As of May 25, Venezuela has recorded 1,121 coronavirus cases (22 per million inhabitants) and only 10 deaths. Venezuela also has the lowest percentage of confirmed coronavirus deaths as a proportion of national population in the region (0.4 percent) and the highest ratio of testing, 20,428 tests per million people, in Latin America.
How have these positive statistics been achieved when for years the mainstream media—along with the United States and its allies, including Canada—has been heralding the imminent collapse of the country?
Of course, it is impossible to analyze the situation in Venezuela without taking stock of the unilateral, illegal and coercive economic measures (otherwise known as sanctions) which have been carried out against the country by the US government, Canada, and various European states since 2014.
For more than two decades the US has backed Venezuelan opposition forces which have mostly been made up of far right elite elements that had previously ruled the country. These opposition forces have carried out street violence, sabotage, and coups—including a failed assassination attempt in August 2018 using drones to target President Nicolás Maduro, and a devastating cyber attack that left the country entirely without electricity for five days.
In January 2019, the Trump administration promoted an “alternative” president for the country in the figure of an obscure National Assembly deputy, Juan Guiadó, who subsequently declared himself interim president. The US, Canada and dozens of other Western countries immediately recognized Guiadó as Venezuela’s legitimate leader. They continue to do so at the time of writing.
Fast forward to 2020 and the Trump administration’s efforts to install Guiadó as president have only intensified. Earlier this month, the Venezuelan armed forces foiled a botched military invasion authorized by Guaidó, who signed a contract with a private Florida-based mercenary firm headed up by two ex-US Green Berets. The invasion, which involved some 300 defected Venezuelan soldiers, ended in a clear debacle for Guaidó and the US. Eight of the invaders were killed and dozens more were captured by forces loyal to Maduro. To date, Canada has not yet expressed any condemnation of this blatant attempt at violent regime change, despite leading a multilateral body, the Lima Group, whose stated goal is the “peaceful transition” of power in Venezuela.
Historically, the most lethal and effective weapon against Venezuela has been the illegal economic blockade that has impeded the sale of its oil, the country’s main source of revenue, and prevented it from importing food and vital medicines.
Sanctions placed on the Venezuelan economy amount to “collective punishment” and have resulted in the deaths of more than 40,000 people, according to American economists Mark Weisbrot and Jeffrey Sachs. In the midst of a global pandemic, impeding the purchase of medical supplies makes the blockade particularly cruel. It is currently three times more costly for Venezuelans to buy medical equipment compared to the rest of Latin America.
The US has ignored the appeals of both UN Secretary General António Guterres and Pope Francis to cease economic sanctions during the pandemic. Canada has added to these sanctions, and continues to lead the ad-hoc Lima Group to discredit the Venezuelan government and encourage its ouster. The US and Canada insist that the 2018 re-election of Maduro, monitored by numerous international observers including a number of Canadians, was fraudulent, despite all evidence to the contrary.
In all, the economic blockade has cost Venezuela more than $130 billion. During the pandemic, the blockade has become not just illegal, but amoral. No other country in modern history has been subjected to this type of intense economic warfare outside of an active military conflagration.
Despite this, Venezuela has launched one of Latin America’s most effective responses to the COVID-19 pandemic, behind only Cuba. The reason for this success lies in a combination of responsive leadership, excellent welfare infrastructure, strong public health measures, social cohesion and international solidarity.
Social Determinants of Health
In 1845 Friedrich Engels published a seminal study on public health, which drew the link between death and the living conditions of workers in industrial England. It indicated that the conditions of employment and its capacity to provide access to food and shelter were crucial to the health and wellbeing of the working class.
During the 1854 cholera epidemic in London, Dr. John Snow discovered that the source of the cholera epidemic was the water pumps around the city. By removing the pump handles, he managed to control the epidemic. This effective public health measure resulted in the protection of the population from a lethal disease for which no medical cure existed. Public health then went on to become an important consideration for epidemiology.
Since these early discoveries, modern science has recognized that the health of a population is determined not just by germs, viruses or vaccines, but by the way in which societies provide quality living conditions including access to food, education, income, employment, housing, health services, sanitation, clean water, social equity, and community support. These are the social determinants of health, which the WHO defines as follows:
…the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.
The Ottawa Charter for Health Promotion further identifies social justice and equity as the standard prerequisites for health.
