Dr. Cecilia González Caro has been the head of the Department of Immunizations of the Ministry of Health (Minsal) since 2018 and, despite having a positive assessment of her management in these years of pandemic, acting in the negotiating group for vaccines against COVID, is at the heart of a set of actions tinged with a clear conflict of interest. This is due to the fact that for 8 years González was the medical director of the British laboratory GlaxoSmithKline Farmacéutica Limitada, GSK (merger of Glaxo Wellcome and SmithKline Beecham laboratories), which for three consecutive years has been awarded almost $30 billion in contracts. to provide three of the mandatory vaccines in the health system.
Just as an example, suffice it to mention that during 2021 the Department of Immunizations headed by Cecilia González Caro awarded almost $15 billion to her former employer, GSK, in the purchase of vaccines that are part of the National Immunization Program. This relationship has generated serious questions about these contracts, given the closeness of the official with hers, now her counterpart in the negotiations.
Although its most urgent task is COVID-19, the mission of the Minsal Immunization Department is the “protection of the population residing in Chile, against vaccine-preventable diseases relevant to public health, with quality, safety and efficiency, according to the development biotechnology and scientific evidence”, according to what is read on the institutional website.
In this context, this division, which reports to the Undersecretary of Public Health, has been buying 16 free vaccines for years against “immune-preventable diseases relevant to public health”, some of them practically eradicated, precisely, thanks to this public policy that It has been applied since 1978.
According to data from the Budget Directorate (Dipres), under the Ministry of Finance, the treasury spent $122,426,158 million on this program during 2021, not counting vaccines against COVID-19.
When reviewing the Lobby Law platform, it is found that Dr. González Caro has met with the vast majority of representatives of pharmaceutical companies in Chile. But, in practice, the tenders in the Public Market for these injections, specifically the vaccines against hepatitis A, hepatitis B and the triple vaccine that prevents diphtheria, tetanus and whooping cough (dTpa), have favored the GSK laboratory.
As indicated, between 2019 and 2021 the GSK laboratory has been awarded almost $30 billion for the provision of these three vaccines ($29,606,138,985), although there are other pharmaceutical companies that provide an equivalent product and at similar prices.
When looking in detail at the purchases made by the Cenabast purchasing center, it stands out that in 2019 this public body bought a total of $7,985,256,720 in triple vaccines against diphtheria, tetanus and whooping cough. While between February and March 2020 he bought doses of the same vaccine, always from the GSK laboratory, for a total of $6,006,060,000.
Finally, in 2021, Cenabast bought the mandatory triple vaccine from GSK within the state plan, for an amount that amounted to $11,322,900,000. Added to this total is the purchase by the aforementioned public institution of hepatitis A vaccines, which, in 2021, totaled $2,695,000,000.
What is legal and what is expected
One point is that the Comptroller’s Office has stipulated that all public officials who have grade 5, the highest on the professional scale, by Active Transparency, must sign a declaration of interests and another of assets. And in this type of role it is key, because elements must be resolved or proposed from any angle, technical or economic, so that they affect the hiring decision, in the assignment of a contract to one or another company. And that obligation exists, regardless of whether the person has the legal status of a public official or is paid a fee.
But, in addition, in the Ministry of Health, these types of decisions are sometimes processed collegially and there are different committees where decisions of technical, health, clinical merit are made, but that have an impact on the market, on the industries.
If it is a process prior to purchase decisions, there must be an Administrative Act, which indicates the committee that worked, and there is fixed in time and space the document or record where the decision was made to assign the purchase to said company. This act has many documents, analysis, etc., and when it is a lot of money, there should be traceability on who decides the purchase. And that is where the record of Dr. Cecilia González Caro’s previous relationship with GSK should be, which should translate, in this case, into a declaration of incapacity, which did not happen or there is no record that it happened.
The other aspect has to do with the curve of behavior in the assignment of the contract, which appears suspicious, for which reason such Act must include the arguments and technical parameters that better dialogue with the definitions made by the ministry, for example, to protect the actions of the authority in these matters.
