What lies beyond normal?
What have we learned in the past 2 years that can help LAC health systems move beyond normal? How have policy recommendations changed for countries that are trying to progress toward UHC while addressing the new demands imposed by COVID-19? The lessons fall into four broad categories: greater priority for investing in public health functions, greater urgency to implement unfinished reforms, greater focus on exploiting new technologies, and greater gains from regional cooperation.
First, we have experienced, intensely, why countries must invest in public health. The pandemic has shown that health is absolutely primary and that public health investments for detecting, controlling, and preventing epidemics are crucial. Without these investments, new outbreaks will continue to threaten everyone’s health, regardless of wealth or degree of access to high-quality health care. Consequently, without investing in health, economic and social activities will face periodic disruptions on massive scales. In the old normal, countries invested insufficiently in public health and preparedness, and many countries invested too little in making health care service access equitable and effective. Despite the current context of fiscal restrictions, countries must prioritize investments that make them increasingly resilient and capable of facing emergencies and natural disasters.
Second, the region’s countries must accelerate progress toward UHC. The region has an unfinished agenda in terms of assuring the population’s access to health services of high quality that are cost effective and equitable. The policies to achieve this are not new, but their implementation is complex and presents significant challenges. Policies that need implementation include strengthening primary care, promoting integrated health care networks, improving quality of care, and investing in human resources. Improvements in efficiency can obtain more health for the money by allocating resources to more cost-effective treatments and medicines, negotiating better prices for pharmaceuticals and supplies, linking provider payments to results and quality of care, and reducing fragmentation in health financing. These urgent reforms must incorporate planning so that essential health care services can be maintained during emergencies with preparations that ensure key supplies are available, physical and human resources can be redeployed, and communication with the public is effective.
Third, the pandemic has demonstrated that digital transformation of the health sector is vital. Effective digital technologies can strengthen epidemiological surveillance, facilitate access to services, improve communication, and provide data for timely decisions. Countries need to invest much more in the digital transformation of health by implementing and strengthening governance, regulation, and standardization of health care technologies and by using electronic medical records, telemedicine, new apps, and artificial intelligence.
Finally, we have learned that the domestic health agenda is intimately linked to the international health agenda. International cooperation and solidarity are more important than ever, and LAC countries must revive and strengthen regional integration of health policies. Cooperation is needed to assure effective epidemiological surveillance. Regional agreements can leverage limited resources by optimizing diagnostic laboratory networks and by establishing mutual agreements for health regulations and drug approvals. As a group, the region has the scale necessary to invest in research and development, technology transfers, vaccine and pharmaceutical production, and storage and distribution logistics. To this end, countries must work with a medium- to long-term vision to strengthen their own capacities while building the mutual trust that is necessary for dividing and sharing responsibilities for the region’s health.
When it comes to health, returning to normal would mean accepting the inequitable, frequently low-quality, and inefficient care of the past. Instead, the pandemic has given us a wake-up call. It is challenging us to use the opportunities generated by this global crisis to break out of conventional constraints. By investing in public health, accelerating progress toward UHC, exploiting new technologies, and deepening regional cooperation, the region can build a healthier and more equitable future —and health care services that go beyond normal.