健康一瞥：2023年拉丁美洲和加勒比地区（英）

Health at a Glance:Latin Americaand the Caribbean2023 For the Organisation for Economic Co-operation and Development (OECD), the work is published under theresponsibility of the Secretary-General of the OECD, and the opinions expressed and arguments employed herein donot necessarily reflect the official views of the Member countries of the OECD. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of TheWorld Bank, its Board of Executive Directors, or the governments they represent. The names of countries and territories used in this joint publication follow the practice of the OECD. This document, as well as any data and map included herein, are without prejudice to the status of or sovereignty overany territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. ISBN 978-92-64-93641-6 (print)ISBN 978-92-64-73262-9 (pdf)ISBN 978-92-64-63932-4 (HTML)ISBN 978-92-64-77530-5 (epub) Photo credits:Cover © SALMONNEGRO-STOCK/Shutterstock.com. Corrigenda to publications may be found on line at: www.oecd.org/about/publishing/corrigenda.htm.© OECD/The International Bank for Reconstruction and Development/The World Bank 2023 Foreword In the wake of the COVID-19 pandemic, societies and health systems inLatin America and the Caribbean(LAC)continue to face large-scalethreatswithfar-reaching consequences for the health and well-being of its population.More than ever, health systems in the region need tobe strengthened to not only deliver high performance in typicaltimes, but also to be resilient against major shocks, such as pandemics, the effects of climate change, or financialcrises. While thepandemiclaid barethe vulnerabilitiesof even the mosthighly funded and well-preparedhealth systems inhigh-income OECDcountries,the tragic health outcomes of COVID-19 in the LAC region were in large part associatedwith structural limitations andchronicunderinvestment inhealth.LACcountries had to tackle COVID-19 with far fewerdoctors, nurses, and hospital beds than the average of OECDcountries. In such context, while policy responses mitigated the loss of many lives in the region,in 2020 and 2021there werestill 2.3million more deaths in LAC thanwas expected for those years in absence of the pandemic. Furthermore, theweaknesses of the health systems in LAC were furthercompounded by a range of social challenges,includinghighlevels ofpoverty, income inequality, and labour informality; large swaths of the population living in informal settlementswithout access to essential services; and the growing threats to the region’s rich ecosystems that also affect thepopulations that are most directly integrated with them. The consequences of climate change add a layer of complexity to health systems in a geographically diverse region,which includes high-altitude mountains and glaciers, the world’s largest tropical rainforest, several small island nations,and megalopolises with tens of millions of people each. Health systems in the region must prepare for changingpatterns of infectious diseases, exposure to extreme temperatures and catastrophic weather events, and rising sealevels, orriskdireconsequences for societies in the region. In the face ofthesemultiplechallenges, it is imperativetodevelop effective health strategies that consider the complexrealities of the LAC region.The limited budget available for health in the region makes the task of providing high-qualityhealth servicesmore challenging, requiring innovative solutions that are based on data, evidence, and the best ideas.However, the investments that were needed to strengthen health systems are a fraction of what the pandemic costtheeconomiesof LACcountries. Similarly, making health systems in the region greener and resilient to face thechallenges of climate change is urgent.Aswemove forward, moreand betterinvestmentin healthwill benecessaryin order to ensure that the healthrequirementsof the population are metwith greater efficiency and focused onpeople’s needs. This volume, jointly prepared by the OECD and the World Bank,aims to offeran important contribution to theseeffortsby combininga retrospective analysis of lessons to be learned from the response tothe pandemic in the region with aprospective look at how health systems can prepare for the future challenge of climate change. It further brings togetherthe most complete and up-to-date set of data and indicatorsonall aspects of health systems in theLAC region.TheOECD and the World Bank will continue to work together and reach out to key partners, such as the Pan-AmericanHealthOrganization, to support governments and societies in the region to improve the performance of their healthsystems. Tableofcontents 3 Foreword 7 Reader’s guide Executive summary 10 1 The impact of the COVID-19 pandemic on Latin American and Caribbeanhealthcare systems 1.1. Introduction141.2. The death toll of COVID-19 was propo