Machu Picchu, Peru.

Peru and COVID-19: Quick Response Hampered by Structural Failures

By Eduardo Dargent and Camila Gianella

Peru was among the first Latin American countries to implement legal measures that restrict civil rights in order to stem the spread of COVID-19.

On March 15, with 28 confirmed cases and no deaths, the government issued the Supreme Decree N° 044-2020-PCM declaring a state of emergency for 15 days. Measures in the decree included closing the borders, ordering a general lockdown, forbidding domestic travel, and closing schools, universities, churches, and all non-essential businesses, among others.

Essential services like water, electricity, urban transport, garbage, continued, but health services have been restricted to emergency and COVID-19 care; outpatient services have been suspended, as well as activities as vaccination campaigns, and tuberculosis case identification.  For people with chronic diseases or health conditions that require regular care, the Ministry of Health (MoH) implemented some measures to guarantee access to treatment (such as weekly distribution of drugs). The impact of these measures on morbidity, mortality, and quality of care remains unknown.

The government was fast to acknowledge the problems of adopting a strict lockdown with a quite limited social security system. With 70% of the population working in the informal sector with no benefits, authorities recognized the need to help people who depend on a daily income.

Taking advantage of good macroeconomic stability and abundant state reserves, the Ministry of Economics announced a series of policies to face this problem and issued Emergency Decrees to allow cash transfers for a total amount of 760 soles (around $220 USD), which were distributed among people living in poverty and independent workers. Emergency Decrees have been issued for business, providing extraordinary funds to complement workers’ salaries,  and allowing workers to withdraw up to 2000 soles from their private pension funds. More cash transfers are on their way, including one for informal workers not already benefited by previous transfers. In general, these quick and comprehensive actions were widely supported by the population, as shown in recent polls.

Yet these strict, early measures did not lead to better control of the disease, in comparison to other countries in the region. The state, which historically has lacked implementation capacity, has failed to deliver the cash and food that were supposed to keep citizens at home. The weak financial distribution system forced citizens to form long queues at banks to receive their cash transfers, creating another source of infection. Also, as expected, weakly regulated food markets have become hotspots for infection.

The impact over formal and informal employment has been devastating. In Lima alone, 1.2 million people lost their jobs between February and April 2020, which helps to explain the growing defiance of the quarantine. Many economically vulnerable workers in cities have started to migrate by foot to smaller cities and rural villages.

As initially feared, demands on the weak health system have exceeded both its disease control and treatment capacity. The health system has also shown a lack of capacity to produce trustworthy and comprehensive data (e.g., only on May 19th did the Ministry of Health begin to include ethnicity data in its COVID report). Data has not been accessible, and experts advising the government are concerned for the lack of willingness showed by authorities to heed their recommendations.  In summary, it remains unclear how decisions are being made by the government.

Prisoners in overcrowded prisons are particularly affected by the pandemic – this 0.3% of the population represents 6% of COVID-19 deaths — and the risks facing the population have not been addressed specifically. And, as in other Latin American countries, states have been slow to recognize and respond to the danger of locking down gender violence victims with their abusers. Transgender women, who also have been disproportionally affected, comprise another group neglected by the state response.

The government has failed to design a quick and comprehensive COVID-19 strategy that could be adapted to the reality of indigenous people and people living in rural areas. Neither has it communicated to indigenous organizations the government response to the pandemic. This failure has fatally facilitated the spread of the disease among these communities. Indigenous organisations have taken it upon themselves to push forward with contingency actions to counter the virus. They have also warned the United Nations about the threat posed by COVID-19 and the lack of action from the central government.

Two months ago, the government was praised by its quick response to the disease; adequate actions that most certainly saved thousands of lives. Nonetheless, these days Peru is among the most affected countries in the region with a high infection rate that risks to jump even higher when the quarantine relaxes. We believe that structural state weakness is crucial to understanding this outcome. Disturbingly, state weakness is making the government response to COVID-19 less transparent, as the response is mainly enforced through emergency decrees, to which civil society has almost no capacity to respond and which have not yet been subjected to oversight by the newly elected Congress.

 

Eduardo Dargent is a full professor at Pontificia Universidad Católica del Perú and researcher at CISEPA Pontificia Universidad Católica del Perú.

Camila Gianella is the Executive Director of CISEPA Pontificia Universidad Católica del Perú, a researcher at the Chr. Michelsen Institute and a Global Fellow at the Centre on Law and Social Transformation. 

The Petrie-Flom Center Staff

The Petrie-Flom Center Staff

The Petrie-Flom Center staff often posts updates, announcements, and guests posts on behalf of others.

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