100 million US dollars could be needed.
In the Government, however, they do not consider that money has been a relevant factor that explains the success of the strategy, because they are not unattainable sums for other similar countries in the region.
Although in the first stage of the pandemic the Government was criticized for not giving a leading role to its primary health system in traceability, at this time it is recognized that it has placed in its hands the vaccination operation against covid-19.
“Despite the vicissitudes that the Chilean health system has faced, such as the privatization onslaught in the Pinochet dictatorship, Chile managed to preserve a structure of the national health services system throughout the territory, which has its antecedents in the 1950s.
Then, the plan to strengthen primary care was the first strategic task in the return to democracy, in 1990 ”, explains the socialist doctor Álvaro Erazo, Minister of Health in the first Government of Michelle Bachelet (2006-2010).
“Currently, primary care has demonstrated its capital and its historical memory, marked by large vaccination coverage, which is at the level of developed countries.
As it has a presence throughout the country, despite its geography, Chile has an immense capacity to distribute vaccines in complex logistics chains, ”says the former minister.
The first case of covid-19 in Chile was detected almost a year ago, on March 3, 2020. Since then, in a population of 19 million inhabitants, 805,317 have been infected and at least 20,151 people have died.
The Health Ministry fears an increase in cases in March, at the end of the summer holidays.
According to the latest report, only 186 critical beds remain.
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