The 2016 Summer Olympics in Rio (“Rio 2016”) are the first Olympic Games taking place in Latin America since 1968 in Mexico (not exactly a resounding success, we recall); it’s also the first time such an event is held in South America. People around the world are eagerly following the games on TV and social media, and Latin Americans are no exception. Despite all scandals and occasional sexism, the ongoing Games are a lot of fun. It is striking however, that the Latin American region, with some exceptions, still doesn’t live up to its sporting potential. One is tempted to compare this situation to ours, the situation we Latin health systems researchers often find ourselves in. “Not living up to ‘our’ potential” sounds rather familiar to many of us, and for the same reasons.
There is little support for health system researchers in the region. Curiously, the same countries that provide more support for their athletes also tend to be the ones that have prioritized health systems research. What do they have in common? Well, they have policies and good financial mechanisms to fund initiatives that lead to success in sports as well as to the development of more equitable health systems.
In the Latin American and Caribbean region, the countries that have won the most medals in the past are Cuba (over 200!), Brazil, Argentina, Mexico and Colombia. Up to date, over half of the region’s gold medals (72 to be precise) come from Cuba, where the government has allocated large amounts of state resources to pursuing (and achieving) international sporting success. You might say that’s perhaps not what a relatively poor country should focus on, but Cuba is also one of the countries that have put a great deal of effort on supporting health systems research. The Ministry of Public Health in Cuba has under its direction an initiative called The Research Program on Health Systems and Services Cuba. The program has a proven impact on health systems in terms of more equity, quality and efficiency in health services. And let’s not forget how Cuba became the first country to halt HIV mother-to-child transmission about a year ago.
Brazil invests the most in research and development as a percentage of its GDP (1.18%) – compare with the regional average of 0.69%. Together with the investments of Mexico and Argentina, the three countries represent 89.7% of all R&D spending in the region. Other countries like Costa Rica, Ecuador, Guatemala, Paraguay and Peru have a specific agenda of national priorities for research for health. On the other hand, Honduras, Panama, Mexico, Uruguay and Nicaragua have not established any national priorities for research for health. In Mexico, however, the Council of Science and Technology issues calls for proposals based on a lists of topics from where research topics are selected.
Admittedly, in 2009, the approval by all member states of PAHO’s Policy on research for health was a breakthrough towards supporting health research in the region. Progress has been made since then, but it has been uneven across the region. Efforts need to go beyond a few conferences aiming to bring academics together to share their experience (even if that’s a favourite pastime of academics around the globe 🙂 ). There is an urgent need to bridge the gap between academics, policy makers and activists. For the latter, see for example a movement like ALAMES (Asociación Latinoamericana de Medicina Social/Latin American Association for Social Medicine), whose presence is significant across Latin American countries. As for policies, a cornerstone for structuring some sort of national initiative for health systems research, some countries still need to add this to their national agenda. We also hope more and more Latin American health systems researchers will find their way to global health systems research symposia (like the one coming up in Vancouver). The Latin American delegation last time, in Cape Town (’14), wasn’t exactly of Olympic proportions. (Do you read this, Health Systems Global? 🙂 )
For now, we’ll keep celebrating our athletes’ triumphs who, defying the odds and in spite of scarce support, continue to let Latin American people dream. For example, the gold medal of Oscar Figueroa, a Colombian weightlifter, just a few days ago.