The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies

Detalhes bibliográficos
Autor(a) principal: Vieira Machado, Cristiani
Data de Publicação: 2024
Outros Autores: Maria Mendes Pereira, Adelyne, Machado de Freitas, Carlos, Souza e Souza, Michele, Tobar, Sebastián, Carlos de Oliveira, Suelen
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624
Resumo: The article analyzes the fight against COVID-19 in three Latin American countries: Argentina, Brazil, and Mexico. A multiple case study was carried out in a comparative perspective, based on a bibliographic review, documentary analysis, and secondary data, considering characteristics of the countries and the health system, evolution of COVID-19, national governance, containment and mitigation measures, health systems response, constraints, positive aspects and limits of responses. The three countries had distinct health systems but were marked by insufficient funding and inequalities when hit by the pandemic and recorded high-COVID-19 mortality. Structural, institutional, and political factors influenced national responses. In Argentina, national leadership and intergovernmental political agreements favored the initial adoption of centralized control measures, which were not sustained. In Brazil, there were limits in national coordination and leadership related to the President’s denialism and federative, political, and expert conflicts, despite a universal health system with intergovernmental commissions and participatory councils, which were little used during the pandemic. In Mexico, structural difficulties were associated with the Federal Government’s initial reluctance to adopt restrictive measures, limits on testing, and relative slowness in immunization. In conclusion, facing health emergencies requires strengthening public health systems associated with federative, intersectoral, and civil society coordination mechanisms and effective global solidarity mechanisms
id FIOCRUZ-5_13f0c558e882144b895045b6a83972e0
oai_identifier_str oai:ojs.teste-cadernos.ensp.fiocruz.br:article/8624
network_acronym_str FIOCRUZ-5
network_name_str Cadernos de Saúde Pública
repository_id_str
spelling The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policiesLa respuesta al COVID-19 en Argentina, Brasil y México: los desafíos a la coordinación federativa de las políticas de saludA resposta à COVID-19 na Argentina, no Brasil e no México: desafios à coordenação federativa das políticas de saúdePandemias; COVID-19; Políticas de Saúde; FederalismoPandemias; COVID-19; Políticas de Salud; FederalismoPandemics; COVID-19; Health Policies; FederalismThe article analyzes the fight against COVID-19 in three Latin American countries: Argentina, Brazil, and Mexico. A multiple case study was carried out in a comparative perspective, based on a bibliographic review, documentary analysis, and secondary data, considering characteristics of the countries and the health system, evolution of COVID-19, national governance, containment and mitigation measures, health systems response, constraints, positive aspects and limits of responses. The three countries had distinct health systems but were marked by insufficient funding and inequalities when hit by the pandemic and recorded high-COVID-19 mortality. Structural, institutional, and political factors influenced national responses. In Argentina, national leadership and intergovernmental political agreements favored the initial adoption of centralized control measures, which were not sustained. In Brazil, there were limits in national coordination and leadership related to the President’s denialism and federative, political, and expert conflicts, despite a universal health system with intergovernmental commissions and participatory councils, which were little used during the pandemic. In Mexico, structural difficulties were associated with the Federal Government’s initial reluctance to adopt restrictive measures, limits on testing, and relative slowness in immunization. In conclusion, facing health emergencies requires strengthening public health systems associated with federative, intersectoral, and civil society coordination mechanisms and effective global solidarity mechanismsEl artículo analiza la lucha contra el COVID-19 en tres federaciones latinoamericanas: Argentina, Brasil y México. Se realizó un estudio de casos múltiple en perspectiva comparada, basado en revisión bibliográfica, análisis documental y de datos secundarios, teniendo en cuenta: las características de los países y del sistema de salud, la evolución del COVID-19, la gobernanza nacional, las medidas de contención y mitigación, la respuesta de los sistemas de salud, los factores condicionantes, los aspectos positivos y los límites de las respuestas. Los tres países tenían sistemas de salud diferentes, pero marcados por financiación insuficiente y desigualdades, cuando afectados por la pandemia, y registraron una alta mortalidad por COVID-19. Las respuestas nacionales se influyeron por factores condicionantes estructurales, institucionales y políticos. En Argentina, el liderazgo nacional y los acuerdos políticos intergubernamentales favorecieron la adopción inicial de medidas de control centralizadas, que no se sustentaron. En Brasil, hubo límites en la coordinación y liderazgo nacional, relacionados con el negacionismo del presidente y los conflictos federativos, políticos y con expertos, a pesar de existir un sistema de salud universal que tiene comisiones intergubernamentales y consejos participativos, poco utilizados en la pandemia. En México, las dificultades estructurales se asociaron con la renuencia inicial del gobierno nacional en adoptar medidas restrictivas, límites en las pruebas y relativa lentitud en la vacunación. Se concluye que para enfrentar emergencias sanitarias hay que fortalecer los sistemas públicos de salud asociados con mecanismos de coordinación federativa, intersectorial y con la sociedad civil, así como mecanismos efectivos de solidaridad globalEste artigo analisa o enfrentamento da COVID-19 em três federações latino-americanas: Argentina, Brasil e México. Realizou-se um estudo de casos múltiplos em perspectiva comparada, baseado em revisão bibliográfica, análise documental e de dados secundários, considerando: características dos países e do sistema de saúde, evolução da