“But here it looks and smells bad, given that it is a person who worked in a company and since he has been in the ministry, there is a behavior of the institution in decisions where she is in line with the procedure for her leadership. The discussion here is: due to the amounts and the relationship, it is necessary to see what is the social control within the most bureaucratic procedure, because all these are decisions of authorities and are processed with an administrative resolution, then, there is some level of control, because it goes through the financial, technical, legal area, before the signature, so it is not that one or two people put the whole process in their pocket, and if that happened, it is even worse”, declare the complaining sources.
“It is very rare, because to buy anything you have a great level of control, so purchase decisions at this level, such as buying one or another vaccine, or that the Ministry says that a disease is or is not GES, there is a econometric, clinical and effectiveness study behind it, that is, that must be in the Act”, they add, because although you are not obliged to buy the cheapest, you must justify a more expensive purchase.
To verify if the documentation and processes of these purchases are in order, including the declaration of incapacity of Dr. González Caro in those specific cases, contact was made with the new authorities of the Minsal assumed last Monday. However, the new authorities reported that they are searching for these reports, and it is not possible – they assure – to issue any communication in this regard, until they have all the background information. For her part, the head of Immunizations questioned did not want to answer the questions of The counter.
Last case
And the shadow of doubt is due to the fact that this is not the first time that a conflict of interest between the Ministry of Health and a laboratory that supplies medicines has become apparent.
Let us remember that, in June 2019, Juan Carlos Corbeaux, then technical supply coordinator of the National Supply Center (Cenabast), was fired shortly after Minister Jaime Mañalich took office, due to questions arising between March 2018 and June In 2019, the same GSK laboratory was awarded $45 billion, a significant increase if one considers that during the four years of Michelle Bachelet’s second government, this company obtained contracts for 17 billion.
And many of the contracts with GSK that Corbeaux endorsed, representing Cenabast, were for direct treatment, and a communications offensive by deputy Juan Luis Castro made his permanence unsustainable. But the issue there was not the millionaire purchases per se, but that Corbeaux –today a professor at the Faculty of Economics and Business of the University of Chile–, between 2009 and 2016, that is, for 11 years, was the general manager of GSK in the country.
During that time, he coincided with Dr. Cecilia González Caro, so the Minsal does not doubt his closeness. Therefore, in the face of possible conflicts of interest, purchases of three vaccines in particular were reviewed, which considerably benefit GSK, his former employer.
However, the case of Cecilia González Caro is very different from that of Corbeaux. She is a pediatrician and infectologist from the University of Chile, and participated in the process of negotiating and purchasing vaccines against COVID, together with former Undersecretary Paula Daza, former Minister Andrés Couve and former Undersecretary of Economic Relations of the Foreign Ministry, Rodrigo Yáñez. .
From inside the Minsal they confirm that González Caro “is a very loyal professional and well evaluated by (former) minister Paris and the (former) undersecretaries, from Paula Daza to María Teresa Valenzuela.”
In addition, they consider that, although Juan Carlos Corbeaux, the technical head of supply in 2019, has left, “the operators inside are still the same ones he left, and they are the ones who close the tenders,” says a source inside the ministry.
Also in February of last year, the president of the College of Nurses, María Angélica Baeza, denounced that Dr. González received them to find out her disposition and proposals for the COVID vaccination plan, but that the meeting ended abruptly, marked by the “mistreatment” and the “arrogance” of the official, which led to a letter against her addressed to the then minister Enrique Paris.
Cecilia González appears in the staff of doctors at the Santa María Clinic, such as a pediatrician, an infectious disease specialist and a specialist in Travel Medicine. Although she does not have her agenda open with hours for the coming weeks, her position at the Minsal prevents her from attending patients in a private way. According to the Transparency portal, Dr. González, as head of the Immunization Department, has grade 2 on the Single Salary Scale, with a critical function bonus for a total of $5,096,000 gross. In addition, she appears on the list of contract officials since 2014.
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