The COVID-19 vaccine scandal in Peru reflects systemic corruption in the country that damages the health of the country's poorest. Georgina Kenyon reports. A COVID-19 vaccine scandal in Peru, dubbed Vacuna-gate, has highlighted the nation's systemic corruption, from politicians down through the health ministry and within universities, according to many health experts. In February, government officials were given the COVID-19 vaccine (Sinopharm's BBIBP-CorV) months before the country was set to begin its vaccination programme. Anger at politicians' behaviour resulted in public protests. But public criticism of Peru's government is not just about political elites having access to the vaccines first, but it is also about the malpractice of research universities administering vaccines before final clinical approval. “The problem we face in Peru is that the permanent political class uses influence and power for the benefit of their families and friends while other people are left to manage an enormous bureaucracy. This is precisely the reason our last six presidents and many former ministers have been charged with serious acts of corruption”, Patrick Palmieri, director of South America EBHC, a Joanna Briggs Institute (JBI)-affiliated group, told The Lancet Infectious Diseases. Palmieri believes Vacuna-gate shows how corruption affects public health in Peru at all levels: “As an example of the corrupt practices impacting health, the country has a continuing oxygen crisis with public hospitals running out of oxygen in intensive care units.” German Malaga, the doctor who administered some of the vaccines during the scandal, testified in parliament in early February. Malaga gave former President Martin Vizcarra the candidate vaccine during the clinical trial after being requested to do so by the president. The scandal forced Vizcarra to resign along with the health and foreign affairs ministers and two vice ministers. Furthermore, the ethics committee at the National Institute of Health responsible for approving the protocol and monitoring the vaccine study was found to have family members vaccinated too. Two Peruvian universities, the Cayetano Heredia University and the National University of San Marcos, have been implicated, with the National Institute of Health suspending Cayetano Heredia University from conducting clinical trials in February. Vacuna-gate frustrates many like Palmieri who are proud of previous vaccine programmes. “Despite all the problems in the Peruvian health sector, vaccinations are something we do very well. The reason is simple—nurses lead the vaccination campaigns. They are the vaccination foot soldiers”, Palmieri said. Other researchers, such as epidemiologist Gabriel Carrasco-Escobar, believe Peru's public health system has been deteriorating over the past 10 years. “Public health in Peru used to be renowned for its performance in controlling epidemics. Unfortunately, in the last 10–20 years, the paucity in financial support to the sector has derailed some programmes”, Carrasco-Escobar told The Lancet Infectious Diseases. He believes Peru does not have a robust epidemiological surveillance system, and it is a major issue for controlling infectious diseases across communities. A lack of ethics in medical trials also worries him. While public health efforts have been focused on COVID-19, measles, mumps, and rubella are spreading in the country, especially among the large influx of displaced people from Venezuela who have not been vaccinated. There have been increasing cases of diphtheria. A dengue outbreak a few months before COVID-19 also affected poor communities, as did leptospirosis. International non-governmental organisation Transparency International has published reports into Peru's health system highlighting serious issues relating to a decentralised health system and also multiple providers of services and insurance with little coordination. Extreme inequality still prevents many people from receiving basic health care. Palmieri believes the government has been focused on COVID-19 rather than on other infectious diseases in Peru as wealthy people were contracting the disease. He is calling for a systematic overhaul of the health system, with increased transparency in the expenditure of resources, full disclosures about potential conflicts of interest, and independent ethical oversight of research projects, with regulations similar to the USA and the EU, codifying research ethics into law. “We also need transparency for the appointments of people to regulatory agencies and expert panels specific to research. These processes are mysteriously filled in many cases”, Palmieri concluded. As Vacuna-gate escalates in Lima, nurses and doctors in remote communities continue to call for oxygen supplies and medical equipment to treat COVID-19, in a region where dengue rates are rising, in part due to warming temperatures. But as health advocates like Carrasco-Escobar believe, poor public health is directly linked to one significant problem: a serious lack of political will. © 2021 shutterstock 2021