COVID-19, governança nacional, medidas de contenção e mitigação, resposta dos sistemas de saúde, condicionantes, aspectos positivos e limites das respostas. Os três países apresentavam sistemas de saúde distintos, porém marcados por financiamento insuficiente e desigualdades quando atingidos pela pandemia, e registraram alta mortalidade por COVID-19. As respostas nacionais foram influenciadas por condicionantes estruturais, institucionais e políticos. Na Argentina, a liderança nacional e acordos políticos intergovernamentais favoreceram a adoção inicial de medidas centralizadas de controle, que não se sustentaram. No Brasil, houve limites na coordenação e liderança nacional, relacionadas ao negacionismo do presidente e a conflitos federativos, políticos e com especialistas, apesar da existência de um sistema de saúde universal que têm comissões intergovernamentais e conselhos participativos, pouco acionados na pandemia. No México, dificuldades estruturais se associaram à relutância inicial do governo nacional em adotar medidas restritivas, limites na testagem e relativa lentidão na vacinação. Conclui-se que o enfrentamento de emergências sanitárias requer o fortalecimento dos sistemas públicos de saúde associados a mecanismos de coordenação federativa, intersetorial e com a sociedade civil, bem como mecanismos efetivos de solidariedade globalReports in Public HealthCadernos de Saúde Pública2024-06-25info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624Reports in Public Health; Vol. 40 No. 6 (2024): JuneCadernos de Saúde Pública; v. 40 n. 6 (2024): Junho1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624/19447https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624/19448https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624/19449Copyright (c) 2024 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessVieira Machado, CristianiMaria Mendes Pereira, AdelyneMachado de Freitas, CarlosSouza e Souza, MicheleTobar, SebastiánCarlos de Oliveira, Suelen2024-06-25T14:47:30Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8624Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/cspPUBhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-06-25T14:47:30Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.none.fl_str_mv The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
La respuesta al COVID-19 en Argentina, Brasil y México: los desafíos a la coordinación federativa de las políticas de salud
A resposta à COVID-19 na Argentina, no Brasil e no México: desafios à coordenação federativa das políticas de saúde
title The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
spellingShingle The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
Vieira Machado, Cristiani
Pandemias; COVID-19; Políticas de Saúde; Federalismo
Pandemias; COVID-19; Políticas de Salud; Federalismo
Pandemics; COVID-19; Health Policies; Federalism
title_short The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
title_full The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
title_fullStr The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
title_full_unstemmed The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
title_sort The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies
author Vieira Machado, Cristiani
author_facet Vieira Machado, Cristiani
Maria Mendes Pereira, Adelyne
Machado de Freitas, Carlos
Souza e Souza, Michele
Tobar, Sebastián
Carlos de Oliveira, Suelen
author_role author
author2 Maria Mendes Pereira, Adelyne
Machado de Freitas, Carlos
Souza e Souza, Michele
Tobar, Sebastián
Carlos de Oliveira, Suelen
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Vieira Machado, Cristiani
Maria Mendes Pereira, Adelyne
Machado de Freitas, Carlos
Souza e Souza, Michele
Tobar, Sebastián
Carlos de Oliveira, Suelen
dc.subject.por.fl_str_mv Pandemias; COVID-19; Políticas de Saúde; Federalismo
Pandemias; COVID-19; Políticas de Salud; Federalismo
Pandemics; COVID-19; Health Policies; Federalism
topic Pandemias; COVID-19; Políticas de Saúde; Federalismo
Pandemias; COVID-19; Políticas de Salud; Federalismo
Pandemics; COVID-19; Health Policies; Federalism
description The article analyzes the fight against COVID-19 in three Latin American countries: Argentina, Brazil, and Mexico. A multiple case study was carried out in a comparative perspective, based on a bibliographic review, documentary analysis, and secondary data, considering characteristics of the countries and the health system, evolution of COVID-19, national governance, containment and mitigation measures, health systems response, constraints, positive aspects and limits of responses. The three countries had distinct health systems but were marked by insufficient funding and inequalities when hit by the pandemic and recorded high-COVID-19 mortality. Structural, institutional, and political factors influenced national responses. In Argentina, national leadership and intergovernmental political agreements favored the initial adoption of centralized control measures, which were not sustained. In Brazil, there were limits in national coordination and leadership related to the President’s denialism and federative, political, and expert conflicts, despite a universal health system with intergovernmental commissions and participatory councils, which were little used during the pandemic. In Mexico, structural difficulties were associated with the Federal Government’s initial reluctance to adopt restrictive measures, limits on testing, and relative slowness in immunization. In conclusion, facing health emergencies requires strengthening public health systems associated with federative, intersectoral, and civil society coordination mechanisms and effective global solidarity mechanisms
publishDate 2024
dc.date.none.fl_str_mv 2024-06-25
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624/19447
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624/19448
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8624/19449
dc.rights.driver.fl_str_mv Copyright (c) 2024 Cadernos de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2024 Cadernos de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/xml
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 40 No. 6 (2024): June
Cadernos de Saúde Pública; v. 40 n. 6 (2024): Junho
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
_version_ 1816705333841625088