WASHINGTON — Venezuela has wiped out 18 years of gains in infant mortality rates as the country continues to experience economic and political instability that has triggered a massive humanitarian crisis, a new paper published in The Lancet has found.
“There has been a constant denial from government officials of the health crisis in recent years,” said Jenny García, one of the report’s authors. “Losing 18 years of progress is a lot. That is really shocking. After having 50 years of constant decreasing infant mortality, we still are going back to the ‘90s.”
The country has not published official mortality statistics since 2013, which presented a challenge for the study authors attempting to get an accurate picture of the health crisis within Venezuela. García said the research team used an aggregation of data including birth and death records, census information, and a national survey of the Venezuelan population’s living conditions administered by three Venezuelan universities.
“Part of what has broken down here is a lot of the basics of public health, childhood immunizations, malaria programs, water and sanitation.”— Chris Beyrer, professor, Johns Hopkins Bloomberg School of Public Health
Venezuela had shown one of the largest improvements of infant mortality reduction in Latin America between the 1950s and 2000. But The Lancet’s data analysis found that in 2016 the infant mortality rate was 21.1 deaths per 1,000 live births — nearly 1.4 times the rate in 2008 (15 deaths per 1,000 live births).
Researchers found that divestments in the public health system beginning in 2007 caused the deterioration of infant mortality rates beginning in 2009 that has continued to the present day. Between 2007-2009, the Venezuelan Ministry of Health stopped vaccinating children under 5 against polio, diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type B. Nearly 20 percent of children were not vaccinated in 2010, and shortages of basic medical supplies have increased the health care cost for individuals.
García noted that due to the lack of availability of data and the modeling the team used, estimates are likely conservative in measuring the impact Venezuela’s economic collapse has had on public health.
“If things could be improved in terms of the quality of the estimation, [it would] show that they are worse. Worse than 18 years is pretty shocking,” García said. “It’s always a challenge to try to combine different data sources, because each data source has their own limitations or assumptions. We try to produce the most reliable estimations, the most probable estimations, that we could know in Venezuela with the lack of data. When we saw the different sources, we found similar trends.”
Child mortality is used to measure the scope of a health crisis for numerous reasons, said Chris Beyrer, a professor at Johns Hopkins Bloomberg School of Public Health, who wrote an accompanying comment published with The Lancet’s article.
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“From a public health perspective, it’s a very sensitive indicator of what is happening in terms of the health systems,” Beyrer said. “When you have a country that has had five steady decades of decline in infant mortality, that is almost always because of the success of interventions around the basics: maternal/child health and nutrition, childhood immunization, management of diarrheal disease, management of infectious diseases like malaria. All of those things bring down infant mortality.”
Child mortality, Beyrer said, is “almost always” malnutrition combined with another condition. According to The Lancet’s article, 61.2 percent of the Venezuelan population was in extreme poverty in 2017, and 89.4 percent of households said they didn’t have enough money to buy food. In the last three months, 61.9 percent of the adult population went to bed hungry at least once.
While some NGOs are operating in Venezuela, President Nicolás Maduro has refused international humanitarian aid. The deteriorating situation has led countries in the region to accept hundreds of thousands of people fleeing Venezuela, where basic supplies such as flour and toilet paper are unavailable or very expensive. On Thursday, the World Bank’s Global Concessional Financing Facility announced that Colombia was eligible for funds through the mechanism that provides support to middle-income countries dealing with a large influx of refugees and migrants.
Beyrer said that if the situation in Venezuela cannot be addressed, it will increasingly spill across borders and threaten public health in other countries in the region.
“Part of what has broken down here is a lot of the basics of public health, childhood immunizations, malaria programs, water and sanitation, and those kinds of things that can’t be addressed within the country without an agreement and the reinvigoration of the public health sector,” Beyrer said. “That ultimately is why we made the call in this comment to call this a complex humanitarian emergency, because that requires the public sector.”