Irene Hartmann
Jose Maria del Pino
03/12/2021 4:51 PM
Clarín.com
Society
Updated 03/12/2021 4:51 PM
The neighborhood, the undeniable cultural bridge and the shared history often give a confusing picture of the similarities between Chile and Argentina.
The coronavirus vaccination campaign shot down any illusions of similarity in the inkwell.
From the side there they received
almost 11 million doses
.
On the side here, just over a third.
On the other side, almost 27 vaccines have been applied for every 100 inhabitants.
Here, less than 4. The aggravating factor?
The Chilean population is 41% of ours.
How do you explain so much difference?
Although comparing ourselves with third parties is not the best way for self-improvement (a topic debated when President Alberto Fernández -filmines in hand- highlighted the local containment of the coronavirus in the face of health collapses in other latitudes), if it is about institutional management, it could be a valid parameter.
See an alternative model
.
Try, to some extent, to incorporate it.
In addition, it is difficult to look west and swallow the toad that
Chile gave vaccines against the coronavirus to 26% of its population
in almost the same time as us.
It is difficult to understand that they have already landed and stocked all the vaccine shipments to complete, at the end of March, the immunization of all risk groups.
It is 32% of the country.
It includes those over 18 with comorbidities and all those over 60 years of age.
Here we cut nails waiting for a flight with a batch, raising hopes of the "
capable now touch me
" type, before the high plateau of more than 7,000 infected daily becomes a real
second wave
.
Weaknesses
The issue of
communication
stands out from the game of differences with Chile
.
While the databases of the Chilean information system SAS offered from the first day all the details of the immunization scenario against Covid (from who and from which jurisdictions were vaccinated, to how many doses were administered by brand), Argentina incorporated the Public Monitor of Vaccination as a palliative of the scandalous
VIP vaccination
.
After the VIP vaccination scandal, the departure of the hitherto Minister of Health, Ginés González García.
Photo Enrique García Medina
Now,
what is the genesis of the weak vaccination campaign in Argentina
, a country that is regionally respected for its very complete official vaccination calendar?
It would be necessary to go to the first months of the pandemic, when - to use an expression of several sanitaristas in this pandemic year - "we sleep".
May was the month in which countries like Chile began to draw up pre-purchase agreements with pharmaceutical companies.
As explained to this medium
Paula Daza
, Undersecretary of Public Health of Chile, "everything was prepared well in advance ... in May and June conversations began to sign agreements with different laboratories, which allowed, today, to have this amount of doses".
The agreements implied disbursements of money (nobody knows the amounts) to promote the developments, in exchange for the guarantee of the companies to prioritize the virtual "investor" when the doses were ready.
The Chilean equation was "the
more agreements are signed, the better
."
Reputation
According to Adolfo Rubinstein, former Minister of Health and Master in Clinical Epidemiology, the Government's difficulty in moving forward in this way has several sides: “On the one hand,
compared to Chile, Argentina is an unreliable buyer
.
You can't get rid of that.
A country that was in default twenty times, that had to reformulate its debt ... is not trustworthy for the pharmaceutical companies.
In addition, while others bought in advance,
Argentina does not have the dollars
, an obvious macroeconomic restriction that puts us at a disadvantage ”.
Rubinstein recalled when Ginés González García (former Minister of Health since February 20) admitted the collapse of negotiations with Pfizer - one of the largest pharmaceutical companies in the world - with the justification that they had wanted to impose "unacceptable conditions."
Dose of the vaccine against Covid from Pfizer-BioNTech, a pharmaceutical company with which Argentina could not reach an agreement.
AFP photo
A few days ago, sources from the Presidency of the Nation confirmed to
Clarín
the words of the displaced minister: they assured that Pfizer asked to include excessive guarantees in the contract, in the form of
sovereign assets
.
A recent report by the Latin American Journalists Network for Transparency and Anticorruption (PALTA) released by
La Nación
delved into the subject and reported that there were impositions of this tenor on the part of several pharmaceutical companies, in different countries of the region that, to top it off, they would have modified their laws to please vaccine developers.
Did Chile give in to these pressures?
Although the contracts are confidential and it cannot be ruled out that the company has sought to impose its rules, reserved sources from the Chilean government assured
Clarín
that the final contract with Pfizer
did not include clauses of that magnitude
.
Thus, it follows that the difference in treatment "on the side here" and "on the side there" has to do with
Argentina's weak reputation
with international economic organizations.
