Proceso 916
August 30, 2000
ISSN 0259-9864
 
 
 

INDEX

EDITORIAL

    Last Saturday in the early morning hours, Deputy Francisco Merino was at the center of an embarrassing incident in which a National Civilian Police agent was wounded. Briefly, and inasmuch as the events surrounding the incident are known, Merino, in a state of unconcealable drunkenness, which was noticeable to all, threatened a private guard in a residential area with his gun and the incident was reported to the 121 emergency system. Members of this police corps in a vehicle went to the place of the incident where they were received with shots from a gun, one of which wounded Police Agent Flor de María Meléndez. It has been clearly established that Deputy Merino was the person firing the gun.

    This incident gives pause to reflects upon a situation which goes beyond the simple condemnation of the ex-Vice President of the Republic who is now a legislative deputy for the National Conciliation Party (PCN). What first catches our attention in the “Merino Case” is the moral quality exhibited by Salvadoran legislative deputies. Obviously it is not a question of requiring these representatives to be models of morality and virtue, but it is a question of such persons complying with the minimal norms of public decency. Legislative deputies cannot be condemned if, in their private lives, they get drunk and behave as they like. But it is the obligation of each one to take care not to become drunk in public and become the central figures in street scandals which disturb the peace and tranquillity of the citizenry. It is, of course, clear that they may, in fact, do so; Merino is a case in point. But they ought not to and if they do, they pay the high price of public irresponsibility. That the deputies—or well-known politicians—should become involved as central figures in street scandals and get off Scott free, is not something that contributes in a positive way to the construction of a democratic political culture but does give a green light to anyone who disturbed the peace and tranquillity of others without having any qualms of conscience and without having to make amends to anyone.

    In second place there is an additional element which is cause for greater seriousness in the “Merino Case”: that as a deputy he was carrying a firearm with which he not only threatened a private guard but also used to fire upon a police agent. This could have reached tragic proportions if the policewoman had died of the gunshot wounds—or if one of the other agents had been killed—or if Merino himself had been wounded or even killed. In a worst case scenario, if the police who were present in the Merino incident had been wounded or killed as a result of the gunshot wounds, the judicial authorities or even the Legislative Assembly itself would surely have gotten to the bottom of such a case involving police because one should not deceive oneself: in El Salvador the situation is still such that the citizenry is divided into two classes, that is to say, first class and second class citizens. Under this scheme of things a police agent wounded by a deputy is not the same thing as a deputy wounded by a police agent. That this is, in fact, the case, one has only to examine the reactions of some of the politicians and public functionaries as they reacted to the events of the case in point: in almost every case the seriousness of the wound suffered by the police agent has been minimized. On the other side of the coin, only a few voices have been raised in favor of a quick investigation to establish immediately who the responsible party was. So now, from among the voices raised not one has been heard to use the term “attempted homicide”, as if to fire a gun at someone did not constitute a crime of this nature. It even seems that among the critics of Merino’s behavior it has not been perceived as a serious crime to shoot at the police and wound one of its agents. Could it be that they think that if a person fires a gun at another person he is not placing the life of the victim at risk? Could it be that they believe that Merino—trained in the best tradition of right-wing militarism—fired at the windshield of the police victim without knowing what he was doing, strongly under the effects of alcohol, as he was at the moment?

    A third point among the reactions to the “Merino Case” is that they have not been characterized only by their aims to lessen the gravity of the police agent’s wound, but also by the absurd ideas which have been bandied about when discussing the case. One of the most splendid bald-faced allegations was offered by Deputy Gerardo Suvillaga who, without blushing even a little, has characterized Merino’s act as “an error which anyone could commit”, as if Merino’s behavior was simply some small fault not merit attention. From now on, smugglers, kidnappers, rapists, drug traffickers and bank robbers can take advantage of this phrase offered up by one of the fathers of the country: “it is an error anyone might commit”. But if this were not enough, this very same deputy compared Merino to Bill Clinton, as if shooting at the police and wounding a police agent were comparable to conducting an extra-marital affair. For all the rest, if this particular deputy were a little more lucid he might take account of the difficulties which Clinton confronted as a result of an affair which was child’s play compared with what he would have had to face if he had, while in a state of public drunkenness, shot at the police.

