Cristina Azevedo (Fiocruz News Agency)
Cooperation between the so-called Global South countries took a hard hit during the COVID-19 pandemic, suffering backtracks due to political and ideological issues in the past few years, but it has the potential to help these nations overcome the public health crisis with a sustainable recovery. These were some of the reflections raised during the South-South Cooperation seminar, diplomacy in health and pandemic that the Fiocruz Global Heath Center (Cris/Fiocruz) held last Wednesday (June 23rd).
Mediated by Regina Ungerer, physician, and researcher of Cris/Fiocruz, the webinar followed the 20th session of the High Level of South-South Cooperation, which took place between June 1st and June 4th and was presided by ambassador María del Carmen Squeff, permanent representative of Argentina at the United Nations. The Argentinian ambassador opened the seminar, wrapping up the conclusions of the meeting.
“Cooperation between Global South countries was negatively affected by the pandemic, which worsened structural problems in developing countries”, said the ambassador in a recorded video. “But we acknowledge the potential of South-South cooperation in overcoming current difficulties, especially in the response against the pandemic. I do not mean it should replace traditional cooperation between developed countries and developing ones, but we should rely on and ensure the support of developed countries and of all development partners by means of an alliance made up of multiple agents.”
Although the expression “South-South cooperation” is relatively new, this modality is old, as Regina mentioned. It has already been called Technical Help Assistance to Countries in Need, and included the commitment of worldwide cooperation at the 1955 Bandung Conference. In the 1960s an International Technical Cooperation existed, later known as horizontal cooperation. But it took shape with the creation of the United Nations Office for South South Cooperation (UNOSSC) and the Buenos Aires Action Plan (Bapa).
"We should rely on and ensure the support of developed countries and of all development partners by means of an alliance made up of multiple agents", said ambassador María del Carmen
Social justice and backtracking
For Anne-Emanuelle Birn, professor at the Dalla Lana School of Public Health, at the University of Toronto, Canada, the roots of South-South cooperation in Latin America date back to the XIX century. In a historical-critical analysis, she emphasized that “we could think of Latin-Americanism, of Bolivarianism, and in Panamericanism as historical processes of this coordination”. She also mentioned 20th-century actions, such as the Cuban cooperation in the reconstruction of the Algerian health system after its independence and the presence of Chinese physicians in Africa since the 1970s. “Is South-South cooperation a continuity of North-South assistance standards or are these new relations based on solidarity?”, asked Anne-Emanuelle, emphasizing that this cooperation will only become an alternative for the world if it is guided by social justice in such a way as to reduce asymmetries.
Colombian Viviana Muñoz Telles, coordinator of the Health, Intellectual Property and Biodiversity Program of the South Center, an intergovernmental organization, drew attention to the lack of international solidarity in the pandemic, especially by developed countries. This led to a difficulty in the operation of Covax, a mechanism that was expected to facilitate access to vaccines. “Many countries are average-income countries, and most global health cooperation mechanisms are based on this distinction established by the World Bank. With this, many Latin American countries were unable to benefit from the lower prices that could have been negotiated through Covax”.
For her, the strengthening of cooperation in Latin America is a complex issue. “It was clear that there was a backtrack in regional integration, with consequences on public health integration. There are historical reasons for this, but the ideological issue is at the base of this disintegration”, she said. She highlights that there was a lack of coordination in the response to the pandemic, with “isolated and insufficient efforts”. Unasul was made up of 12 countries, but the initiative was abandoned. What had been conquered was lost, such as the South American Institute of Government in Health (Isags), which achieved significant results, such as obtaining joint purchases and more accessible prices”.
Glass half full
Ambassador Ruy Pereira, director of the Brazilian Cooperation Agency (ABC in the Portuguese acronym), on the other hand, provided a counterpoint while observing a new appreciation of multilateralism in the fight against the pandemic. However, now this effort in regional cooperation in health would be materializing by means of the Ibero-American General Secretary (Segib). While commenting on the Brazilian experience, Pereira mentioned that last year ABC received a financial reinforcement of about US$ 6 million to support the fight against COVID-19 in developing countries. “This benefitted 25 developing countries in Latin America, the Caribbean and Africa”, he explained. Health and agriculture concentrate the higher volume of Brazilian cooperation initiatives. There are currently more than 700 ongoing projects in more than 70 countries.
The ambassador mentioned that Fiocruz is a great partner of the ABC in the health sector, with projects such as the Global Network of Human Milk Banks. Pereira also highlighted Brazil’s performance at Portuguese-speaking countries in Africa, such as the installation of a drug factory in Mozambique, of which Fiocruz participated. On triangular cooperation, which he prefers to call “trilateral”, so it doesn’t look like someone is “at the apex”, he remembered the alliance with Japan to treat tuberculosis in Africa. “I see the glass half full, and not half empty”, he says.
Paulo Buss, Cris/Fiocruz coordinator, was in charge of describing Fiocruz’s experience in the South-South cooperation, something that has been happening since its creation. “Fiocruz has this cooperation in its DNA. We understand that health is not only a biological issue. This is why we say our cooperation is structuring”, he explained. “Technical and financial sustainability is important, and we have been emphasizing the training of human resources.”
Much of this cooperation and exchange of knowledge takes place through networks, and Buss highlighted that four networks of which Fiocruz is a secretary are now acknowledged by Segib as Ibero-American networks: those of the National Health Institutes, of Human Milk Banks, of Public Health Schools, and of Technical Education in Health. In addition, the Cris/Fiocruz coordinator mentioned that Fiocruz has six centers designated as collaborators by the WHO: Global Health and South-South Cooperation; Pharmaceutical Policies; Health and Environment; Education of Health Technicians; Leptospirosis; Human Milk Banks.