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Vaccine access will be limited in the region by reliance on
external sources
Cuba is currently preparing to test the region's most advanced
locally developed vaccine, Soberana 2; however, this is likely to
take several more months to become available for use and even then
production capacity on the island is likely to be very limited.
Therefore, the rest of the region will remain dependent on
acquiring vaccines from external sources in 2021. Most Latin
American countries have become increasingly open to accessing
COVID-19 vaccines from diverse sources to balance the risk of
supply shortages and delays. Larger countries including Argentina,
Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay,
and Venezuela have vaccine acquisition purchase agreements (APAs)
in place and are also participating in the World Health
Organization's pooled procurement mechanism under the COVID-19
Vaccines Global Access Facility (COVAX) framework. Colombia has so
far signed the most APAs with companies (five), with Mexico, Peru,
and Chile also in stronger positions to cover larger proportions of
their populations with four, three, and two APAs signed,
respectively. Argentina is further behind in terms of number of
doses compared with population needs and will need to secure more
vaccine supply.
Smaller countries such as El Salvador, Haiti, Honduras, and
Nicaragua will be more heavily dependent on the COVAX facility;
however, this mechanism only plans to provide vaccines for up to
20% of each participating country's population. Therefore, to
vaccinate more than 20%, these countries will have to seek
additional funds from alternative private or multilateral sources,
such as the announced funding of USD1 billion from the
Inter-American Development Bank in December 2020. Many countries
with COVAX facility agreements also have yet to confirm a date for
the arrival of the first vaccine doses. Vaccine quantities are
highly likely to remain insufficient in poor and middle-income
countries during 2021, with the Jamaican health ministry estimating
in January that only 16% of its population will have been
vaccinated by the end of the year.
Domestic distribution will be delayed by regulatory,
logistical, and political constraints
It is already evident that securing vaccine supply agreements is
not enough in itself to ensure a successful rollout. For example,
Colombia has more APAs in place than other countries, but it has
yet to start vaccinating its population, while Argentina has fewer
APAs but was among the first in the region to begin vaccinations in
December. Moreover, companies including US vaccine manufacturer
Pfizer and the Russian developers of the Sputnik V vaccine have
already announced expected supply disruptions that will affect
Latin America.
Successful vaccine distribution will be likely to depend on
additional factors, including individual countries' regulatory
approval mechanisms, supply-chain logistics, levels of bureaucracy,
and the availability of trained personnel, medical equipment, and
cold refrigeration. For Latin America, one of the main logistical
challenges associated with vaccinating the majority of individual
countries' populations is reaching more rural and remote areas
that, in many cases, have a poor existing transport and public
health infrastructure.
There is a high risk of political disputes emerging between the
central and regional/state governments over distribution plans as
rollouts begin. This is highest in larger countries such as Brazil,
Colombia, and Mexico, where individual states or regions already
have greater degrees of autonomy and population diversity. In
Mexico, President Andrés Manuel López Obrador contradicted health
ministry recommendations to grant state governments the ability to
source vaccines independently; Brazilian President Jair Bolsonaro
publicly opposed São Paulo state government's production and use of
the Chinese CoronaVac vaccine; and Colombia's central government
halted Cali department's unilateral negotiations with a vaccine
supplier in favour of retaining central management of the
vaccination plan.
Vaccine security risks are highest in Brazil, Colombia,
and Mexico
Criminal activity will also disrupt vaccine rollout through
theft attempts of vaccines and associated equipment by highly
organized criminal groups in countries such as Brazil, Colombia,
and Mexico and from hospitals by corrupt officials or workers. This
includes armed theft risks while in transit through areas where
organized criminal groups are already active (for example on
highways in Brazil's Rio de Janeiro and São Paulo states and
Colombia's Caquetá, Putumayo, and Arauca departments), but also
from hospitals and storage facilities. Online counterfeit vaccine
sales are also highly likely to increase this year, exacerbated by
delays and scarcity. Such sales have already been reported in
Bolivia, Brazil, Chile, Mexico, and Paraguay since December 2020
and could eventually affect vaccine uptake if they become
widespread.
Posted 25 March 2021 by Carla Selman, Principal Research Analyst, Country Risk, S&P Global Market Intelligence and
Carlos Caicedo, Senior Principal Analyst, Latin America Country Risk, S&P Global Market Intelligence and
Ewa Oliveira da Silva, Senior Analyst, Life Sciences and
Johanna Marris, Senior Analyst, Latin America, Country Risk, S&P Global Market Intelligence and
Rafael Amiel, Director, Latin America & Caribbean Economics, S&P Global Market Intelligence
