Venezuela, Public Healthcare Catastrophe with Regional Consequences

A report by Human Rights Watch and Johns Hopkins Bloomberg School of Public Health released on 4 April of this year sets out a devastating picture of the humanitarian emergency presently occurring in Venezuela. The report is based on 156 interviews with health-care professionals, Venezuelans seeking or needing care for a range of illnesses who had recently arrived in Colombia or Brazil, representatives from international and non-governmental bodies, UN officials, and Colombian and Brazilian government officials.

According to the report, the health-care system is in a state of ‘utter collapse’, and further urges the UN to declare a humanitarian emergency in relation to Venezuela, which would trigger a full-scale response and the provision of food, medicines, and medical supplies. Nicolás Maduro’s government has been held largely to blame for the lack of a co-ordinated international response being implemented through the failure to acknowledge the full scale of the crisis, and through the refusal of outside help. Following years of denial that the country was indeed in the throes of a humanitarian emergency – and with Maduro claiming that such assistance would constitute interference with Venezuela’s internal affairs – the Maduro government finally allowed the Red Cross to send in 24 tons of medical equipment on 16 April of this year.

The roots of the crisis

The humanitarian crisis in Venezuela needs to be understood in relation to the broader collapse of the country’s economy. One of the key factors behind this crisis is oil, of which Venezuela has the world’s highest reserves. Undoubtedly, the high price of oil in between 2003 and 2008, and in between 2010 until mid-2014, allowed for significant social gains particularly during Hugo Chávez’s time as President. These social gains included a doubling of state spending on health-care and education and a reduction of poverty and unemployment by half. However, Venezuela, a petrostate – was over-dependent on oil revenues, at the expense of other industries. Its public spending was further beyond its means.

In 2015, Venezuela’s oil dependency was stark, with oil representing 96% of Venezuela’s exports and comprising over 60% of government revenues. The international price volatility of oil was thus directly correlated with Venezuela’s economic performance, and helped explain the prompt contraction of Venezuela’s GDP after the 2014 oil price fall. Between June 2014 and December 2015, the price of oil fell by two-thirds, from over $100 per barrel to $37 per barrel. This was accompanied with years of steady decline of oil production. Without the revenue from oil exports, Venezuela has struggled to import the things its people need, including essentials such as food and medicine. The International Monetary Fund has predicted that Venezuela’s inflation will reach an astounding 10,000,000% in 2019. The primary cause of this hyperinflation has been attributed to the central bank printing money to fund huge public spending deficits.

A public healthcare catastrophe

The economic crisis in Venezuela has had severe consequences on the country’s health-care infrastructure. Shortages in medications, health supplies, disruptions of basic utilities at health-care facilities, and the emigration of health-care workers have led progressive decline in the operational capacity of healthcare and significantly affected the public health of the Venezuelan people. Venezuelan authorities under Maduro have attempted to conceal the crisis by not publishing official health information. However, epidemiological bulletins for half of 2015 and all of 2016 were released in May 2017, which showed a 30% increase in infant mortality, a 65% increase in maternal mortality, a resurgence of diphtheria, and increases in cases of malaria, Zika, TB, and Hepatitis A. Following the publication of this information, President Maduro dismissed the then Health Minister Antonieta Caporale, and replaced her with a staunch supporter, Luis López. The epidemiological bulletins were taken down from the Health Ministry’s official website and have not been re-posted since. No additional bulletins have been published since then, nor have authorities published any other official health data.

As the Human Rights Watch report provides, Venezuela is now experiencing increased levels of infant and maternal mortality, as well as routine outbreaks of vaccine-preventable diseases that had once been eliminated from the country. For example, between 2008 and 2016, only a single case of measles was recorded – in 2012. Since June 2017 however, more than 9, 300 cases of measles have been reported, of which more than 6,200 have been confirmed. Further, Venezuela did not experience a single case of diphtheria – an acute and highly infectious disease of the upper respiratory tract and skin – between 2006 and 2015. But more than 2,500 suspected cases have been reported since July 2016, including more than 1,500 confirmed cases. The World Health Organization has additionally reported that confirmed malaria cases in Venezuela have also increased – from 36,000 in 2009 to more than 414,000 in 2017. Hunger, malnutrition and severe shortages of food are also pervasive.

Regional consequences

The threats posed by the public healthcare crisis are not solely restricted to the borders of Venezuela. A recent study published in The Lancet Infectious Diseases warned that infectious diseases could spread beyond Venezuela’s borders, potentially causing a regional public health emergency. Indeed, neighbouring countries such as Brazil have reported an escalating trend of imported malaria cases from Venezuela, from 1538 in 2014 to 3129 in 2017. Within such a context, one can only hope that the assistance that the Venezuelans so desperately need is allowed to continue reaching them by the Maduro government.