Update: on February 11, government and opposition representatives agreed to cooperate to purchase and distribute COVID-19 vaccines for 6 million people. Read WOLA’s statement on the effort here.

Amid a difficult year in Venezuela, one of the bright spots of 2020 was the June humanitarian agreement signed between Maduro’s Ministry of Health and the Humanitarian Aid Commission of the opposition-controlled National Assembly, coordinated by the Pan American Health Organization (PAHO). Six months after its announcement, however, implementation of the deal has gone off track. Maduro is not fully distributing antigen test equipment as agreed, and it remains unclear whether the opposition will succeed in pressing for certain conditions in order to widen the PAHO deal to include a COVID-19 vaccine.

While the international community (including the U.S. government) has applauded the deal, little has been made public about the terms of this agreement. The only version that has been published, which bears the signatures of National Assembly health policy advisor Julio Castro, Health Minister Carlos Alvarado, and PAHO representative Gerardo de Cosio, is just one page long. It identifies six priority areas, which are: 

  • Detecting active COVID-19 cases through laboratory diagnostics
  • Opportune and adequate treatment of confirmed cases
  • Supervised isolation of symptomatic cases, and quarantine of contacts
  • Protection of health personnel
  • Implementation of measures to prevent and control infections in health centers
  • Epidemiological observation, analysis of information and situation reports
  • Communication campaigns to educate the public about risks and prevention measures

However, this version does not contain details about the breakdown of funding for the response, and instead merely states: “Both parties propose to work in coordination with the support of PAHO in the search for financial resources to strengthen the response to the health emergency caused by the pandemic.” While initial reports suggested that the opposition would donate as much as $20 million in frozen assets to this deal, opposition sources have said that this figure includes funds that were used for other projects such as the “health heroes” program that provided doctors and medical staff with cash transfers. In total, the opposition donated $12 million towards the implementation of the PAHO accord, which went towards protective equipment for medical workers as well as COVID-19 antigen tests and related testing machines.

WOLA has supported this agreement, and in our recent policy memo to the Biden administration we encouraged the White House to support expanding the PAHO deal as a way to build social capital towards a broader negotiated political accord. However, in recent weeks both the opposition and PAHO officials have signalled that the deal is in jeopardy. The protective equipment has largely been distributed in accordance with the terms of the accord, but the antigen tests and testing equipment have not. PAHO specialists have publicly confirmed that only one percent of the antigen tests have been distributed so far. 

While some former Trump administration officials, like Elliott Abrams, have claimed the tests are stolen or unaccounted for, this allegation has not been shared by the opposition nor by PAHO. Instead, they say that Maduro has allocated the tests in areas less affected by COVID-19, possibly as a way to keep the incidence of positive testing low. Ciro Ugarte, Director of PAHO’s Department of Emergency Preparedness and Disaster Relief, told El Carabobeño that most of the tests have been applied in Zulia and Yaracuy, not in the Caracas metropolitan area. On January 13, Guaidó’s UN representative Miguel Pizarro sent a letter to PAHO noting that the decision by the Health Ministry to “locate the antigen testing machines in regional public health laboratories and in other entities with a low influx of COVID-19 cases represents a break from the agreement.”

At the same time as the Maduro government is coming under increasing pressure to fully implement the existing PAHO accord, some have called for the agreement to be widened to include a COVID-19 vaccine. Civil society organizations have been urging some form of broader humanitarian accord for months, and the emergence of viable vaccines has led some analysts to wonder if the Guaidó coalition (which has access to frozen public funds) and Maduro (who remains in de facto control of the country) could possibly coordinate to purchase and distribute vaccine doses in Venezuela.

So far there appears to be little reason for optimism. Maduro has proposed the sale of a portion of the $2 billion that Venezuela’s central bank has sitting frozen in the U.K., but Guaidó has insisted that Maduro cannot be trusted to distribute the vaccines. The fact that Maduro has failed to properly adhere to the agreed conditions for testing distribution has not helped his case. Instead the opposition has suggested that frozen funds could be mobilized only under the following conditions:

  1. The vaccination plan must be created by independent medical associations, universities, and multilateral organizations;
  2. UN agencies, and not the Maduro government, should carry out this program;
  3. The implementation of vaccination must be guided by humanitarian principles, and
  4. A monitoring scheme should be established that guarantees unrestricted access for NGOs and health personnel.

So far there has been no answer from Maduro to this proposal, even as the clock is ticking. On February 2 the PAHO Head of Mission in Venezuela, Paolo Balladelli, announced that the organization had extended a missed deadline for Venezuela to pay its debts to PAHO (which amount to $11 million) until February 9. If Venezuela were to pay these debts, Balladelli said, “between 1,425,000 and 2,409,600 doses of the AstraZeneca COVID vaccine would arrive at the end of February.”

Instead of responding to this window, so far Maduro has emphasized his apparent plan to begin distributing the Russian Sputnik-V vaccine. But while the government has claimed that vaccination could begin in April it has not provided a clearer timeline of where the process stands, even as other countries in the region, like Mexico and Argentina, have already begun distributing the Russian vaccine. Ultimately, the government’s silence may be linked to a broader political calculation. Maduro successfully marginalized Guaidó over the course of 2020, and may perceive a risk that entering into an internationally-recognized agreement with the opposition leader could help the opposition drum up domestic support.