Health systems worldwide were at the forefront of the response to the COVID-19 pandemic. In a context of urgency and uncertainty, additional financial resources were allocated to this sector, and procedures were often relaxed to cope with emergency requirements. As a result, and in a similar way to OECD countries, Latin American and Caribbean (LAC) countries resorted to the use of contingency and extra-budgetary funds, supplementary budgets, and other measures including loans and resource readjustments, as well as tracking these measures. As elsewhere, the response to the COVID-19 within LAC was not homogeneous and was influenced by different institutional realities and the available tools.
LAC countries used different channels to allocate resources to meet specific urgent needs. One of the most common responses in LAC countries during the initial stages of the pandemic was to reprioritise funds from the existing health budget, used by 8 of the 13 LAC countries surveyed in 2020 (62%) and still used by 5 out of 13 in 2021 (38%). The same numbers used loans from international organisations or countries as additional sources of funds: 8 out of 13 in 2020, and 5 out of 13 in 2021. The budgetary measures implemented by LAC countries to cope with the COVID-19 pandemic varied between 2020 and 2021. In 2020, most LAC countries responded to COVID-19 with supplementary budgets voted by legislators to reallocate and increase the spending capacity of the Ministry of Health and/or other health sector institutions. In contrast, by 2021, most countries were including their budget response to COVID-19 in the regular annual health sector budget process (Table 6.1).
The COVID-19 pandemic also affected revenues from health social security contributions for most surveyed LAC countries, but in different ways. Given the impact of the pandemic on economic activity and employment, most countries with data available reported a fall in social security contributions in 2020 (Argentina, Colombia, Costa Rica, El Salvador, Honduras and Uruguay). By 2021, Colombia’s contributions increased, while Argentina and El Salvador were still experiencing reductions. Despite the impact of the pandemic on employment, Brazil, the Dominican Republic and Paraguay reported increases in both 2020 and 2021. Contributions remained stable in Haiti in both years (Figure 6.10).
All surveyed LAC countries adopted a methodology to track and report their health expenditures during the COVID-19 pandemic to ensure the accountability of COVID-19 expenditure and to promote transparency. Most countries published reports of measures and expenditures related to the pandemic (12 out of 13, or 92% in 2020, and 11 out of 13 in 2021). For instance, Paraguay developed the digital tool Mapa Inversiones + Modulo COVID-19 to keep track of all COVID-19 related expenditures, such as programmes, contracts, grants and donations related to the health emergency. Furthermore, most countries dedicated special COVID-19 budgets or accounting codes that allowed such expenditure to be managed separately from the regular budget, making it easier to track and report (Figure 6.11).
