The rise of the revolutionary policies
Back in 2019, way before the rise of the COVID-19 crisis, Peru was amidst debate over implementing a legal framework that would establish the obligatoriness of generic drugs in pharmacies. Later, on October 30, this initiative got consolidated with the Decree of Urgency n˚7 , which not only made possible for countless Peruvians in situations of poverty to access to affordable medicines, but also regulated measures to ensure the availability of strategic resources for the health of the citizens like medical devices, medicines, and sanitary products across public hospitals. Also, this norm recognized the role of the World Health Organization (WHO), United Nations Children's Fund (UNICEF) and United Nations Population Fund (UNFPA) as allies on this mission (El Peruano, 2019).
Therefore, the Human Right to Health, a transcendental element for ensuring the well-being of a person and protecting their Human Right to Life, was included in the country’s social protection legal framework and made available to the population in need. Providing medicines or making them more affordable not only contributes to improving people’s health condition but weighs in to take them out of the poverty cycle and allowing expenditures to focus on other areas of life – such as nutrition and education.
The political debate over the subject highlighted other health-related issues that needed attention, such as the fact that over 4 million Peruvian citizens lack the affiliation to a healthcare plan (INEI, 2017). Moreover, there is a clear consensus on the Peruvian Government to hear the demands of the people and identify their urgent needs to take swift action. Through that guideline, another Decree of Urgency, the 17th one, was approved on November 27, 2019. From that point forward, everything changed: the Government of Peru stopped being reactive and became proactive by taking such a bold step of establishing the Right to Universal Health Care (El Peruano, 2019). Fundamentally, at the core of this universal healthcare is the affiliation of those Peruvian citizens, who lack any healthcare (private or public), to the Seguro Integral de Salud (Integral Insurance of Health), also known as SIS.
According to the WHO, there are 3 dimensions of the implementation of Universal Healthcare that are (1) population coverage, (2) service availability and quality, and (3) financial protection. Governments must ensure their compromise to their people and take the necessary budgetary measures to offer healthcare of quality (WHO, 2019). The universal healthcare coverage provided through the SIS allows for inclusivity and ratifies the importance of Human Rights. Now, all Peruvians can have medical attention, procedures, treatment, and medicines for free of charge for over 1400 issues, including some types of cancer, due to it being included in the coverage of the universal healthcare (Government of Peru, 2019).
An early version of the SIS in 2017 focalized around people who are in any conditions of poverty, pregnant women, children under 5 years old, firefighters, students beneficiaries of the Programme Qali Warma, victims of the violence of armed conflict, the imprisoned, people in rehabilitation or juvenile centres, children and teens of public shelters or non-lucrative private shelters, vulnerable populations determined by the Ministry of Development and Social Inclusion, homeless people credited by the Ministry of Women and Vulnerable Population, peace judges, former employees irregularly fired, among others (Government of Peru, 2017). With the 2019’s Decree of Urgency, the system really transformed into a universal healthcare that does not leave anyone behind. That’s because, independently of their socioeconomic status, every Peruvian that lives on the national territory that lacks any insurance/coverage of healthcare will be affiliated to the public healthcare SIS. Thus, the citizens are at the forefront as well as the State’s supreme purpose of guaranteeing the protection of the Right to Health. Naturally, this measure taken by the Government not only protects and strengths the Right to Health but others like the Right to Equality, the Right to Wellness, among others.
The learning curve
The year 2020 has been called by the Government of Peru as the “Year of the Universalization of Health” (El Peruano, 2020). How this measure goes from theory to practice is going to be a great task for the Peruvian authorities to see the effectiveness of the decision taken. The importance is to learn from any mistake that arises and to improve the mechanisms already in place to ensure the citizens’ experience the public health services through its use in a smooth and professional way.
Regarding the last dimension pointed by the WHO, the Health Sector will require more money to effectively exercise the coverage of healthcare to the citizens. Plus, contingency budgets will have to be put in place in order to ensure the continuance of the coverage of the service. Naturally, a measure with such wide reach across the national territory, such as universal healthcare measure, is going to require the economic resources for such feat, that’s why the Tax Administration should be more adamant in collecting the debts owed to them by other institutions, people & enterprises.
Another aspect that will be of vital necessity going forward is international cooperation. Diverse international organizations like the WHO or countries that already have their own universal health system can provide the Ministry of Health with their technical recommendations on diverse matters of implementing universal healthcare. The Government of Peru could set a special commission that receives and evaluates these recommendations.
During this pandemic, health systems around the world have collapsed due to increased demand associated with the coronavirus crisis. In Peru, for those who have less, among this context, there is a glimmer of hope in the form of the country’s universal healthcare coverage. Since all the measures were in place for the Peruvian State to afford to finance this universal healthcare coverage, those who have less have not been left at the mercy of this sickness. For instance, the SIS covers the complete handling & treatment of COVID-19 patients, as well as any funerary arrangement (Government of Peru, 2019). Due to proactive governmental action, Peruvians have not faced abandonment against the COVID-19. Instead, they have been embraced by the health personnel and supported by their own country.
Also, it’s worth mentioning that 2 million 500,000 Peruvians have been affiliated to the SIS, immediately improving their quality of life. The Prime Minister of Peru, Vicente Zeballos, has said that as of May 11, 2020, Universal healthcare has made it possible that 95% of the Peruvian population currently has access to healthcare (El Peruano, 2020). In the battle against coronavirus, where all efforts are made in order to save as many lives as possible, there’s no doubt it comes as an immense relief for the Peruvian people that the decisions taken by their Government in 2019 are having a positive impact, nowadays, in regards to the protection of public health.
Due to years of neglect from previous governments, the Peruvian health system is a pond of logistical, technological, and infrastructural problems. But, between the universal healthcare coverage and the fight against coronavirus in the country, the health system has shown strength in the eyes of the public and the authorities, and it marked its importance as a fundamental pillar of society.
Still, a reform of the health system is necessary for the population to access better health services and to improve the capacity of hospitals around the country. Implementing and maintaining universal healthcare will benefit a lot of Peruvians, but the health system must be up to the task. Both the governmental decision and the coronavirus crisis have served to take health to the forefront and start the conversation about improving this highly essential public service. Peru has the responsibility to improve its health services to consolidate this universal healthcare, but now has another responsibility as a nation; it can lead to a new era of universal healthcare around the world. Making universal healthcare triumph can strengthen Human Rights worldwide and incentivize other countries to follow. Let’s make way for universal healthcare; no cost is too big if it can change lives for the better.
List of References
Decreto de Urgencia N.° 007-2019. Diario Oficial El Peruano, Lima, Peru, October 30, 2019. Access here.
Decreto de Urgencia N.° 017-2019. Diario Oficial El Peruano, Lima, Peru, November 27, 2019. Access here.
Decreto Supremo N.° 002-2020-PCM. Diario Oficial El Peruano, Lima, Peru, January 9, 2020. Access here.
El Peruano. (2020). El 95% de los peruanos ya cuenta con un seguro. Access here.
Government of Peru. (2017). Condiciones para afiliarse al SIS gratuito. Access here.
Government of Peru. (2019). Seguro Integral de Salud. Access here.
Instituto Nacional de Estadística e Informática. (2017). Población afiliada a algún seguro de salud. Access here.
World Health Organization. (2019). Arguing for Universal Health Coverage. Access here.
 A Decree of Urgency is a legal instrument signed by the President of the Republic of Peru and the members of his cabinet, is has the same legal value as a normal Law approved by Congress.