'I was caught off guard in terms of the appointment, but not the vision'

Peru's ex-president Francisco Sagasti on leading through crisis 🌐

WorldWise readers—

This is one of those notable occasions when we get to host a former head of state. So let’s get straight to it with this special pandemic-anniversary post: Part 1 of an interview with Francisco Sagasti, who spoke exclusively to WorldWise about taking office and preparing Peru to face Covid-19 at a turbulent time. Part 2 of our conversation is coming up later this week.

Anita

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Peru’s pandemic history is tumultuous.

In November 2020, as the first wave of Covid-19 infections was receding to lay bare a ravaged economy, the country plunged into political crisis.

Congress had removed President Martín Vizcarra from office on 9 November, a move that sparked deadly street protests. Manuel Merino took over, but the unrest brought down his new government barely a week later. Then two days after that, on 17 November, Congress finally restored calm with the election of Francisco Sagasti as interim president.

It was a surprise, even to him.

Sagasti wasn’t the obvious choice for the country’s top job. He’d taken office as a member of Congress just months earlier, as the global pandemic was emerging, having entered Peruvian politics in 2016 with the centrist Purple Party. An industrial engineer by training, much of his career to that point was spent outside politics—working on development issues in Peru and internationally, leading or advising on policy initiatives for various organisations including the UN and The World Bank.

His appointment helped to weather the country’s political storm. But a second pandemic wave was looming, and it came with a vaccination scandal that rocked public trust in the one weapon that was just becoming available to fight back the COVID tide.

That new wave turned out to be devastating. By the end of the interim presidency on 28 July 2021 it had claimed hundreds of thousands of lives. Despite strict measures, the country fared worse than others in the region and beyond: on this fourth anniversary of the pandemic, Peru still tops the world’s highest Covid-19 death rates.

Sagasti is looking back on that time and the decisions taken by his government in a new book, "Gobernar en Tiempos de Crisis” (Governing in Times of Crisis).

In this exclusive interview—edited for length and clarity—he pulls back the curtain on his experience in office and argues that behind the grim impact of the pandemic lay solid, science-based policies that spared the country an even worse fate.

Against the backdrop of the statistics, it’s a bold assertion. But it's difficult to prove him right, or prove him wrong.

I was more interested in Sagasti’s experience of leading the country in that singular moment—also a rare instance of someone rising to the presidency after a career steeped in the sciences—and the lessons that can be learned from it.

In this first part of our conversation he recalls the circumstances leading to the appointment and takes us through some key decisions in taking charge of a country in turmoil.

Can you tell me how you came to be involved in that moment of crisis in Peru?

I have spent most of my academic and professional life working on issues of development—from the perspective of a developing countries, what is it that we need to do in order to improve the human condition.

[For instance] during the 1970s I coordinated a large international programme with 10 developing countries on the design and implementation of science and technology policies. That took me all over Latin America. So I was able both to do research but also to be highly focused on how to implement policy decisions.

I then moved back to Peru. We set up a public-policy oriented research institute called GRADE together with colleagues, [where] we did advice to public policy organisations and international institutions. From then, I moved to the World Bank to head the newly established strategic planning division in charge of preparing a long-term plan [for] the work of the Bank during the 1990s.

And after [again] returning to Peru, I created together with colleagues a new think tank focused primarily on the issues of democratic governance, institutional consolidation and development strategies. So by the 2000s, I had managed to really have a very broad experience internationally and nationally.

But as I got a little bit older, and more involved in policymaking, I began to realise that however clever, empirically based you are as a policy-oriented researcher, you always have a politician on top of you who will make their final decisions. There were one or two instances in which what we had available—a logical and clear and effective policy prescription—was simply set aside because of the mood or the antipathy or the political preferences of a politician at the top level.

So I decided the heck with it, I might as well become a politician!

After having toyed with the idea for many years, in 2016 I joined an effort to create a political party, the Purple Party. I became the secretary for programmes, policy and strategy—in charge of preparing the ideological documents, the ways in which we were going to exercise power and authority.

How did the presidency come into the picture?

