Introduction

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

Health condit ions and healthcare systems in South Amer ica have evolved

gradual ly in the past decade. However, South Amer ica exper iences socia l , pol i t i -

ca l , and economic pl ight which heavi ly impac ts countr ies’ abi l i t ies to design

susta inable healthcare systems. This in turn contr ibutes to their st ruggle to

develop the necessar y infrastruc ture. Countr ies within the region have health-

care systems in place, each with var y ing degrees of susta inabi l i t y. Publ ic health

cr ises have become a point of concern for countr ies l ike Braz i l , given the

outbreak of the Zik a v i rus before the opening of the Summer Olympics in 2016.

People in South Amer ica are a lso exper ience lower fer t i l i t y and higher r ise of

chronic diseases. Nonetheless, a var iet y of healthcare systems in South Amer ica

attempt to address high r isk health issues.

Argent ina’s healthcare system is separated into three separate provider

segments. Fi rst ly, s imi lar to Braz i l , the government ac ts to oversee the publ ic

sec tor and provide f ree c l in ical care suppor t at publ ic hospita ls . Outpat ients

are, however, charged a fee for medic ines and roughly hal f of Argent inian

c i t izens re ly on the publ ic hospita ls for healthcare. The remaining 50 percent of

the populat ion fa l ls into e i ther mutual p lans or the pr ivate sec tor. Mutual p lans

are managed by t rade unions and have �xed rates for employers and employees.

The idea of these plans is to have the “mutual ” cover of cost of medical care and

medic ines, meanwhi le the di�erence bet ween �xed fee and ac tual cost i s paid

by the c i t izen. As 45 percent of the populat ion re l ies on mutual p lans, the

sec tor and pay the ful l expenses of their medical care.

Public Healthin South America

Argentina

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

Braz i l combines publ ic and pr ivate healthcare systems in i ts e�or t to

improve publ ic health much l ike the United States. The M inistr y of Health funds

healthcare in Braz i l which takes the form of munic ipal hospita ls that o�er medical

ser v ices through publ ic c l in ics to Braz i l ian c i t izens. However, even as appropr iate

medical ser v ices are provided to a l l c i t izens, rura l and less developed areas of ten

lack wel l maintained hospita ls , and s ince these ser v ices are f ree, people who do

have access to them of ten have to endure long wait ing t imes at fac i l i t ies that do

not have as many resources as pr ivate hospita ls . Regardless, approximately 70

percent of Braz i l ians use publ ic hospita ls . Beyond publ ic hospita ls , the govern-

ment oversees publ ic health programs such as Farmácia Popular, which a ims to

make essent ia l medicat ions and drugs a�ordable and readi ly avai lable for the

populat ion in pharmacies throughout the countr y. Braz i l a lso uses an integrated

por ta l to access pat ients’ medical information through an e lec tronic Nat ional

Health ident i�cat ion card system. So regardless of whether the pat ient is being

treated in a publ ic or pr ivate hospita ls , the Uni�ed Health System net work a l lows

healthcare inst i tut ions within the countr y to openly communicate.

Although Zik a has existed s ince the 1940s, i t only began to spread rapidly

through South Amer ica in 2015. The v i rus was �rst detec ted in Braz i l and eventual-

ly reached more than 50 countr ies across the globe. Braz i l was heavi ly impac ted by

the mosquito -borne v i rus and the s ide e�ec ts of the v i rus speci�cal ly impac ted

pregnant women, as i t could cause bir th defec ts in chi ldren.

M eanwhi le, the Zik a v i rus’ impac t on adults has been proven to be less severe. The

exponentia l r i se of Z ik a in Braz i l ra ised cr i t ica l quest ions as to whether the coun-

tr y ’s preparat ions and exist ing infrastruc ture were adequate to host an interna-

t ional event l ike the 2016 Summer Olympics. Addit ional ly, R io de Janeiro —the

locat ion for the Olympics—had the highest number of Z ik a cases compared to any

other place in Braz i l . The government at the t ime was in turmoi l . Braz i l ’s Pres ident ,

Di lma Rousse�, was fac ing impeachment, the economy was in a recess ion, and

corrupt ion and col lus ion within the government and oi l companies was a huge

point of concern for c i t izens. Ult imately, Pres ident Rousse� was impeached on

Brazil

2016 Rio Olympics: Zika Virus

.