    One reaction that is the cause of much concern is that offered by Francisco Bertrand Galindo, Minister of Public Security. Mr. Galindo, in fact, introduced the less than felicitous expression, much preferred in the world of lawyers, prosecutors and judges of “a conciliated agreement”. Which is to say a private agreement between both parties to avoid the procedures and consequences of a public trial. No one could possibly be unaware of the problems and pitfalls involved in such a procedure: victims of accidents oftentimes accept, sometimes as a result of fear of reprisals or other threats of not agreeing to interminable bureaucratic procedures, a quick agreement which does not provide reparations for the harm occasioned and neither does it satisfy the requirements of justice which a state of law might demand. This is perhaps alright as a subsidiary mechanism, but not as a recourse of the first water to resolve conflicts with judicial implications because conceding a place for this kind of arrangement in the judicial system means that the judicial system must renounce thereby one of its fundamental obligations, which is that of imparting justice. And so one cannot but help feeling that the Minister of Public Security’s proposal to have recourse to “conciliation” in order to alleviate the harm occasioned by Deputy Merino’s actions sets a bad precedent in offering up “conciliation” as a first recourse for alleviating the harm occasioned by Deputy Merino. In so doing the Ministry provides even greater encouragement to the climate of irresponsibility prevalent in the justice system.

    Finally, the “Merino Case” obliges us to pay all due attention to the question of carrying firearms—weapons which are made for the purpose of killing. Firearms in the hands of irresponsible persons—be they drunken deputies, furious neighbors or criminals—are a threat to the security of citizens. That the carrying of arms is a legal act, in fact, guarantees nothing: it is here where the incident involving Deputy Merino serves as a case in point.

POLITICS

    Some days ago the question of the most recent audits carried out by the Comptrollers Office in the National Federation of Football (FEDEFUT) found its way into the headlines of the national news in El Salvador. The resounding nature of the case in this institution that governs Salvadoran football is emblematic of the kind of work the Comptrollers Office carries out. Without mentioning the law’s delay in carrying out the audit, which now reveals millions of colones worth of irregularities in FEDEFUT, nor even questioning the transparency of the methodology and practice of the audit of an institution controlled by the son of who was, until his death, a prominent member of the National Conciliation Party (PCN), it is of particular importance to effect an analysis of the functioning of the Comptrollers Office as the institution charged with scrutinizing the handling of public funds by public functionaries. The net result of this state of affairs is that an audit by society of the Comptrollers Office itself has become an unavoidable imperative.

    The Comptrollers Office of the Republic of El Salvador is the institution charged by law with monitoring the administration of the public treasury and goods. In this sense the Constitution of the Republic, in Article 195, stipulates that “the monitoring of the General Public Treasury and, specifically, of the administration of the budget, will be the responsibility of an independent organism of the Executive Branch of Government which shall be called the Comptrollers Office of the Republic”. Given this, among the attributes of this institution is to be found that of fighting corruption in state offices and dependencies and promoting mechanisms for conducting audits which, when they become public reports, allow the population to know the use of state resources. The attributions previously mentioned are sufficient for any informed onlooker to ask him or herself about the capacity of the leaders of this institution in the sense of examining whether they are ideal and appropriate candidates for their posts in complying with the determination to comply with the constitutional mandate.

    Given this, the functioning of the Comptrollers Office of vital importance for the cause of democracy in El Salvador. It has been proven on repeated occasions that countries where corruption in governmental spheres predominates not only find themselves in difficult straits when it comes to satisfying the minimal institutional exigencies of democracy, but are also incapable of adequately dealing with the serious problems of the populace. In this sense, fighting corruption and the adequate use of taxpayers’ money become the yardstick by which the health of the public administration of society is measured. In the measure in which the scourge of corruption is efficiently fought against, public functionaries find themselves on the road to offering better service to the populace without favoritism and perks which encourage impunity. Below, a summary reflection upon the functioning of the Comptrollers Office is presented and the health of public administration in El Salvador is examined as well as the public willingness of the state administrators to fulfill the constitutional responsibilities incumbent upon them in the exercise of the functions of their office..

    A glance at the recent history of the Comptrollers office highlights, first of all, several efforts tending towards improving the technical capacity of the employees charged with carrying out audits. It might be said that the auditors of the Comptrollers Office in general have sufficient technical training to carry out their work in an effective way. Nevertheless, on the question of their being the ideal and appropriate persons imbued with honesty and determination as responsible functionaries of this institution, the same judgment cannot be made with the same certainty.

