We are living a historic and critical moment in Latin America. The Covid-19 pandemic has devastated the countries of the region due to the severity of the health crisis and the inability of most governments to respond adequately. The crisis has increased inequality, poverty, hunger, unhealthy conditions, inflation and external debt. It has also intensified political and social tensions manifested in the proliferation of revolts and social outbursts and in the confrontation between democratic and extreme right-wing forces. Neoliberal economic models based on environmental destruction, market fundamentalism, the extermination of native peoples and Afro communities, patriarchy and class exploitation have been in crisis, as have the models of restricted democracy and authoritarian state that sustain them.
The pandemic also highlighted the failure of the region’s health systems to meet collective needs. This is due to the legacy of decades of neoliberal reforms that commodify and privatize health. It is also due to the persistent colonial rationality of health policies, centered on the dominant interests and perspectives of the global north. In the 2000s and 2010s, even when the social advances of the pink tide were consistent, there were great difficulties in overcoming the structural limits of social protection systems, generally incomplete, stratified, fragmented, heterogeneous and permeated by strong private interests. These systems have contributed to maintaining unequal societies and restricted citizenship, or even to denying the humanity of marginalized individuals and communities in rural and urban areas.
The scope of the right to health has been limited by a biomedical vision focused on individuals and diseases, which has made it easier to turn our systems into private and profitable businesses hegemonized by the Medical, Industrial and Financial Complex, emptying the community content, the social determination of health and interculturality. This vision has also prevented us from facing and avoiding epidemics and pandemics and the threat to human survival and the persistence of biodiversity posed by the ecological crisis we are experiencing.
On the other hand, the increase in social tensions has led to the need for changes in the agenda of social movements and governments in the region. A new historical momentum is opening up in the struggles for the universal right to health and life in the region. Either by updating the historical demands for the construction of public, unique, universal, integral, sovereign and solidary health systems, and against the mercantilization of health. Either by incorporating new issues such as pluriculturality, racial and gender justice, environmental justice and the decolonization of health policies.
The construction of alternative futures requires the formulation of new socio-health and cultural agendas and collective action for the transformation and decolonization of our health systems. Achieving changes in health will only be possible by strengthening the struggles for life and for structural transformations in our societies.