HEALTHCARE
FOR ALL
Venezuela’s Health Missions
at Work
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Article 83 of the 1999 Constitution states that “Health
is a fundamental social right and the responsibility of the State, which shall guarantee it
as part of the right to life.” |
Despite Venezuela’s great wealth, poor and rural citizens historically lacked access to
basic healthcare services. Constitutional reforms in 1999 made healthcare
a fundamental human right afforded to all. To fulfill this mandate,
thousands of community health clinics have been established throughout
Venezuela to provide care and medicine to the country’s neediest citizens. According to Venezuela's Health Ministry,
more than 80 percent of the population now receives some form of
government-sponsored healthcare. Another striking achievement has been the
decline in postnatal mortality rates, which fell by 50 percent between 1995 and
2005.[i] Venezuela now has one of the lowest infant
mortality rates in Latin America, and is set to reach the UN Millennium
Development Goals by 2015. [ii]
HEALTH SYSTEM FOUNDATION
During the 1980s and 1990s, the public health sector
saw very little growth compared with the rapid expansion of its private sector
counterpart. For example, only 50 new public health facilities were established
in those two decades versus some 400 private clinics.[iii]
This effectively ruled out the universal delivery of public health services.
Moreover, during this period, public investment in health
was on the decline. Health expenditures
accounted for 13.3 percent of the national budget in 1970, falling to 9.3
percent in 1990 and a mere 7.89 percent in 1996, representing only 1.73 percent
of Venezuela’s GDP.[iv] The World Health Organization documented the
results, pointing out that between 1990 and 1998, Venezuela’s impoverished
population had reduced access to medical drugs because of cost-recovery
policies.[v]
All drugs were sold through private pharmacies, with the exception of the most
expensive treatments such as cancer medications and hormone therapies, which
patients had the option of obtaining through private nonprofit foundations.
Venezuela is now undertaking an aggressive program that is
changing the course of healthcare. Under Article 83 of the Constitution, which
makes the State responsible for ensuring universal access to healthcare, the
Venezuelan government has halted the process of privatization. Specifically,
the nation's oil wealth is now being used to finance direct healthcare and an
array of social programs known as social missions. Among these is Barrio Adentro, which provides free medical
services to the population. In 2005 alone, the state-owned oil company invested
$5 billion in the social missions. This
figure is in addition to the regular budget of the Ministry of Health.[vi]
INSIDE THE
BARRIOS
Mission Barrio
Adentro (Inside the Barrio)
began in 2003 as a humanitarian effort undertaken in Caracas with the
assistance of Cuba. Since then, it has
grown into a national public health program committed to wiping out the
healthcare deficit through a partnership of the Venezuelan Ministry of Health,
the Cuban Medical Mission in Venezuela, and the Office of the Pan American Health
Organization in Aruba, the Netherlands, and Venezuela.[vii] Barrio Adentro began by necessity after
too few Venezuelan doctors responded to calls to join a government campaign to
provide care to underserved populations in impoverished neighborhoods.[viii] Because the Venezuelan medical community showed insufficient
response, the government turned to Cuba,
which is renowned for its medical missions, and has doctors volunteering in 69
countries in Africa, Latin America, and the Caribbean.
Barrio
Adentro has already sent an estimated 20,000 Cuban doctors to Venezuela to
serve in poor communities, sometimes even living with residents until a community
health clinic equipped with a housing unit can be built. Moreover, thousands
of community-based health committees have been established to organize
door-to-door surveys to determine local needs and develop a comprehensive plan
for health improvement. Since 2003,
doctors have conducted over 40 million consultations, and health professionals
have held millions of additional educational programs focusing on preventing
high-risk behaviors and improving nutrition.[ix]
By Barrio Adentro’s own estimates in May 2007, almost 50,000 lives had
been saved since the mission began.[x]
Record numbers of young Venezuelans are also training to become community
doctors so that they can provide full care for their own communities. Some 2,000 Venezuelans were awarded medical
degrees toward this effort in April 2007.[xi]
Due
to the mission’s great success, Barrio Adentro II and Barrio Adentro III have
also begun. The first aims to make critical medical services available to the
poor through the construction of high tech diagnostic and rehabilitation
centers throughout the country, and the latter will expand the nation’s public
hospital system.
ACCESS TO
PRESCRIPTIONS: THE SUMED PROGRAM
The SUMED (Distribution of Medicine) program complements the
efforts of Barrio Adentro by subsidizing a national chain of pharmacies at
which prescription drugs are 30 to 40 percent cheaper than market prices.[xii]
The program focuses on distributing essential medications and vitamin
supplements. Victims of AIDS, cancer and chronic diseases also receive
cost-free treatment and medication. Now, more than 4,400 community health
clinics offer 129 essential medicines and treat over 97 percent of the most
common illnesses in Venezuela.[xiii]
DIET AND NUTRITION
To confront poverty and hunger, the Venezuelan government created programs that provide high-quality food at low prices, using commercial and social food distribution networks to reach the poorest sectors of the population. The Agricultural Supply and Services Corporation (CASA) and Subsidized Price Food Markets (MERCAL) work together to meet the nutritional requirements of these citizens, which the Venezuelan National Institute for Nutrition estimates to be 2,600 calories per day.[xiv] MERCAL, for instance, specializes in reaching Indigenous and rural communities through mobile markets, fleets of trucks that deliver food through rugged terrain in order to provide food at discounted prices. Today, over 8 million people are benefiting from a network of 6,000 markets that distribute more than 7 million pounds of food daily.[xv] Testament to the success of the program, an estimated 150,000 people living in extreme poverty in Venezuela are now able to eat a healthy diet each day at no cost.[xvi]