[In 2019] I became a congressman. I was the head of my political caucus and Chairman of the Science Technology and Innovation committee of Congress. But then something unexpected happened, which was that the president was impeached—and because of constitutional succession, the Speaker of parliament became President of the Republic, and the Deputy Speaker became Speaker.

But this generated a huge opposition in the country, with several hundreds of thousands of people protesting against this particular way of changing our government structure and dismissing our president. As a result, the newly appointed president resigned six days after his appointment. After a very complicated system I was designated Speaker, and by constitutional succession—because we had had no president or vice president or speaker of the house for more than 36 hours—I became President of the Republic.

And so lo and behold, in the middle of the worst crisis we had in a long, long time … with a pandemic raging, with no vaccines, with deficiency in our hospital systems, with extremely strict and complicated immobilisation measures that prevented people from working day to day in a country in which 70% of the workforce is informal, and to get income they have to work every day … as well, it was an economic crisis: we had the worst downturn in economic growth in more than half a century, and one of the worst in Latin America.

As someone said, I am the only president that has been elected by his political enemies. Even those who were against me in Congress, most of them ended up voting in favour—I was elected by 96 of the 130 congressmen that we have in Peru—probably so that they could see me fail. And I am sorry to say I disappointed them.

Were you caught off guard by the appointment or did you see it coming?

I didn't seek it. I didn't see it coming at the beginning because I had proposed another candidate for Speaker of Congress. We had all the representatives of different political parties agreed on this. But when we got to the plenary session, even those that had approved it in the small caucus meetings voted against. I wasn't expecting that.

Now that is one part of the answer. The other part of the answer is, as I mentioned before, during many years I had been doing policy-oriented research, thinking of development strategies. And just before I got into the government I published a book with a collection of about 60 of my articles, essays and interviews from 1985 to 2015, in which I proposed strategic directions for the country. So I was caught off guard, if you wish, in terms of the appointment, but not in terms of the ideas and the vision that I had for the country at that critical time.

So let's move towards that and start with what you faced in those first days of taking charge. What was it like to start working in that environment of multiple crises?

Well, I didn't have too much time to think about that. From the very first moment I was sworn in, and walked into the presidential palace, I have in front of me a slew of crises and I really had to start working very, very, very fast.

The first thing that I found was that my predecessor—not the one that stayed the six days, but the one who had governed for several months before—had announced that we had an arrangement with the COVAX facility to purchase [COVID] vaccines. So everybody was confident that vaccines will get to Peru by the end of 2020, or at the latest by the first month of 2021.

Everybody thought that because Peru had signed this [COVAX] agreement that vaccines were going to start coming soon. This was not the case, exactly.

Unfortunately, as everyone should know, [COVAX] basically was a framework agreement. It didn't guarantee the delivery of the vaccines, because it had several conditions. They had a very complicated algorithm to decide on the allocation. So everybody thought that because Peru had signed this agreement that had been allocated 13.2 million doses of vaccines, [that] they were going to start coming soon. When I got into government, I found out that this was not the case, exactly.

First, it was conditional on COVAX obtaining the vaccines, either through donations or purchasing them. Second, they didn't know which laboratory was going to be providing the vaccines. Third, they didn't know the quantity that each of the labs was going to provide. And fourth, they didn't know the timetable. And finally, to cap it off, you needed to negotiate and sign an independent agreement with each of the labs that were going to provide the vaccine.

So: between signing the COVAX facility agreement, and receiving the vaccines, there was a very, very long time—and to my surprise, I found that there was not a single firm contract for the purchase of vaccines.

Was it that the process wasn't understood by the previous government—or was it understood and, for whatever reason, no action was taken?

I think it was a combination of the two. As you know very well, the WHO, organisations like GAVI, like IFIM, the Gates Foundation and so on are very complex organisations. When you put them together, unless you understand how they work, you are simply lost. And in my view, it was a combination of not knowing really how things work at the international level, and on the other hand, some that probably didn't care too much and simply sort of trusted that something would happen.

But from my point of view, I was quite alarmed. We made the decision immediately to accelerate direct negotiations with all the labs that were developing vaccines.

