The chain of drugstores La Rebaja, which for many years served to launder drug money from the powerful Cali cartel of the Rodríguez Orejuela brothers, will become a key part of a large public health network with which the Government of Gustavo Petro seeks to change the current model for a more preventive and inclusive one, which reaches remote places in Colombia where there are still no clinics or hospitals. The chain would be just a first step in a more ambitious plan. As Jairo Buitrago, vice president of companies of the Special Assets Society (SAE), an entity that manages the assets seized from the mafia, reveals to EL PAÍS, “the central idea is the constitution of a public holding company on health issues. We believe that on the basis of these companies that were previously at the service of drug trafficking, we can build a new productive economy. We want to go from a contractual State to an entrepreneurial State, with financial and social profitability”.
Buitrago thus explains the dimensions of the announcement made this Thursday by the Minister of Health, Carolina Corcho, and the president: “We will transform each of the pharmacies into a primary care center,” Petro said during the presentation of the new health program from Aracataca , Magdalena, the town where Gabriel García Márquez was born. The president also reported that two laboratories that also belonged to the drug traffickers of Cali will now become the property of the Ministry. The long-term goal is to develop vaccines and generic drugs at low cost so that the 880 pharmacies of La Rebaja, present in the 32 departments of the country and in more than 500 municipalities, can distribute them. But it won’t just be drugstores converted into health centers and laboratories. Buitrago explains that the SAE will put at the service of the Ministry off-road vehicles, boats, boats and planes seized from the mafia, all to bring health to remote corners of the country.
The president emphasizes that in these health centers, and in others that he plans to build, there will be a team made up of a doctor, a psychologist, a nurse and 8 to 10 nursing assistants. “We started with a thousand medical teams that will be extended to 20,000 throughout the country to cover more than 4 million families,” Petro said. And he added: “Teams will visit each home at least 3 times a year.” This program, which replicates the one he developed with controversial results as mayor of Bogotá, costs about 5 billion pesos a year, a quarter of what the government expects to collect with the recently approved tax reform.
The problem is that the strategy is still an idea that must overcome many obstacles to become a reality. The first, and perhaps the most difficult, is that there is still no official document that serves as a roadmap to direct the actions of the different actors in the sector. Julián Fernández Niño, who was director of Epidemiology and Demography of the Ministry of Health of the previous government, criticized the lack of planning. He said on his Twitter account that the strategy was not consulted with citizens or social organizations or health secretaries: “They went to Aracataca to talk about cart.” Johnattan García Ruiz, Master in Public Health with an emphasis in Global Health at Harvard University, questioned the presentation of the program in the same vein: “I didn’t understand what they launched. I thought they were going to explain something and no, the minister and the president gave the same speech as always. Why are ministry communications so confusing? There is a draft, but where is the official document? It seems like a good strategy to me, but better information is needed to understand it,” Garcia said.
Buitrago, from the SAE, acknowledges that the dialogue tables with the Ministry of Health began only on Tuesday of this week to define the details of the implementation of the program, and says that he cannot give a date when it will begin to be applied. Among others, legal problems need to be resolved, such as the role that the Copsevir cooperative, which manages the La Rebaja drugstores, will play. Mónica Luna Castaño, general secretary of the cooperative, explained in a statement published this Friday that they do not know of or have been notified of any changes, and recalls that in September 2021 Copservir signed a contract with the SEA to manage the drugstores for five years, and that the jobs that benefit more than 10,000 families depend on it.
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President Petro responded on his Twitter account. He said that “the rights of the current workers of Drogas la Rebaja will be respected” and gave more details of the new preventive health program spearheaded by the drugstores of the former Cali cartel. “The program will not require affiliation to EPS, nor will it discriminate against anyone. It will seek to prevent the disease and save lives that today’s inefficient health regime fails to do”.
Despite the lack of a technical document, expert academics from the health sector outside the Government are hopeful about the possibility of including the network of drugstores in the public health system. Claudia Vaca, director of the Center for Thought, Medications, Information and Power, says in an interview with EL PAÍS that establishing service points in remote areas through drug stores seems like a “very good” idea. Vaca explains that one of the most serious issues of the previous pharmaceutical policy is precisely the little public infrastructure that exists in the peripheries. “Establishing networks with primary care points, not only pharmacies that sell and distribute medicines, but also that are the gateway to the health system in areas where there has historically been no care, is interesting.”
For Vaca, however, the most difficult part to carry out is related to the production of vaccines and generic drugs. “It is a valuable proposal, but it should be thought of as a structural public policy articulated with the Ministry of Commerce, Industry and Tourism and with the Ministry of Science and Technology. “The national drug production infrastructure has been dismantled in recent years, if there is no clear strategy to recover it, the idea can remain just wishes.” Carolina Gómez, former director of Medicines of the former Ministry of Health and professor at the National University, agrees with Vaca on the need for the State to have its own capacity to manufacture medicines and be able to react when there is a shortage. “It would be very good to build a public production infrastructure, like the one in Brazil, that has autonomy and does not depend exclusively on the market.” Gómez points out an additional problem: “Colombia does not produce the raw materials for medicines, we will continue to be dependent.” The researcher, however, says that despite this limitation it would be “ideal” to be able to produce generics: “They are easy and cheap and the industry is not interested in making them because they have no profit margin. This could be the first step to make a public-private alliance that helps national drug companies not to be crushed by multinationals.”
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