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

corrupt ion charges and the “inter im pres ident , pres ident , M ichel Temer, named a

pol i t ic ian with no medical background as the new health minister.” Braz i l u l t imate-

ly did not have to postpone the date of the Olympics in 2016. Braz i l proac t ively

attempted to ex terminate R io of mosquitoes. The terra in of the state made this

d i�cult , given the abundance of ra inforests and beaches and the fac t that “ the

hardy Aedes aegypt i mosquitoes that carr y Z ik a can reproduce even within a dab

of water ly ing in an over turned bott le cap.” Nonetheless, the countr y attempted to

address the issue e�ec t ively. I nspec t ions were carr ied out four months pr ior to the

star t of the Olympics, in order to remove mosquito breeding grounds. Fumigat ion

was an opt ion that would only happen based on speci�c cases to provide for the

concerns of the publ ic ’s overal l health . The government ut i l ized genet ical ly modi-

�ed mosquitoes and cr i t ica l ly re l ied on the assumption that the weather would

diminish the impac t of the v i rus. Having a dr ier, cooler August month made mos-

quito populat ions decrease in s ize, and ult imately protec ted the athletes and the

publ ic . There were no repor ts of people contrac t ing the Zik a v i rus dur ing the

games. The problem is that once the internat ional spot l ight was o� Braz i l , they

fa i led to cont inue improving their infrastruc ture to prevent a s imi lar outbreak in

the future. This has happened across the cont inent , and is the reason that so many

countr ies have f rac tured publ ic health systems. I t wi l l be up to the people of

South Amer ica to demand reform to the publ ic health system and better health-

care for themselves and their fami l ies.

1 . Wor ld Health Organizat ion, WHO, a specia l ized agenc y of the United

Nat ions that focuses on publ ic health issues across the wor ld. The agenc y ser ves

to create value for research agendas, monitor health t rends, and create a pol ic y

plat form framework for countr ies to apply as recommendat ions.

2 . Par tners in Health is an internat ional non- governmental organizat ion

that provides publ ic health resources for Peru in the contex t of the South Amer i -

can region. By work ing with local governments, the NGO has created 10 health

posts in the rural s lums of L ima and provides pr imar y access to disenfranchised

indiv iduals .

3 . Doc tors Without Borders operates in over 60 countr ies across the globe.

The NGO provides medical ass istance to countr ies fac ing immediate cr ises l ike

natural d isasters or epidemics. Within South Amer ica , they have worked in Bol iv ia ,

Ecuador, Peru, Braz i l , and Argent ina.

4 . PATH is an NGO that provides vaccines, drugs, and system and ser vice

innovat ions for eas ier access to healthcare resources. Us ing technology, d iagnos-

t ics can detec t and track indiv idual d isease and household water � l ters and

pre -�l led, non-reusable syr inges are used to ensure the safet y of c i t izens. The

organizat ion works in Braz i l , Argent ina, and Peru.

International Organizations and Non-governmental Organizations

corrupt ion charges and the “inter im pres ident , pres ident , M ichel Temer, named a

pol i t ic ian with no medical background as the new health minister.” Braz i l u l t imate-

ly did not have to postpone the date of the Olympics in 2016. Braz i l proac t ively

attempted to ex terminate R io of mosquitoes. The terra in of the state made this

d i�cult , given the abundance of ra inforests and beaches and the fac t that “ the

hardy Aedes aegypt i mosquitoes that carr y Z ik a can reproduce even within a dab

of water ly ing in an over turned bott le cap.” Nonetheless, the countr y attempted to

address the issue e�ec t ively. I nspec t ions were carr ied out four months pr ior to the

star t of the Olympics, in order to remove mosquito breeding grounds. Fumigat ion

was an opt ion that would only happen based on speci�c cases to provide for the

concerns of the publ ic ’s overal l health . The government ut i l ized genet ical ly modi-

�ed mosquitoes and cr i t ica l ly re l ied on the assumption that the weather would

diminish the impac t of the v i rus. Having a dr ier, cooler August month made mos-

quito populat ions decrease in s ize, and ult imately protec ted the athletes and the

publ ic . There were no repor ts of people contrac t ing the Zik a v i rus dur ing the

games. The problem is that once the internat ional spot l ight was o� Braz i l , they

fa i led to cont inue improving their infrastruc ture to prevent a s imi lar outbreak in

the future. This has happened across the cont inent , and is the reason that so many

countr ies have f rac tured publ ic health systems. I t wi l l be up to the people of

South Amer ica to demand reform to the publ ic health system and better health-

care for themselves and their fami l ies.

