I am very satisfied with the care I get. For me, telemedicine is excellent. If I have to come physically to the health center, I have to wake up very early in the morning and I lose a day of work.
Dr. Lisa de León provides remote assistance from the contact center located in Panama City, Panama. Fotograph: Javier Conte for the World Bank
Between March 2020 and June 2024, World Bank investments have contributed to important results in strengthening public health preparedness and in facilitating resilience in both health infrastructure and health financing.
From March 2020 to February 2022, the World Bank approved more than $1.1 billion under 12 dedicated COVID-19 operations in LAC and reallocated an additional $300 million in existing resources to support an immediate response to the COVID-19 pandemic and to strengthen preparedness for future health emergencies. These resources supported 22 LAC countries in combatting the pandemic through a range of measures, including: construction of temporary facilities in Guatemala and El Salvador to increase care capacity during the pandemic; enhancement of laboratory services and surveillance systems, including through wastewater epidemiology, in Belize, Colombia, Haiti, Honduras, Mexico, St. Lucia, Dominica, Grenada, St. Vincent and the Grenadines, and Peru; and procurement of vital medical supplies and extensive vaccination campaigns to control the spread of the virus, including the delivery of more than 133 million COVID-19 vaccine doses in Argentina with 82.5 percent of the population fully vaccinated. Faced with high infection and mortality rates, particularly in the country's largest city, Guayaquil, the government of Ecuador set an ambitious goal to vaccinate 9 million people, over half the country's population, in just 100 days. This effort was supported by the World Bank, which provided crucial resources for the emergency response and vaccination process. The government's strategic use of these resources, along with its collaboration with international and local partners, facilitated the rapid immunization of the population while supporting the most vulnerable groups and promoting economic recovery.
In response to the increasing impacts of climate change, the World Bank has funded activities aimed at making health infrastructure more adaptive to climate events and other disasters, while also mitigating health sector emissions. For example, the Sint Maarten Hospital Resiliency and Preparedness Project financed essential repairs to the island's only hospital following structural damage caused by Hurricane Irma. Upgrades included roof reinforcement and the installation of generators to ensure continuity of care during emergencies. The project also financed the installation of 108 seismic base isolators, a technology that will allow the building to withstand earthquakes up to a magnitude of six on the Richter scale. In 2023, the World Bank financed the installation of renewable energy systems in Haiti's five major health facilities and main laboratories in Les Cayes and Cap-Haitien. These systems have led to a 50 to 100 percent decrease in fuel consumption (depending on hospital size), freeing up an average of $1,200 per hospital per month, and enabling uninterrupted service during (increasingly frequent) power outages. Analytical work has also enhanced these efforts; for example, from August 2022 to September 2023, the World Bank used modeling and GIS techniques in Colombia to estimate the vulnerability of health facilities to primary climate change risks, informing the government's capital infrastructure investment plan for the health sector.
The World Bank has continued to emphasize the importance of maintaining and prioritizing health spending during economic recoveries to bolster public health systems for future crises. The 2023 paper "Health Financing in a Time of Global Shocks" analyzed government health spending in developing countries during the COVID-19 pandemic and emphasized the importance of resilient health financing amid global shocks. This includes advocating for taxes on alcohol, tobacco, sugary beverages, and ultra-processed foods in countries including Brazil, Colombia, Mexico, and Chile, as a means to enhance government revenue and reduce the prevalence of non-communicable diseases such as cancer, diabetes, and cardio-vascular diseases, reducing health inequalities and benefiting the poorest. In Colombia, for example, the World Bank provided technical assistance and financing for the preparation of a fiscal reform that included a new tax on sugar-sweetened beverages.
In many LAC countries, purchasing arrangements for health services present opportunities for improvement, both through the prioritization of the most cost-effective services and the strengthening of provider incentives. In Argentina, for example, the Plan Nacer and SUMAR programs have, over 20 years, laid the foundation for a national policy that provides incentives to provincial governments and public health care providers and finances a prioritized benefit package of around 700 interventions that provides basic health coverage and quasi-insurance to the otherwise uninsured population. As a result, the number of people with effective health coverage reached 6 million by mid-2022.
To build long-term resilience, the World Bank continues to focus on primary healthcare (PHC) as the backbone of the region's health systems, supporting significant improvements in the accessibility and quality of primary health care services. For example, the Costa Rica Program for Results operation supported the successful scale-up of the single digital health record (known as EDUS), from 50 percent of the country's PHC facilities in 2016 to 90.1 percent in 2023, increasing access to quality medical services by reducing equity gaps and promoting the interoperability of information across health platforms. The Panama Telemedicine Program, supported by the World Bank and the Japan International Cooperation Agency, served over 60,000 people with chronic diseases. The program significantly reduced travel time, waiting hours, and time off from work for medical appointments in 12 of Panama's 16 health regions. It also alleviated hospital congestion and improved access to healthcare services, particularly during the COVID-19 pandemic.