Bolivia

Bolivia has amongst the worst health and social indicators in Latin America, with only Haiti scoring consistently lower. During the mid 1990s, the central government of Bolivia decentralized ëresponsibility for health care' (and the necessary funds) to the Bolivian municipalities. The consequence of this was that some municipalities spent the money on other projects, neglecting health care altogether. The health care system is currently being reformed and provision has improved substantially. The number of physicians practicing in Bolivia has doubled in recent years, to about 1.3 per 1000 citizens, a comparable ratio for the region. The problems of the health system are compounded by an unusually high tariff rate on medicines, levied at 10%, including vaccines.