The health system in Colombia consolidated its installed capacity due to Covid-19


Today the country has a figure of 97,000 hospital beds; that is, almost 2 beds for every 1,000 inhabitants. As of November 2022, there were exactly 8,446 Intensive Care beds, which means a growth of close to 60% within the Colombian health system. As of November 3, 2022, 141,850 people had died in Colombia from the virus.

By Juan Carlos Diaz

Human forum journalist


Two and a half years after the covid-19 pandemic arrived, Colombia achieved important results in health care, which allowed it to advance in a phase of hospital expansion throughout the country, in which the intermediate care beds in intensive care and the expansion of installed capacity in clinics and hospitals, among others.

The pandemic put the Colombian health system on the ropes and measured human, technical and infrastructure capacities.

The coronavirus allowed installed capacity in Colombia, which refers to the availability of infrastructure necessary to produce certain goods or services, to have greater coverage to serve the population affected by the virus.

For example, in the case of respirators, the national government, through the Ministry of Health, during the government of former President Iván Duque, spared no effort to buy the equipment in the best possible conditions, despite the fact that in the world market prices for these items were on the rise.

Ministerio de Salud de colombiaFormer President Ivan Duque receiving medical equipment. Photo: Colombian Ministry of Health.

The national government invested more than 45 billion pesos, of which more than 16 billion pesos were allocated to health for more than 20,800 pieces of equipment, including fans, ICU beds, monitors, infrastructure projects, diagnostic tests, and elements of personal protection.

Likewise, five billion pesos were invested in the purchase of the vaccine and its administration. Of the 106 billion vaccines that arrived in Colombia, 17 million were donated.


Resources for Health Emergency Care. Source: Ministry of Finance and Public Credit, Colombia.

A productive growth

In terms of expansion of hospital beds, it went from 19.54% to an estimated 105%; Regarding telecare (virtual appointments), there was an increase of up to 230% in locations and 300% in services between 2019 and 2020. The country responded not only with the expansion of beds, but with telemedicine.

Regarding new technologies, Colombians managed to access the digital vaccination record against the pandemic, through the MiVacuna portal, which was designed to prioritize the National Vaccination Plan.

In this digital tool, the registration of a little more than 61 million people was counted. It was also set up as the main portal for downloading the digital vaccination certificate. There are more than 23.2 million downloads.

Likewise, 66,944 digital certificates for covid-19 tests have also been downloaded; 797,283 digital vaccination certificates from the European Union; as well as 32,129 digital vaccination certificates for tourists, and 678 Covid test certificates for tourists.

Also read: 30 months of Covid-19 in Mexico: lack of doctors, there are language barriers and areas where they still «don’t even know what the virus is».

The role of medical associations in the health of Colombia

The medical associations played an important role in the process of preparing the country and the health system, such as the protocols for ICU patient care, which analyzed, studied, and discussed the protocols for acquiring specialized medical equipment, as well as the possibility of generate knowledge and adapt it to different contexts.

Juan Carlos Giraldo Valencia, general director of the Colombian Association of Hospitals and Clinics, ACHC, in dialog with FORO HUMANOS and TuBarco News, assured that the health sector in Colombia, and specifically the service provision section, significantly expanded most of its service delivery item.


Juan Carlos Giraldo, general director of the Colombian Association of Hospitals and Clinics, ACHC. Photo: Colombian Ministry of Health.

“In installed capacity in beds before the pandemic, we are talking about the year 2019, the country had 86 thousand hospital beds. Today, in the immediate post-pandemic period, Colombia has a figure of 97,000 hospital beds, that is, almost 2 beds per 1,000 inhabitants when the average had been around 1.5-1.6 beds per 1,000 inhabitants in the pre-pandemic period. Revealed Carlos Giraldo Valencia, general director of the ACHC.

Regarding the Intensive Care Units, ICU, Giraldo Valencia stated that they were the ones that were mainly expanded during the pandemic.


Intensive care unit. Source: Ministry of Health of Colombia.

“In 2019 we had 5,300 ICU beds in Colombia. At the worst moment of the pandemic, we managed to have more than 13,300 beds in Intensive Care Units. Today, in November 2022, we have exactly 8,446 intensive care beds, which means a growth of close to 60% compared to the pre-pandemic moment”, highlighted Carlos Giraldo.