The situation in Venezuela demonstrates the importance of the social determinants of health, particularly in the midst of a global pandemic for which there is yet no vaccine and no sure method of treatment.
Over the past several decades, Venezuela has used its significant oil wealth to right 40 years of misrule by elitist governments that left the bulk of the population in abject poverty. The corruption of those years was such that the equivalent of 18 Marshall Plans were squandered or appropriated with little benefits going to the wider population. Since the election of Hugo Chávez in 1999, Venezuelan oil revenues have been used to make massive investments to reduce inequality in the form of anti-poverty programs called Misiones.
Poverty, like health, is multifaceted; it is not simply a question of having money, but of having a better quality of life. The achievements of the Chávez and Maduro governments lie in the dramatic reduction in poverty by providing employment, unemployment insurance, old age pensions, free universal and comprehensive health services, free education, the elimination of illiteracy, effective transportation systems, pollution control, access to clean water, food security, and the completion of three million public housing units over the last nine years. These initiatives provide social supports for those who had previously been marginalized or excluded from mainstream society.
President Maduro has implemented some relevant measures to cope with the economic effects of the pandemic: banks must extend debt payment deadlines without penalties, the state has taken up the payroll of small and medium sized businesses, and there is a firing freeze until December. The government also mandated the immediate suspension of rent payments for six months and prohibited evictions, while salaries and pensions have been raised and a special stay-at-home bonus has been issued.
Food security is fundamental to health. Due to the US-led blockade, the Venezuelan government has been providing subsidized food packages and regularly feeding over six million households. Due to enforced social isolation, these are now delivered directly to homes by a range of social organizations including community councils, grassroots collectives, governing PSUV party units, the armed forces, and the police.
A key component of the political culture in Venezuela is the fight against marginalization. This involves empowering people’s organizations to address the historic plight of the poor, the handicapped, Afro-Venezuelans, women, and all minorities. There are over 40,000 communal councils and over 5,000 communes which serve as important political players in determining local needs and making decisions that affect their communities. These myriad ‘collectives’ address many issues including access to water and land, neighborhood safety, and production. What’s more, there are now over four million civilian members of the Bolivarian Militias, an arm of the regular armed forces, which are regularly mobilized to defend the country. These forms of community solidarity have been crucial in protecting Venezuela’s most vulnerable from the impacts of the coronavirus.
Venezuela’s Heathcare System
Venezuela’s public healthcare system is based on the fundamental, constitutional principle that health is a human right. It is publicly funded, free to all patients and focused on quality, holistic, comprehensive care. No Venezuelan, for example, has to worry about paying for a COVID-19 test.
The system includes hospitals, clinics, diagnostic centres and the Barrio Adentro network, a Bolivarian national social welfare program established by former president Chávez with the help of Cuban doctors to give access to care to poor neighbourhoods. The Barrio Adentro delivers primary, secondary and tertiary care and includes dental and sports medicine programs all over the country. With an historic investment of $120 billion, the network has been in operation for 17 years.
At the time of writing, Venezuela has sufficient anti-viral medicines for 115,000 cases. In the public sector there are 11,000 hospital beds, 450 intensive care beds, 573 beds in the Neighbourhood Clinics (Barrio Adentro) and 4,000 beds in the Comprehensive Diagnostic Centres. The private sector has 4,760 beds plus over 1,200 intensive care beds. With its own reserves, Venezuela has puchased more than 60,000 molecular tests and related testing instruments. For isolation of the mildly sick there are 4,000 hotel beds designated to isolate anyone who has only minor symptoms. Venezuela expects to be able to lift the stay-at-home precautions by July. At present, there are just over 1,100 confirmed cases and only 10 recorded deaths in the country.
Controlling the Pandemic
From the start, and immediately following the WHO’s declaration of a pandemic, Maduro declared a state of emergency despite the absence of a single coronavirus case in the country. In mid-March, the president initiated a state of voluntary social quarantine, restricted air flights and began monitoring the borders with Colombia and Brazil. Large gatherings were forbidden, the wearing of masks was enforced, and most public spaces were closed, including churches which were asked to suspend services.
All non-essential work was suspended, aside from crucial industries including agricultural production and food distribution, health and transportation, pharmacies, electricity and communication.
