PORT OF SPAIN, Trinidad – The Plan for self-sufficiency in health matters in Latin America and the Caribbean: lines of action and proposals is a strategic document setting outlines of action to strengthen capacities to produce and distribute vaccines and medicines in the region.
It was prepared by the Economic Commission for Latin America and the Caribbean (ECLAC) at the request of the government of Mexico, in its capacity as Pro Tempore chair of the Community of Latin American and Caribbean States (CELAC).
The pandemic has highlighted the need for strong health systems and capacities. This document proposes seven lines of action that include short- medium- and long-term initiatives to strengthen mechanisms for pooled international procurement of vaccines and essential medicines; use public procurement mechanisms for medicines to develop regional markets; create consortiums for the development and production of vaccines; implement a regional clinical trials platform; take advantage of regulatory flexibilities to gain access to intellectual property; strengthen regulatory convergence and recognition mechanisms, and strengthen primary health systems for equitable distribution of vaccines and universal access to them.
These lines of action and proposals for a plan for self-sufficiency in health matters in Latin America and the Caribbean are a call to action and set a clear and specific agenda, while advocating and requiring greater regional integration, cooperation and solidarity.
Foreword
The pandemic caused by the coronavirus disease (COVID-19) has highlighted the unprecedented vulnerabilities and challenges facing Latin American and Caribbean countries in the health, economic, social and productive spheres.
This region has been one of the hardest hit by the COVID-19 crisis. Despite the fact that it is home to just 8.4 percent of the world’s population, it accounted for 20.1 percent of COVID-19 infections and 32 percent of deaths by end-August 2021. This has placed the region in a critical situation, prompting it to re-evaluate strategies and public policies and to shift priorities related to productive, technological and health capacities.
In view of the extent of the challenges facing the countries of the region, Mexico, in its capacity as Pro Tempore Chair of the Community of Latin American and Caribbean States (CELAC), requested the Economic Commission for Latin America and the Caribbean (ECLAC) to prepare a plan for self-sufficiency in health matters for the region, not only assessing and analysing the situation but also advancing lines of action for strengthening capacities to produce and distribute vaccines and medicines in CELAC countries.
To this end, ECLAC conducted an in-depth review of vaccination progress (procurement, inoculation, development and production, scenario estimation), established a working group of over 20 experts from different countries in the region, assessed the region’s capacities, highlighting institutional capabilities for policy design and implementation, and developed recommendations for strategies and lines of action.
In a changing and uncertain global and regional scenario, the lines of action and proposals presented herein call for reflection and action on short-term constraints (access to and administration of vaccines) as well as long-term needs (investment driven by industrial policies). Moreover, the plan recognizes the key role of science and technology policies and boards, as well as the substantial financing that is urgently needed to move towards self-sufficiency in health matters. It also highlights the important role of regulatory agencies and competition policies, and the advantages of a strategic approach to intellectual property. This all calls for an analysis of the institutional capacities of governments, with particular attention to organizational weaknesses in institutions, with a view to improving coordination in national strategies and drawing useful and practical lessons for CELAC countries.
The lines of action and proposals included in the plan for self-sufficiency in health matters Latin America and the Caribbean had to take into account the specificities of the pharmaceutical industry and supply- and demand-side issues. The supply-side analysis covered all links in the industry chain, from research and development to the production and distribution of vaccines and medicines. On the demand side, the plan affords special consideration to the public primary healthcare system and its role in the access to vaccines and medicines and their efficient distribution, given their potential for driving new activities.
The ultimate goal of regional self-sufficiency in health matters will require substantial investment in resources in the medium and long terms, especially to build capacity in weak sectors or creating capacity where there is none, as in the case of messenger RNA vaccines. However, the region also needs to finance responses to immediate or very short-term emergencies, such as the need to source COVID-19 vaccines on the international market to cover its population.
The plan for self-sufficiency in health matters and the initiatives it contains are regional in spirit, with proposed lines of action that can be implemented at regional or subregional level. While a plan of this nature requires capacity-building in each country and recognizes the importance of national policies – its focus is not on domestic proposals but on regional cooperation and integration.
Pursuant to the mandate given by CELAC and based on the work of the group of experts established for this purpose, ECLAC has defined and prioritized seven lines of action:
(i) Strengthen mechanisms for pooled international procurement of vaccines and essential medicines
(ii) Use public procurement mechanisms for medicines to develop regional markets
(iii) Create consortiums for the development and production of vaccines
(iv) Implement a regional clinical trials platform
(v) Take advantage of regulatory flexibilities to gain access to intellectual property
(vi) Strengthen regulatory convergence and recognition mechanisms
(vii) Strengthen primary health systems for equitable distribution of vaccines and universal access to them
These lines of action are supported by an exercise to identify key stakeholders and assess regional capacities in research, development and production in the pharmaceutical industry. The progress associated with this supporting exercise is presented under the heading “Inventory of capabilities”.
ECLAC wishes to thank the countries of CELAC for the opportunity to propose a plan that is a call to action and sets a clear regional agenda. We firmly believe that to fully benefit from the hard lessons learned from the COVID-19 pandemic, greater regional integration, cooperation and solidarity are of the essence.
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This document was prepared under the direction of Alicia Bárcena, Executive Secretary of the Economic Commission for Latin America and the Caribbean (ECLAC), with the collaboration of Mario Cimoli, Deputy Executive Secretary.