In view of the foregoing, it should be noted that Colombia has more than 3,500 IPS (Institutions that provide health services) that were enabled to provide telemedicine services, given the crisis that the covid-19 pandemic generated in the health system.

«This implies, in a few words, an expansion that occurred with a correlative growth of resources, especially all the human teams, associated with that infrastructure that was expanded to be able to respond adequately,» said Giraldo Valencia.

Colombia, ready or lagging behind?

In this regard, Juan Carlos Giraldo Valencia, general director of the ACHC, hopes that with all the equipment and knowledge acquired, Colombia can respond adequately to other pandemics.

“We hope that with everything learned during the pandemic and with the expansions that occurred in infrastructure, staffing and equipment, in beds, and in human talent teams, an adequate level can be achieved to respond to the different challenges that are coming. To have the burden of disease and the epidemiological profile from now on”, he stressed.

Carlos Giraldo highlighted that beyond the issue of infrastructure during the pandemic period, it was learned that, starting from knowledge, going through power, reaching authority and executing, a series of very effective processes can be carried out within the health system. Without so much redundancy and «redundancy», as has been usual in the pre-pandemic period and now that the country has returned to the new normality.

“What could be expanded must be maintained to the maximum. The sustainability of all these new services must be sought. but it must be understood that the rapid ways in which the processes were implemented in the pandemic period should be achievements that should not be dismantled and that we can maintain in this period”, suggested the general director of the Colombian Association of Hospitals and Clinics, ACHC.

He also pointed out:

The first thing is to face the fatigue and exhaustion and the difficulties of the human health talent, subjected to the enormous pressure of facing the pandemic.

The second, to obtain sufficient resources to be able to maintain these expansions, and specifically services that are socially sensitive, such as pediatrics, obstetrics or mental health, may have new sources of financing to be maintained over time.

The third thing is to face great challenges also derived from the pandemic, such as: the shortage of medicines, the shortage of some devices, the price increases that have occurred with these different items, and also finding a source of financing to be able to maintain the entire supply of elements. Personal protection for all the human talent that works in the health sector.

Carlos Giraldo added that there is a very special point to address now and that is to harmoniously resume all the services that were dammed at some point and be able to face this enormous epidemiological challenge, which is the growth of a burden of chronic diseases that in its moment they were postponed in their attentions to be able to face the issue of covid-19.

Challenges for health in Colombia

Once the pandemic, which has left a series of difficulties, is under control, Colombia has to make decisions about how much expanded capacity can be maintained and whether there are enough resources to give it long-term sustainability.

Being a vaccine-producing country

Fernando de la Hoz Epidemiologist, director of the Department of Public Health of the National University, proposes that Colombia should once again acquire the capacity for vaccine production, research and technological development.

“Having some kind of sovereignty in developments in the biotechnological field in health, something that Colombia lost almost entirely by privileging purchasing models. Countries that have some vaccine production capacity have had greater flexibility to deal with technological development companies,» he says.

Likewise, it indicates that “the country must have a vaccination infrastructure that depends above all on the public network. We must go back to public hospitals, to local health systems that have real coverage of the geographical area, that know their population, so that these public health processes have greater efficiency and coverage.


Fernando de la Hoz Epidemiologist director of the Department of Public Health of the National University. Photo: Colombian Ministry of Health.

 Luis Méndez President of ASINFAR, Association of Pharmaceutical Industries in Colombia, maintains that the Colombian pharmaceutical industry could advance towards the development and production of vaccines for humans if it had technology transfer, investment, commitment from the Government and regulatory authorities to provide stability legal and financial possibilities, and in guaranteeing the further development of this industry.

“Today the country does not have the industrial capacity to produce vaccines for humans. There are capacities in some laboratories to do it at an experimental, micro level, but not at an industrial level to serve an entire population. The same happens with some laboratories that develop and produce vaccines for the veterinary sector. We still need to move towards the development and production of vaccines for humans”, he commented.

indicated that, since the beginning of the pandemic, when the vaccine solution was discussed, ASINFAR associates expressed to the national government their intention to participate within the capacities:

«Unfortunately, there are no installed capacities to produce vaccines in their entirety, but they do have to participate, as some Latin American countries did, in some stages of production, for example in the filling, dosing, labeling and finalization of the product,» he explained.