Pre-purchase
According to Rubinstein, in addition, “
Argentina married the Sputnik V vaccine
.
When the commercial agreement with Pfizer began to collapse and AstraZeneca announced that its production was so delayed that there would be no vaccines for the summer, they stayed very
close to the promise of the Gamaleya Center
”.
“As for the vaccines from China, they did not manage them.
They slept
", he pointed out, and clarified:" Sinopharm is a significantly more expensive vaccine, but something earlier could have been agreed.
Anyway, although they are all conjectures, one would believe that
China negotiates strongly
, in the sense of saying '
I give you ... what do you give me?
'.
The same, Russia.
There is a huge
geopolitical component
that exceeds the health ”.
Based on the data collected by the Center for Innovation in Global Health at Duke University (United States),
Chile made four pre-purchase agreements for 34 million doses
, enough to cover the vaccination of the entire population over 16 years of age.
And they have agreements in place for 60 million doses for future waves of Covid.
Immunization of teachers from Rosario, Santa Fe, with the China Sinopharm vaccine.
Photo Télam
The detail?
With Sinovac they closed at 14 million doses, of which 12 million will have arrived by the end of March.
With Oxford-AstraZeneca, 6 million (which, unlike Argentina, would arrive in Chile from South Korea), of which 1,620,000 correspond to the COVAX fund and the rest are private agreements.
With Pfizer, 10 million doses, which should have arrived by June of this year.
They also negotiate unit doses with Janssen (4 million) and Cansino (1.2 million), and there is a preliminary dialogue with the Gamaleya Center.
To the East
The photo on this side is bleak.
Duke University recalls that
Argentina has committed 47 million doses
, a short figure to cover the population over 18 years of age (which would require 60 million), but that it would give for more than one toast, if it could be materialized.
At the end of this note,
4,050,540 doses
had arrived in Argentina
.
President Alberto Fernández, in a vaccination center in Villa Dominico.
Photo: Luciano Thieberger
Many put tokens on Sputnik V, which has committed to 20 million doses, but its production is clearly
oversold
and only 2.5 million doses arrived (rounding off).
As for AstraZeneca-Covishield, with the 580,000 that arrived we are still far from the 22 million scheduled doses.
In addition, less than a month ago (thanks to a recent purchase agreement) 1 million doses of Sinopharm arrived, which the ANMAT did not authorize - for now, due to lack of scientific evidence - for people over 60 years of age.
And this Thursday the signing of an agreement for 3 million more doses was confirmed.
Finally, from the COVAX fund (for the equitable distribution of vaccines), in theory, 9 million doses were going to come this month.
In reality it will be less than 2 million, before May.
The fund is already distributing vaccines in other countries in the region, but has not yet announced when it will do so with Argentina.
Logistics
“Note that we are not worse in everything.
Regarding complex healthcare devices,
Argentina is much better than Chile
.
The issue is the primary devices, which work much better there ”, remarked Rubinstein.
Beyond the questions to the tripartite division of Health (the national, provincial and municipal spheres) and without counting the bids of these months between the Government and social and prepaid works, the management of the pandemic, in general, and the The vaccination plan, in particular, honored the federal system: they were
subject to the organization of the provinces
.
Long lines for senior vaccination at Luna Park.
Photo Rafael Mario Quinteros
Or its
disorganization
, as could be seen at the end of February in the city of Buenos Aires, with the famous "dysfunctional shift", and also when this Tuesday there was a daunting demonstration of inability to vaccinate people over 80 years of age.
In Chile, the vaccination plan did not require or require registration
.
There is no shift.
This is how Daza explained it: “The Government communicates the calendar weekly, according to the target groups that were defined with a vaccination council external to the Ministry of Health.
The primary care system allows us to reach all people, even the most distant, since they have experience in previous inoculation programs ”.
In practice, for example, this Monday was the turn of people with comorbidities, 58 and 59 years old.
On Tuesday, with comorbidities, but 56 and 57 years old.
On Wednesday, 54 and 55 years old.
And so.
The contrasts between Argentina and Chile are countless.
There, a good part of primary care falls to the municipalities.
From that sphere,
$ 15 per person
is sent to the clinics
each month
.
The clinics, thus, want to add patients, in order to increase the subsidy.
It is a model.
The system looks for people.
Not the other way around.
ACE