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In Ecuador, the neoliberal policies of the last three governments have prioritised the economic benefit of a tiny group of wealthy families, to the detriment of collective well-being. This has contributed to restricting access to public health services. Indeed, these policies, alongside the health crisis caused by the COVID-19 pandemic, have led to a severe reduction in the national budget for the healthcare coverage of the National Health System.
This health issue is most evident in the periphery of the country, particularly in the Amazon region.
From a political standpoint, these recent governments have been characterised by a lack of respect for the law, with direct consequences for the population suffering from catastrophic illnesses, who no longer receive the minimum benefits established by the Law of the Special Territorial Circumscription of the Amazon (CTEA). This law, which came into effect in 2018, stipulates that a portion of national economic income from oil production (4% per barrel extracted and sold, not less than $2 per barrel) be redistributed to benefit individuals with catastrophic illnesses caused by this extractive activity, in order to ensure free access to public health services. However, the Technical Secretariat, the institution created to administer the CTEA funds, does not guarantee timely access to this benefit. For this reason, many individuals choose to abandon medical treatments, which are mostly carried out in Quito, Cuenca and Guayaquil, due to the complete lack of oncology centres in the Amazon, drastically increasing the mortality rate from oncological diseases in the Amazonian provinces.
For this reason, UDAPT has undertaken four legal actions against the Ecuadorian State, due to the helplessness of cancer patients. The judiciary has recognised the violation of the rights of patients and has ruled that the Ecuadorian State must immediately restore the established benefits. The court also ordered the State to create an oncology unit in the Amazon, extend coverage for transportation, accommodation and meals for a caregiver for each patient, as well as provide free psychological support to cancer patients in the Amazon and ensure the supply of necessary cancer medications at the General Hospital “Marco Vinicio Iza” in Nueva Loja.
Why do the government of Daniel Noboa, the Technical Secretariat of the CTEA, and the Ministry of Public Health fail to comply with the ruling?
Because all this is managed in a completely illegal manner, through deceptions and the issuance of regulations that hinder access to the benefits established by the law:
The Constitution of the Republic (Article 47) and the planning law of the CTEA provide for guaranteed access to public health services for people with catastrophic illnesses, including cancer. Despite this, due to a regulation of the CTEA law that increases the delegations by the State and the responsibilities of provincial institutions, the delivery of funds has become the responsibility of the latter. The process requires the approval of a sufficiently convincing project, according to the Technical Secretariat, to justify the delivery of funds. In 2023, the projects from the provinces of Sucumbíos and Orellana, which contribute significantly to oil production and consequently to the CTEA funds, were rejected. This justifies and legitimises the non-compliance with the Constitution, the law and the rulings by the State itself.
There are three rulings that establish that the Ministry of Public Health must build an oncology unit or a specialised health centre in the Amazon. To avoid complying with this measure, the State relies on a legal loophole. In fact, it justifies its position by claiming that there are not enough patients in the Amazon to justify such expenditure. This is false. What is missing are patients registered in the Amazon because Amazonian patients must be registered in Quito, Cuenca or Guayaquil to access oncology treatments. Furthermore, if a person is not registered in the Amazon, they are also not entitled to receive the CTEA funds intended to cover transportation, accommodation and meals during medical treatment. Thus, the funds that legally belong to cancer patients residing in the Amazon remain in the State’s accounts and are used for other purposes, such as paying off foreign debt.
Similarly, if there are no cancer patients registered in the Amazon, the State does not recognise the need for accompaniment during medical transfers. Even worse, the State refuses to implement a psychological support service for this vulnerable group.
Given that almost all Amazonian oncology patients are undergoing treatment hundreds of kilometres away from the Amazon, there is a need for the supply of these medications at the General Hospital “Marco Vinicio Iza” in Nueva Loja. Oncological medications are specialised drugs that can only be prescribed by an oncologist. There is only one oncologist at the General Hospital “Marco Vinicio Iza”, which is a second-level hospital, and despite having the infrastructure and space to be classified as a third-level facility with an oncology unit, there is no political will to do so. Therefore, the Ecuadorian State justifies its failure to comply with this measure by claiming that specialised medications such as oncological drugs cannot be supplied to a second-level hospital. As a result, many people choose to abandon their treatment, shortening their lives.
Moreover, there are other measures established by the judiciary that the State fails to comply with: training for Ministry of Public Health (MSP) officials about the care of patients with catastrophic illnesses and their rights; presentation of records of patients with catastrophic illnesses residing in the Amazon and reports on compliance with fund deliveries and adherence to rulings; and conducting quarterly visits to patients with catastrophic illnesses in the Amazon.
In light of this flagrant violation of the Constitution and the rights to health of the most vulnerable population in the Amazon, affected by oil contamination, we call on civil society, popular organisations and all people at the local, regional and national levels to engage in active and combative solidarity through the strength of truth and human rights.
Join us, support, and be part of this fight for the life and dignity of cancer patients!
We are collecting signatures to seek national and international support to pressure the central government, the ST-CTEA, and the MSP to comply with the reparatory measures established by the rulings. Additionally, we aim to place this issue of health and contamination on the agenda of presidential and national assembly candidates in the national elections to be held in February 2025.
Be part of this struggle, sign the appeal below.
Let’s fight, march and rise up for the violated rights of our neighbours with cancer!
Enough of an indifferent and corrupt State!
