5 de enero 2022
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Nicaragua closed 2021 with minor advances in access to information and transparency related to the covid-19 pandemic, despite commitments to multilateral agencies that urged disclosure of pandemic data.
CONFIDENCIAL conducted a review of the transparency agreements to which the Government of Nicaragua agreed in order to obtain a series of loans to combat the pandemic, totaling US$185.4 million, from the International Monetary Fund, the World Bank and the Inter-American Development Bank. According to the review, the authorities have partially complied with their commitments.
The main commitments in the agreements were to publish official figures on infections by sex, age and location; deaths, case fatality, PCR tests performed and their results, pandemic-related expenditures, ward updates and epidemiological bulletins. Although some of this information was recently shared, it was not shared with the level of detail and accuracy requested.
The authorities of the Ministry of Health (Minsa) published 46 of the 2021 epidemiological bulletins this month, which had been suspended in May 2020 after an increase in pneumonia deaths attributable to covid-19 were reported. These revealed, for the first time, data on the total number of PCR tests performed in the country: 144 170 as of November 28, but did not include a breakdown of how many were positive, how many were negative or how many were paid for travel reasons.
These documents also include a couple of graphs in which the Ministry of Health (Minsa) shows the number of people infected in 2021 by gender and age, but without revealing figures that would allow corroboration of the information or more in-depth analysis. Meanwhile, the epidemiological records, where the impact of epidemics by department can be seen, have not been updated since May 2020.
The “covid contracts” have also not been updated in real time. Authorities have included four updates of purchases made during the pandemic that include at least 60 contracts, but leave out acquisitions that favored companies related to the government, according to journalistic investigations.
Two years without vital statistics
During 2021, Minsa also failed to update the Health Map which reveals information on the number of hospitalizations and the 15 most frequent causes of death in the country. The latter data made it possible to determine the excess mortality that occurred during the first six months of the pandemic, which, according to medical opinions are attributable to covid-19 and placed the country among the countries with the highest excess mortality.
“It is a devastating disease, we have among the highest mortality rates in the world and the continent, and have the largest underreporting in countries with studies. Let's draw lessons from this, let's avoid a repetition of the tragedy,” said members of the Multidisciplinary Scientific Committee, which self-dissolved in 2021, in the face of political persecution by the Government.
The authorities have also not published the compilation of vital statistics of the last two years, where they collect the figures of deaths and births at national level in detail. This document is released by the National Institute of Development Information (INIDE), but has not been updated since 2019.
Instead, the authorities have limited themselves to sharing certain data in interviews with official media, in which they highlight the achievements they had in the year and mention some numbers on hospitalizations, but not deaths.
According to an interview given on December 13 last year by the head of Minsa, Martha Reyes, up to that date in 2021 there were 538,800 hospitalizations, 43% more than those reported a year ago. However, she did not explain whether this increase is related to the second wave of covid-19, which was higher than the first.
Regarding mortality figures, he only compared infant, maternal and cervical cancer mortality rates in 2021 with those recorded in 2006, before Daniel Ortega assumed the presidency.
Repression against doctors who warn about the pandemic
In an effort to impose opacity, the authorities also unleashed a wave of repression against the medical profession, health organizations and journalists reporting on the pandemic.
At least 15 medical organizations, among them the Nicaraguan Medical Association, the Pneumology Medical Association, the Diabetology Association, among others, lost their legal status after the National Assembly approved a cancellation decree stating that they did not “comply” with their legal and statutory obligations, despite the “obstacles” imposed by the Ministry of the Interior (Migob) during the last three years.
Likewise, the Minsa summoned a dozen independent physicians before the Directorate of Health Regulation and the Directorate of Legal Counsel of this institution, and questioned them for making statements to the media and threatened them with the Law of Cyber Crimes and the cancellation of their medical license.
“According to what I was told, the Ministry of Health is the only one authorized and that information should not be disseminated so as not to cause anguish and anxiety in the population”, said one of the doctors summoned.
The threats to the guild caused many doctors to decide to go into exile, others to stop giving interviews or to protect their identities when speaking out. However, the greatest loss caused by the repression was the self-dissolution of the Multidisciplinary Scientific Committee, which during the first year of the pandemic provided preventive information and analysis of the pandemic.
The Citizen Observatory COVID-19, which carries out independent monitoring of suspected pandemic infections and deaths in the absence of official statistics, was also affected. At several points in 2021 they lost capacity to collect information due to the government repression.
“The reports received by the Observatory showed a clear increase starting in the month of May 2021, which coincided with the increase reported by the Minsa in their weekly reports. Curiously, despite the increase reported by Minsa and the fact that we know the pandemic is not under control, the reports we receive have decreased ever since the arrests and enforcement of recent laws began”, they said in June of last year.
However, during the second wave of covid-19, which was stronger than the first, the frequency of infections and deaths resumed. But after the outbreak subsided, which coincided with the elections in which Daniel Ortega secured his fourth term in office without electoral competition, they lost capacity and have now changed their weekly report to biweekly.
This article was originally published in Spanish in Confidencial and translated by our staff
