Poverty, precarious work, and the COVID-19 pandemic: lessons from Bolivia

Calla Hummel, Felicia Marie Knaul, Michael Touchton, V Ximena Velasco Guachalla, Jami Nelson-Nuñez & Carew Boulding

The Lancet | Open Access | Published: January 25, 2021 | DOI:

Bolivia is one of the poorest countries in Latin America with a gross domestic product of around US$3500 per capita, health spending of approximately $220 per capita, a labour market dominated by informal work, and a weak health system. However, in the response to COVID-19, Bolivia has fared better than other health systems in the region and provides insight with regard to the implementation of subnational non-pharmaceutical interventions and supporting workers without social protection.

The Bolivian Government confirmed the first case of COVID-19 in the country on March 10, 2020, and responded quickly by cancelling events, closing schools and borders, and implementing a national lockdown on March 22, 2020. However, the Bolivian Government was under pressure to open the economy in an election season. In response, the Bolivian Government shifted responsibility for most non-pharmaceutical interventions to departmental and municipal governments on June 1, 2020. The Bolivian Government maintained a mask mandate, school and border closures, and a nightly curfew, while allowing departmental and municipal governments to set workplace, social gathering, population mobility, and public transit policies. Daily deaths from COVID-19 increased markedly from 20 on June 1, 2020, to 96 on Aug 1, 2020.

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