    Although there are no resounding proofs of irregularities committed in the Comptrollers Office, denunciations of doubtful management in that institution occur on a regular basis. The forced resignation of Francisco Merino as president of that institution in July of 1999 is a case in point illustrating the deficiencies of that organism charged with financial control. At this point in time, Merino is accused of participating in irregularities which hold up to doubt his being the ideal person to lead an institution of such importance. Finally, after much pushing and shoving, public opinion prevailed and the ex-functionary, now a deputy for the National Conciliation (PCN) party, had to resign under suspicion of having mishandled funds and was involved in a scandal concerning the doubtful sale of doubtful properties. It is a curious fact that at this writing there has been no other news concerning the accusations weighing against Mr. Merino.

    Francisco Merino was replaced as president of the Comptrollers Office by one of his party cohorts, Rutilio Aguilera. Party loyalty, understood incorrectly, obliged such an appointment: silence concerning the truth or falsity of the accusations against the ex-functionary is proof of this. The political pact signed some years ago between the Republic Nationalist Alliance (ARENA) and the PCN permitted the Comptrollers Office to be what might be considered the spoils of office falling to the lot of the PCN. This is the key to understanding what happened within the Comptrollers Office. According to the provisions of this pact, the PCN controls the institution as the spoils of war in return for favors involving loyalty and support for ARENA initiatives emanating from the executive office and the legislative branch of government, the Legislative Assembly. Also a product of that pact is the cover-up of the systematic mishandling of funds in diverse state entities. As a result, an institution that ought to be free from party maneuvering and intrigue has made political criteria the guiding light of its work.

    Beyond an analysis of the technical capability of the employees of the Comptrollers Office, for this reason there must be a review conducted of up to what point party criteria permit the good functioning of that institution. The fact that an entity charged with monitoring the good and correct use of public resources has become a political prize for a party whose leaders enjoy dubious reputations makes one suspect the capability of the Comptrollers Office to carry out the tasks which have been assigned to it. This is because endemic corruption which corrodes public administration in El Salvador has not been attacked. In this way, the state is in the hands of a group of corrupt politicians who cover their backs. So things go. The entity charged with auditing has lost its raison d’etre. This situation is what has prevailed since the PCN took control of the Comptrollers Office. Instead of promoting a real monitoring of state spending, the PCN has become the very entity for covering up the sleights of hand committed by public functionaries. It could not be any other way when ARENA, the party which is favored by arithmetical legislative weight, never for one moment confided the future and destiny of the institution to an honest opposition party willing to put an end to governmental corruption. In this respect, it is revealing that the President of the Republic, Francisco Flores, never admitted the problem of corruption as one of the scourges of Salvadoran society. In the already ethereal alliances, considered to be the pillars of the government program, no action is contemplated for rescuing the country from the clutches of corruption.

    Constructing an alliance against corruption would mean a commitment with truth and a strong willingness to break with the past and with the privileges accruing the fossilized dinosaurs as a result of the corruption rampant in the country. A commitment of this seriousness seems to overflow the interests and capability of the current government team and the right-wing group which has imposed its voice upon the Legislative Assembly. Not even the legislators themselves are free from corruption. Denunciations of proven cases of nepotism and favoritism in this state body leave no doubt: a good portion of the deputies considers public resources theirs to be used to benefit their families and close friends.

    On the other hand, the hoped for audit procedures, postponed on several occasions, which the Legislative Assembly ought to effect in the Comptrollers Office, is another indication of the low level of disposition in favor of transparency existing in that body. The question of the Comptrollers Office has been discussed without exhibiting the slightest willingness to scrutinize its internal functioning. The political agreement oriented towards obstructing the work of an institution so important for the democratic ordering of the country is considered to be more important. If the institutional empowerment of El Salvador is what is sought, a political party such as the PCN is not the institution to confide the task to given that the opportunism of a good number of its leaders can hardly be concealed. It is because of a lack of serious and honest commitment to democracy (and to truth) that the right-wing political parties refuse to review the Comptrollers Office. All to the contrary, this state of affairs encourages them to hold it hostage for their own benefit. The silence of the president of the republic on the topic of corruption and good functioning in the institution charged with “monitoring, inspecting and examining the accounts of the functionaries which administer and handle public goods”, as the Political Constitution reminds us, could not be more disconcerting.

