Jan. 30, 2004 – Colombia's Minister of Social Protection, Diego Palacio Betancourt, said yesterday in an interview with Colombian daily El Tiempo that the outbreak of yellow fever in the country could not be declared under control, although there have been no new cases since January 23. But a Columbian analyst charges the government is downplaying the severity of the outbreak and doing little to address the root causes of the health crisis is Colombia.
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Over the month of January, at least eight people died of yellow fever and dozens more contracted the mosquito-carried disease. Mass vaccination had reached new lows before the outbreak, according to the figures Palacio gave El Tiempo, with the Colombian government acquiring 2.15 million doses of vaccine in 2001, but just 1.16 million doses in 2002. In 2003, when there were already signs of a problem, with more cases than in the previous 10 years, the government stepped up its acquisition to 3.83 million doses.
While Palacio said there had always been enough vaccine to cover an emergency, El Tiempo reported earlier this week that during the current outbreak 500,000 doses were acquired from Venezuela and 1.25 million from Brazil. Downplaying the scale of the outbreak, the minister said, "If you were to sum up the numbers reported in the media, you would think there were at least 50 deaths, when there have only been 8."
Palacio also denied that the government's reforms of the Health Ministry and its merger with the Ministries of Labor and Social Security into the Ministry of Social Protection were responsible for the outbreak. "They say the fusion of the ministries was a bitter experiment and that the epidemic of yellow fever is one of its consequences. The results contradict this. This government can show improvement in all public health indicators," he said. According to the minister, the problem was a lack of "inspection, vigilance, and control," caused by corruption.
Hector Mondragon, an economist and advisor to campesino (farm worker) and indigenous organizations in Colombia on agrarian issues, disagrees. In an article published at ZNet on January 29, Mondragon suggested that the fusion of the ministries was partly to blame, along with the privatization and shutting down of various parts of the public health system.
"How can a single ministry," Mondragon asked, "simultaneously (a) raise the retirement age and lower pension payments, (b) implement a labor reform that takes $3 billion USD away from workers annually, (c) destroy collective bargaining rights and deny the right of new unions to register, and still have time to prevent a yellow fever epidemic (and stop malaria?)."
Mondragon also assigned responsibility for the Yellow Fever outbreak to the aerial fumigation program, purportedly intended to eradicate coca crops and eliminate cocaine at its source. The fumigations force peasants to head deeper into the jungle where they are more vulnerable to the mosquitoes that spread the disease.
Disputing the government's figures, Mondragon said, "Ten indigenous who died in the Sierra were not included in the official statistics of yellow fever deaths, because no one went to see that they had died. Nor did some campesinos and day laborers who were not registered."
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The analyst also noted that the involuntary mobility of a peasant population in a country with over 3 million internally displaced by paramilitary massacres as well as aerial fumigation complicates Colombia's public health problems, of which malaria is even more severe than yellow fever: "Colombia has problems other than the guerrillas. Malaria kills more campesinos than the paramilitaries. Yellow fever could have far worse effects if vaccination is not immediately extended."
