Weak primary health care could cost Caribbean, Latin America 165,000 lives

A new report from the World Bank and the Pan American Health Organization (PAHO) warns that Latin America and the Caribbean face staggering health and economic losses unless urgent action is taken to strengthen resilience within primary health care (PHC).

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The study, No Time to Wait: Resilience as the Cornerstone of Primary Health Care in Latin America and the Caribbean, was launched today during PAHO’s 62nd Directing Council in Washington, D.C., where ministers of health and regional delegates gathered. It projects that a disruption in PHC delivery of 25–50%—whether from a pandemic, natural disaster, or other crisis—could result in up to 165,000 preventable deaths and between US$7–37 billion in economic losses.

Those deaths could include more than 11,000 maternal fatalities, 10,000 child deaths, and nearly 150,000 deaths from noncommunicable diseases, alongside as many as 14 million unintended pregnancies.

“There is no trade-off between building strong primary health care and building resilience—they go hand in hand,” said Dr. Jarbas Barbosa, Director of PAHO. “Without resilient PHC, the next crisis will again hit the poorest and most marginalized communities the hardest.”

The report defines resilience as the ability of health systems to maintain equitable access to essential services before, during, and after crises, including pandemics, hurricanes, floods, heatwaves, and disease outbreaks.

COVID-19 Exposed Vulnerabilities

The Commission highlights how the COVID-19 pandemic underscored the fragility of health systems in the region. Although Latin America and the Caribbean account for only 8.5% of the world’s population, the region registered 30% of all COVID-19 deaths. Essential services, including maternal care, immunizations, and treatment for chronic illnesses, fell by as much as 50%, with some disruptions lasting two years.

Adding to the challenge, the region is among the most disaster-prone globally, yet health systems remain fragmented, hospital-centered, and underfunded at the primary care level.

“Strengthening primary health care is one of the greatest health challenges of Latin America and the Caribbean,” said Jaime Saavedra, Director of Human Development for the region at the World Bank. “Governments need to place primary health care at the heart of their agendas, invest in it urgently, and ensure universal coverage so that protecting lives and economies is not optional but a priority.”

A Five-Point Plan for Resilience

The Commission’s report outlines a five-point roadmap to build resilience in PHC:

1. Expand equitable and comprehensive care models to ensure culturally sensitive services for all communities.

2. Embed essential public health functions like surveillance, vaccination, and health promotion at the primary care level.

3. Place communities at the center by involving them in decisions and building trust through accountability and communication.

4. Work across sectors, recognizing the links between health, education, housing, climate resilience, and social protection.

5. Secure sustainable financing, with a focus on public investment and rapid funding mechanisms during emergencies.

The Commission stressed that resilient PHC is not only a health priority but also central to social stability and economic growth. The report urges governments to act decisively, closing financing gaps, strengthening governance, and investing in a digitally supported health workforce to ensure people-centered care can withstand future shocks.