    For this reason, the intervention of society is necessary in order to oblige the political class to recognize and promote the independence of the Comptrollers Office. Social scrutiny lacking in the supervision and handling of this institution goes beyond simply allowing free access to information relative to the audits. A firm decision in this sense might be a good beginning. The media could offer much to society with serious and continuous investigations of the Comptrollers Office, without backing down before threats or giving in to possible efforts at graft and bribery. But monitoring by society might include a mechanism which permits the president of the entity charged with auditing to make public its findings to society—as it should—as much on the audits carried out as the results of these same audits.

    Along these same lines, it is urgent for the very same pressure now being applied by some organizations of civil society in favor of a de-politicizing of the naming of the Ombudsman for Human Rights be exercised as well on the question of the process for naming of the President of the Comptrollers Office. Just as in the case that, thanks to the permanent state of alert by the human rights organizations of the country, the ex-ombudsman for human rights, Eduardo Peñate Polanco, had to resign his charge, a permanent state of alert against corruption and the dubious administration in the Comptrollers Office might render positive results for the citizenry. In any case, an immediate objective of civil society would have to point out the necessity for impeding the access of the PCN to the presidency of the Comptrollers Office. For now, it is a question of demanding and requiring that the Legislative Assembly implement an audit of the Comptrollers Office at the earliest possible opportunity.

ECONOMY

    During the last few months the economic situation has been affected by an exogenous economic conditioning factor: the increase in international petroleum prices. In reality, during the last fifteen months, petroleum prices have increased drastically from approximately 18 to 15 dollars per barrel, an increase of close to 83%. Evidently this external conditioning factor has impacted El Salvador as it has affected all petroleum importing countries as a result of the substantial increases in prices of combustible fuels which have almost doubled since December of 1998.

    In this context, the discussion of the gross margins for intermediation by petroleum producing companies has been revived. In the government point of view, what follows is a reduction in order to alleviate the effect of the increases in international prices of petroleum. The petroleum producing companies did not accept the governmental suggestion and the Legislative Assembly, as a result, approved Legislative Decree 107 which made the reduction obligatory. It is not yet known if President Francisco Flores will promulgate the decree or veto it. All in all, according to his public declarations, everything seems to indicate that he might be willing to veto it if the petroleum producing companies accept a voluntary reduction of their margins of intermediation to the suggested levels.

    The foregoing obliges us to pay attention to two aspects: first of all, the implications of a reduction in the margins of intermediation of the final prices of combustible fuels and, secondly, the discretionality with which the ARENA administrations have negotiated the conditions for functioning and price fixing and rates for key activities such as the generation and distribution of electrical energy, telephone service, pension systems and, of course, the distribution of petroleum derivative products.

    As a result of the heavy price increases for petroleum mentioned above, the topic of the profit margins of the intermediation by petroleum companies came to light publicly, especially after the Minister of the Economy himself made public statements to the effect that they were close to triple those obtaining in neighboring countries such as Guatemala and Honduras. For example, if for each gallon of special gasoline the petroleum companies of Guatemala and Honduras received a profit of between 80 and 84 cents on the colon, respectively, in El Salvador they received 2.55 colones.

    It was in this context that the petroleum producing companies decided to reduce their profits voluntarily, although on a temporary basis only, after July 10. This means that special gasoline was reduced by 70 cents and regular by 90 cents and diesel by 40 cents. Even so the government, by means of the Minister of the Economy, insisted that the profit margins had to be reduced even more and fixed them at levels of 1.12 colones for special gasoline, 1.00 colon for regular and, 0.83 for diesel. And the Legislative Assembly Decree established the rates at these levels.

    Given this situation, the petroleum producing companies argue that the differences arise in different market conditions. In the case of El Salvador there are no ports on the Atlantic side, for which reason freight costs increase, labor costs are greater, land costs as well and the size of the market is smaller. Evidently these factors, although amenable for discussion, have some incidence in the price dynamics for petroleum and petroleum derivatives, but even so, it remains clear that the profit rates obtained per gallon of combustible fuels sold in El Salvador is greater than that obtained in Guatemala and Honduras. And the very fact that the petroleum producing companies might reduce their profit margins voluntarily fate July 10 reflects this state of affairs. Should they abide by the reductions provided for in the Legislative Assembly decree, the profit margins in El Salvador would remain at some 30% above those obtained in Guatemala or Honduras, which is more than sufficient to cover the supposed greater costs which petroleum producing companies have to deal with in El Salvador.