1 . Wor ld Health Organizat ion, WHO, a specia l ized agenc y of the United

Nat ions that focuses on publ ic health issues across the wor ld. The agenc y ser ves

to create value for research agendas, monitor health t rends, and create a pol ic y

plat form framework for countr ies to apply as recommendat ions.

2 . Par tners in Health is an internat ional non- governmental organizat ion

that provides publ ic health resources for Peru in the contex t of the South Amer i -

can region. By work ing with local governments, the NGO has created 10 health

posts in the rural s lums of L ima and provides pr imar y access to disenfranchised

indiv iduals .

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Lorem ipsum

.

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

3 . Doc tors Without Borders operates in over 60 countr ies across the globe.

The NGO provides medical ass istance to countr ies fac ing immediate cr ises l ike

natural d isasters or epidemics. Within South Amer ica , they have worked in Bol iv ia ,

Ecuador, Peru, Braz i l , and Argent ina.

4 . PATH is an NGO that provides vaccines, drugs, and system and ser vice

innovat ions for eas ier access to healthcare resources. Us ing technology, d iagnos-

t ics can detec t and track indiv idual d isease and household water � l ters and

pre -�l led, non-reusable syr inges are used to ensure the safet y of c i t izens. The

organizat ion works in Braz i l , Argent ina, and Peru.

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

Bibliography

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

- – -

“Braz i l ' s March towards Universal Coverage.” WHO, Wor ld Health Organizat ion, w w w.who. int/bul let in/volumes/88/9/10-020910/en/ .

“Doc tors Without Borders - Our Work .” MSF USA, w w w.doc torswithoutborders.org/our-work .

Douglas, Bruce. “Braz i l Warns Women Not to Get Pregnant as Z ik a Vi rus Is L inked to R are Bi r th Defec t .” The Guardian, Guardian News and M edia , 4 Dec. 2015, w w w.theguardian.com/glob-al - development/2015/dec/04/brazi l -z i -k a-v i rus-pregnanc y-microcephaly-mosquito -rare -bir th- defec t .

“Healthcare in Argent ina.” Just Landed, 28 Sept . 2016, w w w.just landed.com/engl ish/Argent ina/Argent ina- Guide/Health/Healthcare.

“Healthcare System in Braz i l .” Angloinfo, w w w.angloinfo.com/how-to/brazi l /healthcare/health-system.

K assam, Ashi fa . “Z ik a Vi rus M akes R io Olympics a Threat in Braz i l and Abroad, Health Exper t Says.” The Guardian, Guardian News and Media , 12 May 2016, w w w.theguardian.com/wor ld/2016/-may/12/r io - olympics-z ik a-amir-attaran-publ ic -health-threat .

PATH, w w w.path.org/about/ index.php.

“Peru.” Par tners I n Health , w w w.pih.org/countr y/peru.

Tavernise, Sabr ina. “No Zik a Cases Repor ted Dur ing R io Olympics, W.H.O. Says.” The New York Times, The New York Times, 2 Sept . 2016, w w w.nyt imes.com/2016/09/03/health/z ik a-r io - olympics.html.

Vox, Ford. “Zik a and the R io Olympics : I s There a Threat?” CNN, Cable News Net work , 12 Feb. 2016, w w w.cnn.com/2016/02/12/health/z ik a- olympics-threat/ index.html.

“ WHO.” Wor ld Health Organizat ion, Wor ld Health Organizat ion, w w w.who. int/en/ .

“Zik a : Olympics Plans Announced by R io Author i t ies.” BBC News, BBC, 24 Jan. 2016, w w w.bbc.com/news/wor ld- lat in-amer ica-35394297.

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

Questions to Consider:

Please answer all questions either in the space provided or on a separate sheet of paper and bring your answers to PIRC.

We will use your answer in the discussion and be collecting your worksheets.

1. What are the similarities and di�erences between the aforementioned healthcare systems in South America? How do these healthcare systems compare to the United States?

2. How can an epidemic like Zika impact the social, political, and economic state of a country such as Brazil?

3. What is importance of international cooperation through international organizations and NGOs?

4. In what ways can pre-existing healthcare systems be improved?

U N I V E R S I T Y O F P E N N S Y L V A N I A | I N T E R N A T I O N A L A F F A I R S A S S O C I A T I O N

5. Is healthcare a fundamental right? Should the government provide all citizens with universal health care?