The Colombian health system is based on Law no. 100 which was issued in 1993. While access to essential health care services is considered universal under this law, health care is treated as a commodity. The mainly private companies in charge of providing health care services try to maximize profits by keeping costs and expenditures low. This implies that costs for treatment and medical personnel are kept at a minimum. The low national budget for health (in addition to an almost non-existent public health system) is a recipe for disaster in the case of a major health event. Moreover, around 65% of the labor force in the health sector is informal. And most of those who have formal working contracts are hired on a short-term basis, not as regular employees. Needless to say, the government does not provide unemployment subsidies. The COVID-19 outbreak in Colombia finds a health system that is not capable of coping with many seriously ill people simultaneously.

Curfew: a special challenge for poor people

Even if all imposed measures prevent people from getting infected and makes them stay at home, more than half of the Colombian population is working in the informal sector and depends on daily income from street sales. Only a few of them can afford the “luxury” of quarantine while living from financial reserves. At the end of 2019, just before the coronavirus world crisis started, Colombian people took to the streets to protest for significant changes. Among the many issues people demanded was a transformation of the neoliberal public health, labor and social protection systems. Currently, people cannot protest in the streets due to quarantine, but sadly, COVID-19 arrived in Colombia only to show that the protests in 2019 were justifiable. In addition, NGOs in Colombia have reported that the curfew worsens the situation of potential victims of domestic violence, especially in the bigger cities. Only a few days after the curfew had been imposed, UN Women reported that more women had been murdered and assaulted than in other comparable periods. The crisis will particularly affect the socially vulnerable and exacerbate existing structures of poverty and inequality within the country.

The current health crisis is a global one from which the poorest and most marginalized people all over the world will suffer most. The crisis bluntly reveals global issues of inequalities, as well as unequal terms of trade and asymmetric dependencies in supply and commodity chains. Future research priorities should focus more on hygienic precautions and health prevention. How can we overcome the two-tier health care system in order to protect those people who are hit the hardest? More attention should also be paid to global processes and the socio-economic implications of COVID-19 on the short, medium and long run. How can small- and medium-size enterprises, those working in the informal sectors and as low-wage laborers, especially in and from the global South, be empowered so they are less vulnerable to these unexpected but far-reaching global shocks? Neoliberal principles and the commodification of almost every part of our societies, politics, culture, religion, education and last but not least health-care systems need to be re-thought fundamentally.