ASINFAR, Association of Pharmaceutical Industries in Colombia. Photo: Colombian Ministry of Health.

Proposals for the health system in ColombiaASINFAR also proposed that a regulation be developed that favors and encourages, from a technical, economic and human resource perspective, the production and guaranteed supply of local vaccines.

“The technology is invented and there are experts around the world and companies that provide the required equipment. Colombia needs to make the investments to reinstall them, validate them and submit them for approval from Invima, which should make an agile evaluation, but with all the rigor of the case”.

Faced with a possible release of patents for the covid-19 vaccine, Méndez declared: “We welcome the United States’ request to join the initiative for the World Trade Organization (WTO) to help in the release of patents. There is still a process to be discussed and signed with all the members of the WTO, because there are many who oppose it. But if that were to happen, there are companies interested in entering the process, understanding that the mere announcement of releasing patents is not enough”.

Health in Colombia, example

Covid-19 was undoubtedly a test for the health system in Colombia, which, with all the limitations, knew how to respond to the pandemic and has practically been the only country in Latin America that has been able to double its ICU capacity, without starting from a low capacity.

According to the Ministry of Health, today the country has one of the lowest covid-19 fatality rates in the world, since it had the right incentives to double technology and human resource capacity to deal with the pandemic.

«If we had not had an integrated public-private mixed health system, a system with an insurance response capacity and with universal coverage greater than 95%, we would not have been able to respond,» said former health minister Fernando Ruíz, who had his position to attend to the pandemic in its entirety in Colombia from March 2020 until when he left this portfolio in August 2022.

Ministerio de Salud de Colombia

Graph corresponding to the cases of death from Covid – 19, currently there is a notable decrease in deaths. Photo: Colombian Ministry of Health.

Regarding the installed capacity, former minister Fernando Ruíz pointed out that what currently exists is sufficient «and probably even excessive in some areas of the country.»

However, the point is the public hospital, an aspect in which progress has been made, «but it still needs to be perfected, where we want to go, how we want to integrate it,» he said.

“In my opinion, Colombia cannot continue with small public hospitals, which are not integrated into the network with the others. It is time that comprehensive networks can be generated, ”said former health minister Fernando Ruíz at the time.

The country did not have to face the tragedy of other countries such as Italy, Spain, Peru or Ecuador, where many of those infected died on the street. The authorities’ strategy was supported by a group of suitable professionals and an infrastructure that was at its limit, but was enough to meet the needs.

The president of the Association of Comprehensive Medicine Entities, Acemi, Gustavo Morales, assured that the pandemic forced a technological leap that the actors in the system anticipated for three or four years and that had to be resolved in four or five months.

The FOME was created under the need of the national Government to guarantee the provision of the services required to attend the health emergency, alleviate the adverse effects on households and companies, and provide the necessary inputs to maintain and restore the economic activity of the country depending of the evolution of the pandemic.}

Through the creation of the Emergency Mitigation Fund, an independent management of the resources administered there from the other resources of the PGN was allowed and by granting a specific destination of these resources, the opportunity, speed and efficiency in the attention of the emergency.

Vaccination plan

The National Vaccination Plan against covid-19 stated that in order to achieve herd immunity, 70% of the population must be reached; that is, 35,734,649 people should be vaccinated.

For this purpose, Colombia acquired 61.5 million doses of vaccines. Despite the confidentiality agreements with pharmaceutical companies on the cost, it is known that the Government committed $3.07 billion in the acquisition of biologicals, according to data from nine resolutions of the Ministry of Finance, to guarantee agreements with six pharmaceutical companies.

In addition to these vaccine acquisition costs, the Government committed $525 million to transport 192,000 doses of Sinovac from China and $668,925 million to pay for the vaccine application procedure and to carry out monitoring and verification actions by the EPS. These costs associated with the application of vaccines are also financed from FOME resources.

