Caracas Chronicles

Photo: Quartz

Last year, when diphtheria made its reappearance in Venezuelan ERs, we thought it couldn’t get any worse. We were already under heavy attack from the most challenging, ugliest of parasites (malaria), maternal mortality rates were the highest in Latin America, highly qualified health care personnel were fleeing the country by the hundreds and supplies, vaccines or functioning operating rooms were extinct.

That horror movie seemed like el llegadero, right? Think again. It’s not only that all of the above has stayed pretty much the same (or worse), we now have the icing on the cake: polio is back.

It’s not only that all of the above has stayed pretty much the same (or worse), we now have the icing on the cake: polio is back.

The outbreak was first reported all over national media last Thursday, when a statement by Venezuela’s Public Health Society and the Defendamos la Epidemiologia national network said a five-year-old Warao was diagnosed with Acute Flaccid Paralysis (AFP) in Delta Amacuro. A sample was reportedly taken from the child in April, and sent to the National Institute of Hygiene where it was confirmed that, indeed, the child was infected with polio type 3. Two other children presented AFP, suspected to be caused by polio too (according to that source).

Despite the fact that polio is a Notifiable Disease, and any case must be notified to the World Health Organization (WHO), its Pan American branch (the Pan American Health Organization, PAHO) issued an Epidemiological Update last Friday, stating it first found out about the polio case from an “unofficial report” and it demanded information from the Venezuelan IHR National Focal Point (NFP).

According to the PAHO/WHO update, the confirmed case is a two-year-old. The report also claims there’s another suspicious case, an eight-year-old girl who resides in the same community as the confirmed case. PAHO states no more cases of AFP have been found through active search.

PAHO first found out about the polio case from an “unofficial report” and it demanded information from the Venezuelan IHR National Focal Point (NFP).

José Felix Oletta, former Health minister, says there are three other suspicious cases in Delta Amacuro, and PAHO is trying to determine the origins of the outbreak. He also claims it took the government a month to notify the case, despite WHO’s International Health Regulations demanding it must be made within 24 hours.

To further increase the misinformation, just a day before PAHO’s director, Carissa Etienne, is set to arrive at Venezuela for a meeting, the Health minister, Luis López, went on the record to deny any confirmed polio cases in the country, saying he “has no information” about it and, so far, “there’s no record of it. In here, it’s Venezuela who certifies it, not PAHO/WHO.”

In a candid interview, the minister went as far as saying NGO Codevida was a cartel, with a subtle threat to health syndicalist Pablo Zambrano, for being outspoken about health workers’ rights. All of that while denying the humanitarian crisis.

From now on, he says, Venezuela will purchase drugs for chronic diseases through PAHO and no longer depend on intermediaries, as a way to overcome the “economic blockade”.  The minister also threatened, again very subtly, with occupying the remains of the operative pharmaceutical industry left in the country.

Health minister, Luis López, went on the record to deny any confirmed polio cases in the country.

Lopéz also referred to the measles cases reported in Venezuela as “caused by an imported case from Europe”. Sure, and polio is back because we brought it from where, minister?

Those cases took place in 2017; as of today, Venezuela is responsible for 1,427 of the 1,685 reported cases in the Americas. PAHO says there’s currently an active transmission of the disease between 17 states, with most cases coming from Bolívar State.

It doesn’t take an expert to figure out why these outbreaks are happening: The government dropped the ball on the Expanded Programme on Immunization (EPI). We’ve been reporting about this since last year; with no official figures for 2017. In 2016, the coverage was as little as 82%. In 2018, the diseases speak on their own.

Frustration is what comes to mind when thinking about decades of lost work in immunization because of this government’s inefficiency. Venezuela, once an example in Public Health Policies, is a rampant danger for the whole region.