Private sector clinics and hospitals immediately began working in cooperation with public hospitals to fight the virus. While this type of private-public coordination has been unusual in the past, it is now commonplace.
Venezuela’s coronavirus protocol was developed through a collaboration between government officials and the country’s chief science and health advisors. The strategy consists of:
- Widespread testing: Venezuela has carried out more than 600,000 tests, a ratio of 20,428 per million inhabitants, the highest in Latin America. Venezuela combines quick tests and PCR for screening, while confirmation is guided by social questionnaire data collected by medical teams travelling home-by-home.
- Social questionnaire: A voluntary digital questionnaire was issued using social identification cards, and 11 million Venezuelans responded. Asking people to self-identify symptoms allowed a triage of the population. 18,000 people reported cold or flu symptoms, and medical teams conducted follow-ups, visiting those who self-identified as feeling ill. More than 1,000 were diagnosed with the common cold/flu, while 135 were deemed “possible” and they and their contacts were examined and went into isolation. On May 13, more than 19 million Venezuelans answered a secondary questionnaire. Medical teams visited 210,678 homes of which 23,688 were further tested. On May 16, antibody testing was carried out on a statistically representative sample in all of the 335 municipalities of the country to detect coronavirus antibodies.
- Home visits: Medical teams follow up on each case at the homes of patients and their contacts.
- Quarantine of all arriving travellers for 14 days.
- Self-isolation and social distancing is voluntary but police enforce wearing masks in public and prohibit large gatherings.
- Border control: There is strict medical testing on the borders with Colombia and Brazil, and there are medical stations along access routes to the country. Thousands of Venezuelans have returned from neighbouring countries to flee the pandemic, including more than 56,000 from Colombia.
- Flights: All national and international flights have been cancelled.
- Cleaning: 20,000 workers and the armed forces regularly disinfect public spaces, public buildings, and plazas.
- Intensive public education campaigns to inform the population about the virus and appropriate preventative measures.
On March 18, the IMF denied Venezuela a $5 billion loan it had requested to purchase much needed medicines and medical equipment, citing the pretext of Maduro’s “illegitimate” presidency.
Yet, Venezuela has received support from a range of other nations and international organizations including Cuba, China, Russia, the WHO, the United Nations, UNICEF, the Pan American Health Organization, and the Red Cross, all of which have provided medicines, medical supplies, and food.
As early as March 16, Cuban medical specialists arrived in Venezuela to assist with the prevention and containment of COVID-19. Among them was the Cuban physician Dr. Luis Herrera, the creator of the antiviral drug Interferon Alfa 2-B, one of the most successful medications being used to treat the virus.
Also in March, China sent a team of medical experts to Venezuela for a week to interface with Venezuelan physicians and scientists about their experiences with respect to epidemiology, diagnostics and treatment. China has established an air bridge between Beijing and Venezuela, and has already sent four planes with tons of medical supplies including masks, test kits, personal protective equipment (PPE), and ventilators. On May 12, 46 tons of equipment arrived that will allow the country to conduct 80,000 new polymerase chain reaction (PCR) tests, plus four million masks and other PPE for health care workers.
Russia has also sent planes with large supplies of sorely needed medicines such as insulin. Venezuelan farmers have been unable to deliver food to cities or run their tractors due to a lack of gasoline, as the country is unable to buy a special thinner its refineries need to dilute Venezuela’s dense oil. Iran is now defying US sanctions and an ongoing naval blockade by sending oil tankers with the desperately needed gasoline.
Meanwhile, the US remains the global epicentre of the pandemic, with a death rate of 281 per million, and over 100,000 deaths. The Trump administration has led a disorganized approach to the pandemic that has been exacerbated by a privatized and deeply unequal medical system, inadequately equipped hospitals, competing civil authorities, and a president who openly contradicts medical experts and appears more concerned with re-election than the health of his own people.
Venezuela, long a target of US imperalism, has been following the best scientific advice available, and it has benefitted from genuine international solidarity despite the hardships of the economic embargo. The Maduro government is doing everything it can to save lives during this pandemic—and it is succeeding.
Maria Páez Victor is a sociologist, born in Venezuela, educated in Caracas, New York, Mexico City, England and Canada. She has twenty years of national and international experience in policy analysis and environmental assessment, with a particular focus in the areas of health and energy. She is an active member of the Latin American community in Canada.