The goal was set since the end of 2020 by President Iván Duque: 70% of the population immunized by the end of 2021. But, at the end of March this year, Colombia has only administered doses to 2.5% of its population.
Most are the first of a necessary guideline of two.
With this, the complete scheme is in the bodies of just 60,000 Colombians.
There are several voices that demand patience before evaluating results, but the reality with today's data in hand is that vaccination in Colombia started late, and it does not go quickly.
Since the effectiveness of a vaccine is verified until it reaches the arms of the population of a country, there is a whole obstacle course that is proving more arduous for countries that are not part of the exclusive club of the richest 35 or 40 .
These barriers are of two types, and both are higher and more complex for Colombia, which would require an extra effort on the part of all levels of the State: first, the lack of dose that acts as a bottleneck in distribution;
then, the dilemmas between speed and equitable access, which become particularly intense in a country as unequal between people and territories.
What has not yet arrived
Insufficient supply for infinite demand is the key feature of the global vaccine market today.
There are options on the table that go through international agreements to expand production, and in fact it is likely that this restriction will relax as other pharmaceutical companies join the production process (some, like Jannsen, with their own formula; others, like Merck, supporting the production of others).
But, for now and nationally, there is no dose for so many people.
Even less so for those who live outside the countries that had privileged access to negotiate with suppliers (such as the United States, United Kingdom or the European Union) or those who deployed an early, intense commercial action and without taking into account expenses or contacts ( Chile or Israel belong to this group).
But not even in the middle section to which Colombia belongs stood out.
The Colombian government did not close agreements or pre-agreements promptly with other countries in the region.
In addition to Chile, Argentina, Costa Rica or Mexico announced signatures between October and November, while at the end of this month Fernando Ruiz, Minister of Health of Colombia, assured that “we are not going to acquire vaccines that do not have the respective approvals of international agencies. ”.
Indeed, those countries bought with less certainty, but this enabled them to start immunizations between one and two months before Colombia could do the same.
According to [information revealed by the independent media
La Silla Vacía
at the end of January], the Andean government would have approached its relationship with pharmaceutical companies in a different way, perhaps more cautiously: avoiding demands to exempt some such as Pfizer from serious liability for negative effects ( that for now have not been detected);
betting on the Covax multilateral mechanism with greater determination;
and with the aforementioned premise of waiting for effective announcements.
The advantages of this “slow but safe” approach (as a [recent editorial in
El Espectador
] described the Colombian vaccination strategy) are, perhaps, less clear than its disadvantages given the health urgency that the world is experiencing.
In this context, and taking into account the scarcity of doses that still reigns in the market, the real bargaining power of a government of medium size and specific weight such as Colombia collides with reality quickly, translating into an arrival with a dropper that determines the irregular rhythm of daily vaccination in the country.
However, the fact of having started later has in all probability helped the availability of doses to be better for Colombia in its first five weeks of vaccination, when compared to others that started earlier.
The country has already received more than 3.3 million doses, but has only administered less than 1.3.
And although the last million barely arrived on March 20, and is made up of three-quarters of vials from China Sinovac and the remaining 25% from AstraZeneca, it is worth wondering what prevents going faster with what is already available.
Inefficiencies or inequity
The idea of a "slow but safe" process has been raised by the country's own Minister of Health, as a banner for equity.
"Equity and general interest cannot be traded in the Vaccination PN," he stated on March 21 on Twitter.
“The health system must serve with respect and dignity.
And Colombians must respect the priority of those most at risk. "
It is true that the scandals of politicians and other figures skipping the vaccination shift in Ecuador, Peru or Argentina have placed the rest of the governments of the region in a defensive position, trying to ensure that the line is maintained.
But, beyond the logical need to avoid corrupt traps, in the Minister's message there would be a clear position regarding the inevitable dilemma between speed and order.
This order was established in Colombia in a similar way to other countries: in several stages (five, in this case) that go from the first one destined to first-line health personnel and those over 80 years of age to the final, which includes all the population that does not meet the criteria for age, risk due to comorbidities or exposure due to their work.
Of the intermediate ones, Colombia has already entered stage two, focused on adults aged 60 to 79 years.
He did it before completely ending the first phase: in Bogotá, for example, the line of those aged 80 and over has been "broken up", allowing anyone of that age to come without a turn to receive their doses, given that no less than a percentage of them could not be located through the channels established by the health authorities.
In this case, rigorously maintaining the line, not opening the second stage until the first stage was finished, would have further delayed the aggregate rate of vaccination.
If this logic is extended, it seems inevitable that the Minister's commitment to order will fall under its own weight.
In Colombia, access to health on paper is almost complete (coverage greater than 90%), but the nuances of reality are very different.
This access does not end at the door of the hospital, even less with a vaccination process as urgent as it is inevitably improvised.
For many people, the path to that door is difficult to navigate.
Due to lack of knowledge about the operation of a remarkably complex system (divided into countless provisional health entities with an uneven level of effectiveness and collaboration with the public sector), due to distrust (not only towards the vaccine itself, but towards some institutions with little reception history) or, simply, due to physical distance.
The result is that not all arms in Colombia are equally close or far from receiving a dose.
The differences can already be clearly seen in the data of doses used over those received for each of the territorial entities that make up the country's sanitary puzzle;
in fact, the Ministry of Health has decided in its latest decree on vaccination that those territorial entities with less than 50.7% of doses used will not have new ones until they use those available.
This is equally true for the social chasms that run through Colombian society: being on the margins of the system will also imply staying on the edges of the process.
In the Minister's statements, and in the spirit of the principles stated in the official Vaccination Plan, there is no doubt the intention that this is not the case.
But it is difficult to imagine how to contrast the structural inertia with just a few weeks, how to build and sustain the walkways that shorten the distances from the margins to the heart of the system.
With this, it is likely that, although the ambitious goal of 70% of the immunized population is met before the end of 2021, these two-thirds of the citizenry do not represent evenly, but biased, the whole of Colombia.
Subscribe here
to the
newsletter
of EL PAÍS América and receive all the informative keys of the current situation in the region.