Ambassador: Ariela Rozenek
1. Which aspects of Pandemic Preparedness is most pertinent to your country and why?
The Costa Rican health care system, known as the Caja, features universal health insurance and access to private and public hospitals. Yet, the Caja’s low cost and high quality attract many to its clinics and hospitals (10 major public hospitals.) This leads to extremely long wait times for anything from a routine checkup to vaccinations. This would most likely be a centrally pressing issue in the event of a pandemic. It is additionally important to distinguish between the country’s public government run health care system (as mentioned the Caja) and the private health care system. Incorportating both systems, private and public clinics into a pandemic will prove to be a struggle. An important aspect of Pandemic Preparedness, as outlined by the WHO’s Pandemic Preparedness Checklist is universal access to vaccinations and antivirals (for example in the case of influenza.) The two aforementioned issues could pose a problem in ensuring universal access.
Additionally, the Costa Rican Pandemic Preparedness Plan does not include measures to ensure the maintenance of access to essential services. With and already stretched public health system, ensuring the continued access to primary health care would be challenging for Costa Rica.
2. How would you as the WHO Ambassador of your country address this issue?
With regards to the first issue of universal access to vaccines and antivirals, Costa Rica has taken the first steps to ensuring that this issue is dealt with. Costa Rica remains the only Latin American country with an actual estimate of the size of its “priority groups” immediately eligible for vaccination. Additionally, they have identified priority groups for access to antivirals including those who are central to the maintenance of necessary services to continue life as usual in communities. The Pandemic Preparedness plan also addresses the fact that due to financial constraints, a plan for a universal rollout of vaccinations or antivirals is unlikely yet, the private sector and their facilities will become and asset in a pandemic situation as services can be mobilized to aid communities.
3. How has your country addressed Pandemics in the past? What would you have done differently?
In the past, the second issue mentioned regarding continued basic care support has been poorly addressed. In 2009, this was seen when H1N1 spread in Costa Rica with 1,596 confirmed cases, 1,275 pending cases, 8,000 already discarded, and 38 deaths. In the event of a pandemic, it is crucial that health services are kept in service. To do so, sensible personnel management must occur, as well as plans to optimize the use of facilities. Within this, there should be budgetary reforms within the Pandemic Preparedness Plan to allocate funds towards absorbing some of the country’s private resources and services during a pandemic into the Caja to provide continued low-cost universal access to care.
4. Which countries do you see yourself becoming allies or rivals with? Why?
Costa Rica has included plans to work with neighbouring countries in terms of human and animal surveillance of pandemics. These include Ecuador, Panama and Nicaragua. Because of this, I believe that Costa Rica will align itself with countries in the Central American region in hopes of strengthening surveillance projects.