This blog was written by Carolina I. Andrada, intern at the Johns Hopkins Center for Health Security, and Andrés Constantin
On October 15, 2018, the Medical Federation of Venezuela (FMV) alerted that the nation’s measles epidemic had become sickeningly large. The FMV’s president, Douglas León Natera, warned that the case count had surpassed 650,000 and that the size of the epidemic could largely be attributed to dangerously low levels of medical supplies at hospitals. As a vaccine-preventable disease, measles should not have made such a shocking resurgence. However, given the near-collapse of Venezuela’s health system, measles is one of the many manageable diseases that have become deadly in Maduro’s Venezuela.
The deterioration of the Venezuelan health system is not new news. In the last few years, Venezuela’s health system has become infamous for its sudden and dramatic demise. Reports have detailed how Venezuelans struggle with shortages of food and medical supplies, and the effects that these have on sick Venezuelans seeking care at empty-shelved medical facilities. Venezuelans have spoken out against the illness-inducing shortage of food and medical supplies.
Faced with this situation, many Venezuelans and people living in Venezuela have decided to flee the country in search of better conditions. However, leaving their country has not meant an improvement in their health and access to food. The massive departure of people from Venezuela, motivated by a humanitarian emergency caused by the breakdown of democratic institutions, the rule of law, and massive violations of fundamental rights has generated a human mobility crisis that calls for national, international and humanitarian protection for the affected population.
Despite different solutions offered to these people, most of them have been insufficient and sometimes restrictive in the face of the magnitude of migrant and refugee flows. In this context, the governments of the Americas must recognize, guarantee and protect the rights of the populations that are particularly affected, and develop differentiated care and protection plans for children and adolescents, women, LGBTI persons, the elderly, people with disabilities, indigenous peoples, afro descendants and Roma, as well as to any other person who is in a situation of special vulnerability.
Venezuela has also failed to uphold the International Health Regulations (2005), a legally-binding document which establishes the framework for protecting people from the development and spread of infectious disease. Specifically, Venezuela has violated Article 13, which states that “each State Party shall develop, strengthen and maintain… the capacity to respond promptly and effectively to public health risks…”. Although the same article explains that States Parties have up to five years to fulfill this and other requirements, many countries have been granted extensions. This is the case of Venezuela, which has already been granted the maximum amount of time to fulfill its responsibilities as a signatory to the IHR (2005), and yet has failed to uphold the IHR (2005) requirements. Similarly, Venezuela has been systematically violating its obligation under Article 12.2 (c) of the International Covenant on Economic, Social and Cultural Rights (ICESCR) to prevent, treat and control epidemic and endemic diseases.
The failure to uphold the IHR (2005) and ICESCR is especially grave given two factors. First, the ongoing outbreak of measles, which is highly contagious, has already spread from Venezuela to a number of surrounding countries via migrants fleeing the chaos. Brazil recently slammed the Venezuelan government for permitting the outbreak to grow to an unmanageable size. Colombia, too, has succumbed to the pestilence, reporting the first case of measles in years imported by a 14-month-old from Caracas. Second, measles is unfortunately not the only infectious disease that has been able to take advantage of Venezuela’s crumbling health system. Diphtheria is among the many other infectious diseases that have made headlines for reemerging in Venezuela, and, like measles, is vaccine-preventable. Malaria and other vector-borne diseases have also reappeared in large numbers, potentially due to lack of vector control.
The rapid decline of the Venezuelan health system has mirrored and contributed to the collapse of political and economic systems within the country. Without a solution to the inaccessibility of medical supplies such as vaccines and insulin, and the collapse of health systems which support contact tracing, vector control, and basic healthcare for impoverished people, Venezuela’s health crisis will continue to spiral downwards and extend its impact and effects across its border.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.