By doing that, and by getting to know very clearly—through newsletters like yours and many others, by reading material obtained from my advisors and ministers in Peru, through a very broad network of contacts that I had developed during the earlier 50 years—what was the situation: this allowed us to develop a strategy that managed to secure for the country 78.2 million doses in six months. That was enough to vaccinate two times the target population before the end of 2021.

We developed a sequence of vaccination that moved on to the most vulnerable, until we managed to vaccinate the whole target population by the middle of October.

We started with Sinopharm. I knew exactly the difference between the Sinopharm and Sinovac vaccines [from] China—and within Sinopharm, what was the difference between the vaccine they produce in Beijing and Wuhan. For example, this allows us to specify in the contract with Sinopharm that we only accepted the vaccine developed in Beijing, because it had—according to the data—73.9% efficiency in comparison to the vaccine developed by the same company in Wuhan, which had just over 50% efficiency. We also knew the difficulties the Russians had in scaling up production [by] Gamaleya, then marketed under the name of Sputnik, [which] was an extremely complex vaccine.

This is just to give you two examples of what we had to do. Then we negotiated with Pfizer, with AstraZeneca, and [others]. In the end, we succeeded to vaccinate very quickly the target population. My slogan was, "we first have to take care of those who take care of us": doctors, nurses, medical personnel, internists in the intensive care unit, the police in charge of supervising the vaccination stations, and so on. We then developed a sequence of vaccination that moved on to the most vulnerable, until we managed to vaccinate the whole target population, starting on February 9, 2021, and completing by the middle of October.

We had to do quite a bit in order to increase between four and seven times the supply of medicinal oxygen [and] to more than triple the number of intensive care units for those who really had some severe impacts. We had to finetune the restrictions on mobility. [Starting] from a nationwide curfew, we managed—according to figures on the severity of a pandemic, the capacity to deal with it—to instead specify different levels of restriction, first by region and then by province. In this way, we were able to follow every week what was going on, and adjust those policy restrictions.  

What about the vaccination scandal involving the previous president and members of government—how much do you think that affected trust in what you were trying to do with the vaccination process?

It was a major disturbance, I must say. I had to accept the resignation of two ministers that had [been] vaccinated not with an official vaccine, but with one of the vaccines donated by Sinopharm to the Ministry of Health for vaccinating those who were involved in the initial trials. Unfortunately, the president at that time, two ministers and about 200 top [government] people managed to get the vaccine way ahead of that. But it was a temporary disturbance. Because the public in general were able to see that we were doing the best we could, and that vaccines were arriving, that vaccines were saving lives.

How do you square all this, the sound decisions as you describe them, with the result—which is as we know that Peru has one of the highest COVID death rates in the world, if not the highest?

I know, it's a tragic situation. Our health system was totally unprepared to deal with a pandemic of the scale we had. We had just a few thousands of intensive care unit specialists. We had no vaccines as I pointed out. And the trust in COVAX basically made us delay negotiations that could have obtained vaccines earlier. We also had a lack of medicinal oxygen. So, you know, we inherited the worst possible situation that you can imagine. We couldn't stop the tide. We did our best to reduce it as quickly as possible. But we couldn't, for example, prevent that by March or April of 2021 we had a very high rate of fatalities during the second COVID wave of infections. It was too late.

Independent estimates suggest we saved tens of thousands of lives. You never know that for sure. But certainly things would have been worse.

Nevertheless, if we had not done what we did in terms of vaccination, measures to prevent contagion, supply of medicinal oxygen, intensive care units and so on, then the fatalities would have been even much higher. I have not made an estimate. But all the independent estimates suggest that we saved tens of thousands of lives as a result of what we did. You know this is a counterfactual hypothesis, so you never know for sure. But certainly things would have been worse.

📕 Learn more in Gobernar en Tiempos de Crisis (Governing in Times of Crisis).

📌 Coming up later this week—Part 2 of our conversation, where Francisco Sagasti discusses the principles that guided his government’s policy decisions, some awkward moments in the early days of the presidency, and reflections on leadership in times of crisis beyond the pandemic.

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