Within the framework of collaboration with the ILO and PAHO, and joint work with the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) and the Development Facility in Transition of the European Union, ECLAC is organizing the II Regional Seminar on Social Development , which in this edition aims to provide a space for dialogue and reflection on social security systems in the region, with attention to diagnoses, challenges and strategic guidelines for reform and restructuring processes in pension and health systems in the face of a uncertain context of recovery and the need to consolidate full guarantees for the exercise of social rights in the countries of the region.
Since 2020, the countries of the region have faced unprecedented challenges to respond through timely and relevant public initiatives to the impacts of the COVID-19 pandemic and guarantee essential levels of well-being for citizens and access to health as a fundamental right. and an essential public good. The scenario faced has deepened structural factors that had been intensifying prior to the COVID-19 pandemic: high levels of informality, in a scenario of profound transformations in the face of ongoing technological changes, the increase in poverty and the rapid aging of the population, among others. Although the measures implemented by the countries in terms of social protection have been substantive and have made it possible to mitigate, in part, the devastating social and economic effects of the pandemic, two years after its start, a considerable deterioration in the living conditions of its inhabitants and the important distance that exists in the region to consolidate true welfare states, with social security systems that guarantee equal conditions to access benefits with adequate levels of coverage, sufficiency and financial sustainability is evident. . This is expressed in the marked increase in social inequality in its various expressions and in a setback of 27 years in extreme poverty: in 2021, according to ECLAC projections, the rate of extreme poverty would have reached 13.8% and the of poverty, 32.1% of the population. Along with this, a significant deterioration in the labor market can be seen, with a marked drop in labor participation, especially female participation. This would have given rise to a significant drop in the proportion of people who are affiliated or contribute to health systems and a setback of a decade in the effective coverage of pension systems, which would have reached only 45% in 2020. % of the economically active population in 15 Latin American countries (ECLAC, 2022). Likewise, an increase in unmet health needs is observed during the pandemic due to the exacerbation of access barriers (WHO, 2022).
Social security systems, and in particular, pension and health systems have been at the center of attention. This has occurred due to the urgent need to strengthen the response capacity of health systems in the face of an increase in the needs of the population in this area, with a demand that is often unsatisfied and unequally met, as well as in the framework of debates on pension systems and the insufficiency of benefits to guarantee a dignified old age. Citizen demands for guaranteed access to these systems and sufficient benefits, and greater equality have increased, envisaging higher levels of fiscal pressure in line with the strengthening of public systems, of universal scope and increasing coverage with comprehensive interventions of pension systems. and health that respond to the needs of the population and ensure the sufficiency of benefits in both systems. In this context, the need to move towards universal, progressive, solidarity and sustainable schemes has been raised, in order to guarantee access and coverage of the entire population to key policies of these systems.
The pandemic has thus opened up a new scenario and possibilities to rethink the architecture of welfare regimes in the region and the way in which the distribution of old and new risks is
redistribute. From the consequences of the social and economic deterioration resulting from the COVID-19 pandemic, the gaps and inequalities in access to key social protection instruments to protect against to the risks of poverty, including access to pensions, health and unemployment insurance. The increase in the levels of unemployment and labor informality constitute important barriers to the financial sustainability of social protection systems. Faced with this, it is imperative to investigate strategies that allow strengthening the institutional capacities of the State to advance in comprehensive reforms aligned with the principles of social security.
On the one hand, the COVID-19 pandemic has revealed the centrality of strengthening the articulation between the health and social protection systems, as well as the structural weaknesses of the health systems of Latin America and the Caribbean, with a strong impact on the health of groups in vulnerable situations. Given this reality, it is necessary to deepen the development of public policies to restructure and strengthen the response capacity of health systems and move towards universal coverage and access, with timely and quality care for the entire population. Said reflection must consider the need to increase investment in health through an increase in financing that is sustainable and a more efficient organization of health services, with a strong emphasis on a first level of care strengthened in its resolution capacity and with models of care and care, integrated and comprehensive, centered on people and communities, and with the ability to address the social determinants of health.
In the case of pensions, these systems are a constitutive element of the universal social protection systems and welfare architectures of the countries, being decisive in the economic security of millions of elderly people. As ECLAC has indicated, it is essential to consolidate sustainable pension systems from a triple perspective, coverage, sufficiency and financial, and that they consider social security principles centrally in their design, including social solidarity and gender equality. Advancing in the articulation of the contributory and non-contributory components of these systems, as well as in mechanisms to universally guarantee levels of basic benefits, with adherence to the set of social security principles, becomes a core challenge for the region, especially , in the face of the impacts produced by the COVID-19 pandemic.
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