http://www.economist.com/world/americas/displaystory.cfm?story_id=13998616
Swine flu in Argentina
Pigheaded policies
Jul 9th 2009 | BUENOS AIRES
From The Economist print edition
The dangers of a reputation for dodgy statistics
AP
IT IS winter in South America?s southern cone, so it is no surprise that swine flu is rampant. But its impact is not uniform. It came first to Chile before it turned up across the Andes in Argentina. But in Argentina 2.4% of reported cases have resulted in the death of the patient while in Chile the corresponding figure is just 0.2%. Why?
Part of the answer seems to lie with the way that health services are organised. In Argentina health policies as well as health budgets are in the hands of provincial governments. That is a contrast not just with Chile?s centralised system but also with Brazil, which like Argentina is a federal country, but where the health ministry in Bras?lia sets overall national goals.
This means that when a bug strikes Argentina it is met by a health system whose officials talk to each other infrequently, have different objectives, and dip into pots of cash of widely varying size. For example, Santa Cruz, an oil-rich province in Patagonia, spends eight times more per head on health care than Corrientes, in the poor north-east, according to Daniel Maceira, a health economist. On July 6th several of the needier provincial health ministers were promised a bit more federal help to fight the flu.
A second factor that may have made things worse in Argentina is that the government may have been slow to respond. Some doctors accuse it of deliberately downplaying the outbreak until after a mid-term election on June 28th. The health minister resigned because her request to delay the election was denied (though she waited until after the vote to go). An advisory committee of medical experts assembled by the government has called for a national health emergency to be declared, but that has not yet happened.
The accusation of time-wasting may in fact be unfair. But Argentines have come to mistrust the authorities. Under Cristina Fern?ndez, the president, and her predecessor and husband, N?stor Kirchner, they have become accustomed to the government fiddling economic statistics, such as inflation and growth rates.
Rightly or wrongly, many seem to believe that officials have understated the number of people who have gone down with flu (which might be an alternative explanation for the seemingly high death rate). This week panicked Argentines travelled to Chile and Uruguay in droves to buy drugs such as Tamiflu, despite the government?s insistence that it would ensure there are sufficient stocks.
Chile?s response seems to have been swifter, better co-ordinated and more decisive. On the same day that the World Health Organisation raised the alert about swine flu back in April, Michelle Bachelet, Chile?s president, gathered a committee of experts to discuss the threat. It may have helped that Ms Bachelet is a medical doctor by profession.
Argentina?s halting reaction could affect the economy. Miguel Kiguel, a consultant, reckons that swine flu could shave 0.5% off GDP between July and the start of spring, in September. Theatres have closed down for ten days, the first time they have all gone dark since 1918 when Spanish flu swept the world. Brazil?s government has urged its citizens not to visit Argentina. Flights from Brazil to Bariloche, a Patagonian ski resort, have been cancelled. Unluckily for the town?s winter sports, swine flu is expected to die down only when the snow melts.
Swine flu in Argentina
Pigheaded policies
Jul 9th 2009 | BUENOS AIRES
From The Economist print edition
The dangers of a reputation for dodgy statistics
AP
IT IS winter in South America?s southern cone, so it is no surprise that swine flu is rampant. But its impact is not uniform. It came first to Chile before it turned up across the Andes in Argentina. But in Argentina 2.4% of reported cases have resulted in the death of the patient while in Chile the corresponding figure is just 0.2%. Why?
Part of the answer seems to lie with the way that health services are organised. In Argentina health policies as well as health budgets are in the hands of provincial governments. That is a contrast not just with Chile?s centralised system but also with Brazil, which like Argentina is a federal country, but where the health ministry in Bras?lia sets overall national goals.
This means that when a bug strikes Argentina it is met by a health system whose officials talk to each other infrequently, have different objectives, and dip into pots of cash of widely varying size. For example, Santa Cruz, an oil-rich province in Patagonia, spends eight times more per head on health care than Corrientes, in the poor north-east, according to Daniel Maceira, a health economist. On July 6th several of the needier provincial health ministers were promised a bit more federal help to fight the flu.
A second factor that may have made things worse in Argentina is that the government may have been slow to respond. Some doctors accuse it of deliberately downplaying the outbreak until after a mid-term election on June 28th. The health minister resigned because her request to delay the election was denied (though she waited until after the vote to go). An advisory committee of medical experts assembled by the government has called for a national health emergency to be declared, but that has not yet happened.
The accusation of time-wasting may in fact be unfair. But Argentines have come to mistrust the authorities. Under Cristina Fern?ndez, the president, and her predecessor and husband, N?stor Kirchner, they have become accustomed to the government fiddling economic statistics, such as inflation and growth rates.
Rightly or wrongly, many seem to believe that officials have understated the number of people who have gone down with flu (which might be an alternative explanation for the seemingly high death rate). This week panicked Argentines travelled to Chile and Uruguay in droves to buy drugs such as Tamiflu, despite the government?s insistence that it would ensure there are sufficient stocks.
Chile?s response seems to have been swifter, better co-ordinated and more decisive. On the same day that the World Health Organisation raised the alert about swine flu back in April, Michelle Bachelet, Chile?s president, gathered a committee of experts to discuss the threat. It may have helped that Ms Bachelet is a medical doctor by profession.
Argentina?s halting reaction could affect the economy. Miguel Kiguel, a consultant, reckons that swine flu could shave 0.5% off GDP between July and the start of spring, in September. Theatres have closed down for ten days, the first time they have all gone dark since 1918 when Spanish flu swept the world. Brazil?s government has urged its citizens not to visit Argentina. Flights from Brazil to Bariloche, a Patagonian ski resort, have been cancelled. Unluckily for the town?s winter sports, swine flu is expected to die down only when the snow melts.