The VI Conversation in Positive, an exercise in dialogue about the future governance promoted by ORU Fogar to identify the consequences of the pandemic, highlighted the difficulties that -with the arrival of COVID-19- public and state initiatives reached all corners of the territory. In a dialogue between Carlos Rua, governor of Ayacucho and president of the National Assembly of Regional Governments of Peru, and Mario García, mayor of Lavalleja, Uruguay, concluded that the paradox of the situation was that COVID-19 had reached the most inhospitable places, while the public health authorities couldn’t, due to lack of human and financial resources.
Governor and mayor explained how Peru and Uruguay had a completely different first approximation to the pandemic. Peru's first reaction was to close borders and bet on confinement. In Uruguay, the government appealed for the responsible freedom without a confinement. People voluntarily restricted their mobility. The dialogue between central government and regional governments was also different. Governor Carlos Rua explained that the Peruvian institutional crisis, with several changes of presidents and several health ministers during the most serious months of the pandemic, greatly hindered emergency management and cooperation between the national government and regional and local governments. The regions were key for the health resources to reach the territory and the budget had to be modified to provide all the necessary hospital material. “Our territory is so extensive,” said the governor of Ayacucho, “that reaching rural territories is very difficult. The main challenge of the pandemic has been to get health resources to remote populations. Without the participation of the regions, the central government would have bypassed groups that are sensitive to the virus”.
Mayor Mario Garcia exposed similar difficulties in dealing with the pandemic: “No one was prepared for an alert of this dimension. Tests, laboratories and beds were lacking in hospitals. In order to obtain all these resources, all the private and public providers had to be coordinated and put to the limit. Only in this way it was possible to prevent the health system from collapsing ”. The mayor of Lavalleja, however, described a very different approach to the pandemic by the different levels of government in Uruguay. He explained that one of the successes of the national government was the decentralization of decisions. The government issued decrees, but with freedom for the departments, as regards their application. Thus, decision-making followed a guide, but not homogenized. "The national government -explained Mayor García- was transparent with all the information."
The governor and the mayor paid attention to the vaccination process in their respective regions. Both pointed out the existence of sectors of the population reluctant to vaccination. They belive that, the regions should play a fundamental role in overcoming these resistance. The greatest concern, however, was the difficulty in getting vaccines to all territories and social sectors. Carlos Rua explained how expensive a vaccination process was in a territory as extensive and lacking in good communications, such as Peru. Thus, he demanded an "equitable" distribution of the vaccines. Mario García appealed to the joint action of different actors to achieve a rapid arrival of the vaccines.
The two regional leaders concluded that future governance will be determined by the idea that, if there is no health, there is no development. Another conclusion was that the best way to confront the dangers of globalization is to have local and regional consolidated powers.