By Mac Margolis

EXAMPLES ABOUND of how reprehensible leadership has worsened Latin America’s plight during the coronavirus pandemic. After consistently flouting public health safeguards, right-wing populist Brazilian President Jair Bolsonaro and his left-wing coeval, Mexico’s Andres Manuel Lopez Obrador, turned their countries into COVID-19 killing fields, with a fifth of reported global fatalities between them.

Nicaraguan strongman Daniel Ortega went AWOL, failing to show up in public for more than a month as infections spiked. And what to say of Venezuelan autocrat Nicolas Maduro, who used the quarantine to stifle dissent instead of tending to the country’s decrepit health system, ranked 176 of 195 countries by the Global Health Security Initiative?

Of all the comorbidities the pandemic has laid bare in Latin American democracies, populism and polarization are among the deadliest, Amherst College political scientist Javier Corrales told me. What’s harder to explain is the debacle elsewhere in the Americas, where more demonstrably temperate leaders have committed to heeding democratic institutions and global public health directives.

One of the preferred tropes among Latin Americanists is that the region’s miseries are due to crowd-surfing politicians. Leaders who play to the gallery too often disparage consensus, trample institutional checks and balances, and make enemies of adversaries while promising deliverance on empty coffers. Get rid of the barker on the balcony, the argument goes, and progress will follow. Yet last year’s wave of public turmoil and street protests was a clear caveat that even the best performing nations — look no further than Chile — run by reform minded “rationalists,” in Corrales’ words, are prey to dysfunction and historical inequities. Coronavirus has only added to that social debt.

Start with Colombia and Peru, whose governments acted early and swiftly to implement strict social distancing, followed expert medical advice, and rolled out robust assistance to those most vulnerable to economic shutdowns. After the initial success in flattening the epidemiological curve, both countries have since been clobbered. Despite President Martin Vizcarra’s bold reform agenda, Peru has almost as many active cases as Mexico with one-fourth the population, and as of Thursday had buried more than 21,500 victims to Mexico’s 54,666. Colombia has logged 43.1 deaths for every million people, the world’s highest fatality rate.

Along with public health, the hopes of both governments that a quick response to the outbreak would convert into popular indulgence if not outright political capital quickly imploded. Instead, a steep drop in new cases lulled authorities into easing the lockdown by early July, which promptly sent the infection rate soaring again. Now Vizcarra faces increased public scrutiny, a renewed epidemic and one of the worst economic contractions on record.

It’s much the same in Colombia, where Ivan Duque, a mostly dispassionate technocrat who cut his teeth at the Inter American Development Bank, is struggling. A spiking caseload — Latin America’s fourth highest — forced authorities to reinstate lockdowns in the country’s main cities, Bogota and Medellin. Compounding Duque’s woes is the predicament of hundreds of thousands of Venezuelan migrants who fled the collapsing economy at home only to be thrown out of work as Colombia locked down. Now he must manage a refugee crisis on top of a racing contagion in an economy forecast to shrink 7.8% this year.

What binds all these countries is a legacy of disabilities, from paltry social welfare backstops to a vast informal economy, where up to half of Latin America’s work-age population toils without perks, unemployment compensation or safety nets. For the one in five Latin Americans living in densely inhabited slums, like the ones ringing Buenos Aires, sheltering at home also means social compacting, exposing millions of poor in cramped airless quarters where infection flourishes.

And while most nations have managed to reach the poorest households with targeted cash transfers, millions more in the gray economy have slipped through the cracks. Consider that six in 10 Peruvians have no bank account. That invisible demographic is a major reason why as the region ramped up spending and blew up debt to offset the outbreak, even those extraordinary outlays have fallen short and done little to correct long standing inequities.

Although virtually all countries ascribe to universal health care, coverage is at best patchy. Most Latin American and Caribbean nations fell short of the Pan American Health Organization’s benchmark of investing 6% of gross domestic product on health well before the virus began to spread.

Simply pouring money into the system will not help. In 2017, Mexico spent 10% of its health budget on the health bureaucracy, more than any other country in the OECD. Despite this largesse, the coronavirus has overwhelmed Mexico’s hospitals. Bulking up spending “without addressing the challenges of inefficiency and poor performance would be a fundamental omission of local competent authorities and decision makers,” a London School of Economics reported last year.

Health spending is bled away by corruption, obfuscated by opaque governance. Instead of opening its books to account for inflows of international aid to fight the pandemic, El Salvador neutered its Transparency and Anti-Corruption secretariat and shut down the finance ministry’ s Anti-Corruption Unit.

One exception to the dismal Latin American tableau is Uruguay, which stanched the spread of the disease without locking down, and is now preparing for an economic restart even as its stricken neighbors reel. But Uruguay’s good fortunes — low urban density, near universal health care, falling poverty, and a culture of fiscal sobriety unburdened by partisan caviling — are mostly self made. Thanks to decades of reform and social consensus, the nation of 3.5 million is the hemispheric outlier.

No doubt, toxic politics has put Latin Americans at greater risk during the pandemic, even to the point of squandering vital public goods. Look no further than Brazil, where 286,000 community health workers trained to contain contagion have been repeatedly thwarted and second-guessed by the Bolsonaro government’s conflicting directives on health protocols.

Yet in nations where underlying conditions and a “manana” approach to reforms impede deficient states from effectively tending to the sick, delivering emergency assistance and ventilating failing businesses, even the most committed rationalists will stumble.

BLOOMBERG OPINION