- How can health systems in Latin America and the Caribbean respond to today’s health challenges while preparing for an aging population?
- New IDB initiatives in Haiti, Argentina, and Ecuador show how countries are addressing health access, quality, and system management.
- Investing in people-centered health systems is key to reducing inequities, improving care, and building resilience across the region.
Latin America and the Caribbean are at a turning point. The region's health systems face challenges in terms of equity, access, quality of care, and efficiency, in the context of a rapidly aging population. The proportion of people over 60 in Latin America and the Caribbean will reach approximately 25% by 2050, which will increase the demand for continuous and more complex services. In terms of access gaps, around 55 million people — 9.4% of the regional population — must travel at least 30 minutes to reach a health center, a figure equivalent to almost the entire population of Argentina. In terms of quality, 70% of preventable deaths from treatable causes in the region are due to poor quality of care. On the efficiency side, the fragmentation of the system is associated with a 24% higher mortality rate among cancer patients. The challenges are significant, but so are the opportunities to transform systems and ensure that no one is left behind.
This year, three new initiatives that we are undertaking at the Inter-American Development Bank (IDB) in Haiti, Argentina, and Ecuador represent concrete steps toward that goal: expanding access to essential services, improving the quality of care, and strengthening the management of health systems.
More than just projects, these are commitments to improving people's health and lives.
In northern Haiti, a non-reimbursable grant of $100 million will rebuild access to essential health services and strengthen the health system. The operation will benefit approximately 750,000 people, helping reduce preventable mortality and disabilities.
The initiative is part of a $150 million program package and continues the operations begun in 2022 that integrate social protection and health. The program is expected to drive concrete progress through four lines of action:
- Strengthening health system management;
- expanding service delivery in 40 priority locations;
- promoting user participation and reducing barriers to access; and
- improving health infrastructure, with the comprehensive rehabilitation of the Hôpital Universitaire Justinien in Cap-Haïtien as one of its main milestones.
In a context where 43.5% of health spending is out-of-pocket, and there are only 0.7 hospital beds per 1,000 people, this operation represents much more than new construction or equipment: it is the possibility of responding to an emergency, having a safe delivery, or treating an illness without traveling miles. It also promotes inclusive care protocols for women in vulnerable situations, people with disabilities, returning migrants, and internally displaced persons. In Haiti, rebuilding health also means rebuilding social cohesion and hope.
In Argentina, the IDB approved a $500 million loan to strengthen health care for more than 5.4 million people affiliated with the National Institute of Social Services for Retirees and Pensioners (INSSJP).
With this operation, we seek to improve the quality and timeliness of health care and treatment with digital tools to monitor chronic diseases and cancer; streamline access to treatment to ensure that people receive timely responses and medication; and expand care services to people with functional dependencies. Among the expected results are doubling comprehensive coverage for chronic diseases, reducing waiting times for cancer surgeries, and increasing access to formal care.
Every faster consultation, every more accessible service, and every support program is a way to ensure that older adults live this stage of life with well-being and dignity.
In Ecuador, a loan of $250 million will support a comprehensive response to chronic noncommunicable diseases, such as cardiovascular disease and cancer. The goal is to help contain the morbidity and mortality associated with noncommunicable diseases, which today account for more than half of all deaths in the country.
With this program, we seek to help strengthen both primary and specialized care by developing care pathways and digital information systems for disease monitoring, strengthening diagnosis and primary care with new equipment, and improving hospital treatment, which will include training health personnel and implementing electronic medical records. This will benefit more than 10 million people, including 3 million indigenous people and more than 5 million women.
With this investment, Ecuador is moving toward a more comprehensive care model, capable of responding to current public health challenges with better evidence, coordination, and quality of care.
These three initiatives reflect the IDB's commitment to supporting countries in building health systems that are more equitable, efficient, and people-centered. From Haiti, where it is still necessary to guarantee access to basic services and strengthen the foundations of the system, to Argentina and Ecuador, which face the challenges of an aging population and chronic diseases, the region is moving forward in the face of persistent challenges and new ones that are emerging as the population ages.
Improving equity, quality, and management are not isolated goals, but complementary paths toward the same end: that all people, regardless of where they live or their circumstances, can access quality health services. As we approach the end of 2025, we reaffirm our conviction that improving lives begins with caring for the health of each person.