Distribution of funds for health emergency care. Source: Ministry of Finance and Public Credit.

When talking about health spending, the charge for availability, a measure provided by which resources are delivered to the IPS for the maintenance of ICU beds. According to the figures provided by the Ministry of Health, $463,000 million has been recognized to 358 IPS for this concept.

In relation to the benefits or bonuses given to first-line health human talent, these represent a cost of $403 billion; an amount that has been delivered to 266,255 health professionals who meet the criteria to receive this economic recognition.

Despite the fact that last year the resources from the covid baskets were not used, ready to attend to the health emergency in the event that the UPC resources were not sufficient, 13 EPS of the contributory regime and 26 of the subsidized regime will receive said resources to strengthen your operations.

As in other mechanisms of the health system, the funds will be transferred directly by ADRES to the service providers from October 25. In total, these values amount to $1.9 trillion.

Financial aid

Finally, regarding the ‘Emergency Assets’ program, which facilitated the permanence of Colombians within the health system, there is an implementation represented at a cost of $2.1 billion, destined to the UPC financing of those people affiliated with the contributory regime who lost their job or source of income during the pandemic.

For people in the subsidized regime, there is an economic benefit when a positive case of Covid-19 occurs, since they do not have stable sources of income and their day-to-day life is seriously affected when they have to go into isolation. So far, resources have been delivered to 266 thousand beneficiary families worth $57 billion.

Latin America has been one of the regions hardest hit by the double impact caused by the pandemic. On the one hand, the toilet, with a high number of deaths; on the other, the economic one, with the largest drop in GDP in history and significant increases in poverty and unemployment.

However, some countries knew how to respond better than others at the start of the crisis.

According to a report by the University of Anti and the Andi Insurance Chamber, those with higher health coverage and greater public financing fared better because families did not have to reach into their pockets as much, for example, to the preparation of covid-19 tests, the acquisition of medicines or external consultations, among other medical expenses.

Populations not vaccinated

El Guaviare, is one of the departments of the Colombian Amazon, where communities no longer see the need to continue vaccinating or completing the vaccination scheme, after the health emergency ended on June 30, 2022, which was in force since March 12, 2020.

Of the 10,282 people who inhabit this population, only 45% have the complete vaccination schedule against the virus.

One of those populations in the department of Guaviare is the municipality of Calamar, one of the four that has not yet completed covid-19 vaccination coverage; this because people have relaxed thinking that the pandemic has completely ended. .

«Indeed, given that the ministry has already ended the health emergency at the national level, the population of the municipality chose that, since we no longer have Covid, then they no longer see the need to continue vaccinating or completing the vaccination scheme,» he warned. Carmen Marzola municipal public health coordinator of Calamar.

But despite the indifference to the covid-19 vaccine, they are looking house to house for people who in this population of the Colombian Amazon have not wanted to be vaccinated.

“Since we started vaccination in the municipality of Calamar on March 1, 2021, we have been implementing many strategies, for example, we have carried out house-to-house searches of people, we have raised awareness through the Caracol Radio Guaviare station, by the National Army station and meetings with the different educational institutions, but the difficulty has arisen because to vaccinate children, we must have the consent of the parents, otherwise we cannot vaccinate them,” Marzola warned.

The population from 5 to 9 years of age in the municipality of Calamar, in Guaviare, has very good coverage, as well as the population from 18 to 19 years of age, and also the older adult population from 80 years of age.

“Even in the department of Guaviare we continue to identify and diagnose covid cases; So the call that we always make to the communities is that they must still continue with the biosafety protocols because we have not achieved that complete vaccination scheme above 80%.” Marzola stressed.

The municipal public health coordinator of Calamar, Carmen Marzola, warns that there is a sufficient quantity of biologicals available to the community.

“We are locating ourselves in strategic places in the city where there is more flow of people and vehicles applying the biological. There are people who refuse to continue with the scheme or to get the first dose themselves, so we ask them to sign the dissent, ”said the municipal public health coordinator of Calamar, Carmen Marzola.

The municipality of Calamar is part of the four municipalities that make up the department of Guaviare, to which are added San José de Guaviare, El Retorno and Miraflores.

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