    By promulgating the decree referred to above, the reductions which could be expected in the final price of combustible fuel will oscillate between 2% and 3% of the final price of combustible fuels, which is not very significant and poses the challenge of seeking additional alternatives. With this last we do not intend to say that the profit margins for intermediation by petroleum producing companies should not be reduced. Rather, aside from this factor, other components exist which affect prices and so make it necessary to examine these very factors.

    Prices for combustible fuels are calculated according to the following variables: international prices, the Value Added Tax (IVA), gross profit margins for petroleum producing companies, profit margins for gas stations and the price subsidy on diesel fuel to public transportation as well as propane gas prices. Among these factors, the only one which is not affected by political economy is the price on international markets. All the rest can be touched but not without incurring huge economic and social costs that merit being considered in a cost-benefit analysis. In the first place, if IVA were reduced on gasoline, a new pressure on public finances would be created to such an extent that income at any given moment would be reduced in that a high fiscal deficit is already in effect. Secondly, if subsidies on diesel and propane gas were to be reduced, pressures would be created which would cause the increase to be passed on in public transportation rates and the cost of the basic food basket (which includes combustible fuels for cooking food). Only the profit margins of the petroleum producing companies and gas stations could manipulate the situation without provoking greater consequences for the economy because only profits on transnational businesses would be affected and these are already very high and even excessive).

    Another factor must be taken note of: a substantial reduction in combustible fuel prices would only succeed in affecting the subsidies or the application of IVA which represent close to 5.83 colones and 2.43 colones, respectively, which is to say, more than 20% and 10% of the final price. One must inevitably evaluate this alternative vis-a-vis the possibility for obtaining other necessary fiscal income from other tax sources in order to continue with the subsidy for diesel and gas and/or in order to compensate for the reduction in tax income from IVA which would result from such a measure.

    The case of the petroleum producing companies is not the only case in which the government must intervene in order to prevent abuses by transnational enterprises. The memory of the polemic between the General Superintendence of Electricity and Telecommunications (SIGET) and the electrical energy generating enterprise Nejapa Power is still fresh. As is the increase in electrical energy and telecommunications rates which have been felt since these came to be operated as private enterprises which now receive benefits as they provide these services.

    The case of Nejapa Power is much to the point: in mid-July, SIGET decided to back out of the contract with Nejapa Power because it had decided that it meant that the state lost close to 215 million colones per year from the electrical energy sold at prices which were substantially lower in Guatemala and that the contract offered by the previous ARENA administration established mechanisms for price fixing which would permit Nejapa Power to obtain unnecessarily high profits. The same suspicions exist in the case of telecommunications and electrical energy distribution where fixed charges have permitted and where the method for calculating rates gave rise to substantial doubts.

    Everyone knows that foreign investment is important for development. But when foreign investors aim to obtain extraordinarily high benefits in a country, the state is obliged to intervene in such a way as to correct market distortions which, in the end, affect the majority of the populace of the country to the benefit of the big transnational enterprises which ought to be contributing to make underdeveloped economies more viable as in the case of El Salvador instead of continuing to exploit them.

SOCIETY

    Tears cannot wash away national ills. A few days ago, given the advance of the epidemic of classical and hemorrhagic dengue fever in our country, Herbert Betancourt, the Vice-Minister for Health, wept in front of the cameras at a press conference in order to demonstrate the depth of feeling provoked by the number of children who have died as a result of this deadly illness. Doubtless the 14 children dead and 1,784 proven cases of infection throughout the country are not something which should be taken lightly. The tears of those who have lost their loved ones or who, suddenly, see their lives in almost absolute despair given the low level of hospital efficiency do merit maximum respect and solidarity. But the Vice-Minister, perhaps a faithful adherent to the best school of North American pretentiouness, should save his energies for something more than crying in front of the cameras. Instead of presenting an excessive show of bitterness to the population, the health functionary ought to work for the security of the many Salvadorans who do not feel confidence in institutional health care providers which he and those who accompany him administer so poorly.

    Doubtless the National Health System has not seen its best moments during recent months. It has been pushed to the limit since the epidemic outbreak of dengue fever began to take more and more patients to the hospital throughout the country. The capabilities of health authorities not only in preventive health but also—and above all—in investigative and research matters, have not been able to deal with the situation which, day by day, present difficult surprises for deal with the population exposed to the illness. So it is that, although proceeding with the utmost caution when a red alert was declared for some areas of the country as a significant increase in the number of deaths and infections began to be documented, the Health Minister could not prevent the avalanche of criticisms and demands which fell upon the health ministry. In the majority of cases, these voices were well justified given the antecedents which reveal the low level of effectiveness with which the Ministry of Health responds to the health needs of the populace.

