Exploring Barriers and Enablers to Peru’s COVID-19 Pandemic Response, and the Local, Regional, and Global Implications

Abstract

Background: Peru had more COVID-related deaths per capita than any other country. Given its relative wealth as an Upper Middle Income Country, Peru did not receive many COVID vaccine donations through COVAX, and challenges directly negotiating for vaccines with pharmaceutical companies delayed Peru’s initial response. However, once vaccines were procured, Peru successfully initiated wide-spread vaccination campaigns. This study was done to understand Peru’s unique COVID challenges and successes and aims to explore barriers and enablers of Peru’s pandemic response to offer lessons for the scale-up of vaccinations, health innovations, and pandemic response capacity in Peru, Latin America, and globally. Methods: 31 semi-structured in- depth interviews were conducted in Lima, Peru with 35 individuals from public, private, academia, healthcare, and civil society sectors that worked in diverse geographies across Peru. Participants were recruited through purposeful and snowball sampling via WhatsApp, based on the inclusion criteria of being involved in Peru’s COVID-19 pandemic response and preparedness (i.e., with vaccine procurement and distribution, emergency health innovations, and community responses). Ethics approval was received from the Duke University Campus Institutional Review Board. Written and verbal consent was obtained from participants before each interview. A qualitative content analysis is currently being done on the interview transcripts. Afterwards a force field analysis will be applied to understand which factors most negatively and positively impacted Peru’s pandemic response capacity. Results: Preliminary findings from the 31 interviews indicate political instability, cross-sector competition, a fragmented health system, and limited medical resource manufacturing and regulations limited Peru’s pandemic response. However, previous experience with vaccination campaigns, community-based support, and cross-sector collaboration influenced effective COVID vaccine distribution and vaccination levels. Conclusion: Peru experienced some small-scale effective COVID response measures, but these were overshadowed by large-scale systemic and political issues, hindering Peru’s pandemic response. This study explores economic, cultural, political, and social factors that impacted Peru’s COVID response, and includes diverse perspectives from various sectors and geographies, increasing the validity and generalizability of findings. However, future studies should include equal representation of sectors and geographies, as most participants represent the public sector and worked in Lima.