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The Equity Test: Stronger Covid-19 Testing and Tracing in Latin America is Enabling an Equitable Pandemic Response

Mia Scott — Former Summer Associate, Health Initiative, The Rockefeller Foundation

The global Covid-19 response has been unprecedented, but it has also been deeply fragmented and inequitable around the world. While high-income countries are now taking steps to reach the next normal, low- and middle-income countries continue to face devastating losses. This is especially visible in Latin America and the Caribbean, where more than 65 million cases and 1.6 million deaths have been reported since the start of the pandemic. In fact, in the first two months of 2022, the Americas accounted for 63% of worldwide cases despite making up just 13% of the population.

Throughout the region, overburdened health systems, political and economic instability, and insufficient resources have stacked the cards against vulnerable communities. The poor and marginalized bear the brunt of Covid-19’s impact. People living in dense neighborhoods, for example, are particularly at risk of infection, while those in isolated areas like the Amazon Basin have limited access to care. All these factors have hampered Covid responses, threatening the health, livelihoods, and ultimately the lives of people in low-income communities.

Seeing this crisis unfold, The Rockefeller Foundation made the region a priority geography in our pandemic response. We focused our efforts on testing and tracing, which provide decision-makers with essential information needed to implement adaptable, scalable, and equitable response strategies.

Data-Driven Solutions

Data is an especially important tool in health, allowing us to spot and track health trends and pinpoint gaps in care. Unfortunately, however, data collection is still inconsistent in many countries. Working with partners in regions affected by health disparities, the Foundation leveraged existing relationships with governments, institutions, and communities to develop a three-pronged testing strategy that would generate the data needed for an effective and sustainable Covid-19 response:

Expand testing and contact tracing capacity

To better equip communities to track and respond to Covid-19, The Rockefeller Foundation coordinated with the Pan American Health Organization (PAHO) on building local testing capacity and improving surveillance across Latin America and the Caribbean. Now leading a network of 32 laboratories across the Americas, PAHO has acquired over 42 million tests spanning 36 countries.

Additionally, to maximize testing capacity in areas with scarce resources, we partnered with researchers at Universidad de los Andes in Bogota, Colombia on their work to develop Smart Pooling, a testing approach that leverages artificial intelligence to assess Covid-19 risk levels in samples. Using this strategy, communities can increase the number of samples tested without needing additional supplies. Researchers found that this approach maximized resources, allowing communities to test twice as many samples compared to traditional methods.

Enable equitable access to testing and tracing – particularly in indigenous communities

Testing and tracing strategies are only effective when available to all. But Indigenous communities in Latin America often lack access to these essential resources, despite being among the most vulnerable to the virus. Fortunately, organizations like Hivos are working to ensure testing and tracing services are available to everyone throughout the region. As part of its Amazon Indigenous Health Route project, Hivos works to develop culturally relevant programs, link indigenous communities to formal health systems, and equip community health workers with digital tools. Their work facilitates more regular access to testing and tracing so that indigenous populations in the Ecuadorian, Peruvian and Brazilian Amazon can protect themselves from the virus.

Amplify and inform testing and tracing strategies through sub-regional convenings and collaboration

To make sure that testing and tracing services reach everyone, everywhere, decision-makers across the region have also leaned on each other to share valuable lessons learned from their experiences with the pandemic. For example, the Inter-American Development Bank has established sub-regional pandemic response communities in Jamaica, The Bahamas, Trinidad and Tobago, Argentina, and Brazil so that public health leaders can share best practices on topics ranging from increasing vaccine confidence to support strategies for homeless populations. Here, information-sharing has the power to guide actions that can protect entire communities.

The Way Forward

By expanding testing and tracing across the region, countries and their communities are able to create adaptable mechanisms that both support Covid-19 response and create more resilient health systems that can withstand future threats. But our work doesn’t end here. Efforts to bring testing to communities have also highlighted new disparities, especially around vaccine equity. While 63% of people in the region have been fully vaccinated, gaps in coverage mean that many are still left behind.

The pandemic’s steep toll on marginalized communities around the world has been a wake-up call. The global pandemic response needs to include a sustained commitment to equity so that we can ensure that everyone, everywhere is given the means to survive this crisis and thrive as we look towards recovery.