    The specific case of dengue fever in our country seems to reveal the inheritance of inefficiency to which the country is heir. In each and every one of the declarations by health authorities, they reserved comments upon all but technical balances, comparisons of current figures of illness as compared with other periods and the results of fumigation campaigns and other small projects, the results of which create the illusion that they are doing something to stop the advance of the epidemic. But nothing could hide the fact that, for example, the germ for dengue fever (Jamaica 2) was not identified for almost two months. Nor could they hide the fact that the team of specialists from Puerto Rico, before they began to announce the specific characteristics of the outbreak in our country, presented sharp criticisms of the low level of dedication which the authorities who should be fighting the illness should have used in preparing the population against the illness with one of the most effective tools used throughout the world: education.

    In this way, the prevailing incongruities between the discourse of the Health Ministry with respect to the other actors have enjoyed a preponderant place in the situation (among them the media) forcefully present the need to effect a restructuring of the National Health System which would at least permit it to respond in an effective way to this kind of crisis. Just as we have come to be informed, the advance of dengue fever in El Salvador has obliged the authorities to respond more and more to the immediate necessities than to any kind of previous contingency planning. The areas of high risk, as much for the exposure which the inhabitants suffer as for the capacity for providing places for mosquitoes to breed in, have been identified for a long time now. Nevertheless, very little has been done to concentrate efforts to prevent such areas in such a way as to halt the incidence of an outbreak of epidemics starting from the sources of the problem.

    At the same time, official control of infections never seems to be up to date. In the Bloom Children’s Hospital alone, 20 cases per day have been treated in which there is a suspicion of the presence of dengue fever, but the official indices practically annul such suspicions when they offer a picture of a panorama in which the situation is much more controlled. There even arose a suspicion that the illness that provoked such an accelerated and uncontrollable death principally among children was a type of dengue fever virus which was more resistant than any other known virus in the whole of Central America. The Medical Guild requested the implementation of a more focussed and serious analysis which might determine if we were not witnessing the arrival of the hanta virus in the country. The level of lack of confidence could not be higher. The human and technical team provided by the state for the investigation and treatment of disease is not the most advanced. In order to determine, in cases of extreme urgency, the specific characteristics of the extension and attack of a disease such as dengue fever international cooperation must be requested.

    Taking into account this and other anomalies in the national health system—a very small portion of the National General Budget, periodic crisis of lack of medicine, the nonexistence of policies for the encouragement of the training and formation of medical personnel, among others—the least which might be expected is that their work include a minimum of coherence with respect to “demographic, epidemiological, cultural and economic reality” of the population (Medical Guild of El Salvador, Citizen Proposal for Health, 1999). But far from this, the calculation that issued in a declaration of emergency (either local or national) depends almost exclusively on the number of deaths and persons infected which are documented during a specific period of time. In this way, if the number documented this year passes the average established from previous years, an emergency is declared.

    The problem is that this kind of formula does not pay sufficient attention to other variables which also intervene in the definition of an emergency situation. The identification of areas of risk where the incidence of a disease of illness could double or triple does not appear in this kind of calculation. Neither does there exist any evidence that control of the cycles of mutation for virus might reach an alert stage with sufficient anticipation in hospitals and health units. In fact, it is not even very clear if any effort is given to carry out such controls, nor that the health ministry has the necessary mechanisms to maintain the network of health centers informed about the state of illness or disease which, because they are not common, become dangerous, as is the case of dengue fever.

    The situation to which the advance of dengue fever within the country is reaching, there is much to be learned. What is most important is to recognize that the capacity of the health system have been reached and surpassed many years ago given the epidemiological characteristics that the region presents. In this sense, very little will be done if a decision is made to make an effort only a budgetary level in order to confront present or future crises. It is a fact that the structure of the health system throughout the country ought to be examined once again and areas such as preventive health and research ought to be encouraged. This scenario implies effort—of which there are no indices that there will be a commitment made—is awaiting our public functionaries in order to demonstrate what they are capable of. It is clear that, in this context, there is no room for useless tears. Upon what is defined now will depend the health of future generations and the health, as well, of those who are now fighting for life against the impending threat of death.