Failures in Colombia’s health system were highlighted this week after a young boy died from “completely preventable” complications from blood condition after going off treatment for two months.
Seven-year-old Kevin Acosta was rushed to hospital in Pitalito, Huila, on February 8 after falling off his bike and hitting his head, a situation complicated by his hemophilia.
According to his mother Katherine Pico, the boy required regular injections of clotting factors to prevent the genetic condition that can cause fatal bleeding if untreated.
But due to failings by his health insurer, Nueva EPS, Kevin had missed his regular injections for two months, and on the day of his accident he was denied emergency doses even while bleeding from his head in the hospital in Pitalito.
When the health insurer finally agreed to evacuate Kevin by air ambulance 24 hours later to Bogotá, where clotting factors were available, the blood loss was severe. Kevin died four day later in the Intensive Care Unit of the Hospital de la Misericordia in Bogotá.
Since then, Kevin’s death has caused huge indignation in Colombia both among medical experts who claim the death was preventable and critics of the current government’s political intervention in the health system which has left many users worse off.
Get off your bike
Adding to the furor, President Gustavo Petro waded into the debate blaming the mother for allowing Kevin to ride a bicycle.
“A hemophiliac child shouldn’t ride a bike; it’s a matter of prevention. We need to know if the doctor or the health system isn’t providing education, because mothers don’t learn about it, especially given the low educational levels in Colombia,” he said.
His own health minister, Guillermo Jaramillo, added: “Children with hemophilia should be restricted from activities that can generate violent trauma,” he said.
These comments were challenged by patient’s rights groups, who pointed out that cyclists with hemophilia have competed in the Tour de France, and medical experts who emphasized that in recent decades in Colombia prevention has been based on weekly or monthly injections of “clotting factors” which allowed hemophiliacs to lead normal lives.
Many medical experts concurred that children with regular prophylaxis to prevent excess bleeding could, and should, integrate in physical activities.
“The child died from the accident, but the reason he died was because he didn’t have the medication,” Dr Sergio Robledo, president of the Colombian League of Hemophiliacs, told Blu Radio. “Prevention in hemophilia means having the drugs, not locking the child up at home.”
“For more than 20 years in Colombia we have not had any [hemophilia] deaths specifically due to a lack of medicine,” Robledo continued.
Chaotic plan
Kevin’s case was symptomatic of problems in Colombia’s health system which had worsened under the Petro government, Denis Silva told the Bogotá Post this week.
Silva, spokesperson for Paciente Colombia, a coalition of 202 patients’ rights groups, said Kevin’s death was “100 per cent avoidable”.
“If Kevin had been given the prophylaxis or given the treatment when he went to the clinic to coagulate his blood, the situation would have been different”.
Kevin’s mother had been asking Nueva EPS for the life-saving medicines since December, he said, but they were never delivered because the EPS had “failed to pay the clinic” that administered the drug in Pitalito.
Blame for these errors should bounce back to the Petro government, said Silva. State entities had forcibly intervened in Nueva EPS in 2024, claiming fraud in the huge health insurer, and were thereafter legally responsible for managing the entity that covered 11 million Colombians.
Interventions in EPS insurers was not unusual in Colombia, he said. Previous governments had done the same to avoid a crisis for patients.
But were timely actions to “administrate, improve and, where necessary, rescue” the health insurers, though in some cases they were shuttered and patients moved to other companies. Petro’s current takeovers were more chaotic and linked to political overhaul of the health system, he said.
Health system in crisis
This agenda was heavily criticized in an opinion article ‘How Politics Destroyed Colombia’s Model Healthcare System’, by Colombian-based journalist Luke Taylor and published in the prestigious British Medical Journal in January.
Referring to President Petro’s “bungled reforms”, the story claimed that maternity wards and neonatal units were shutting their doors, emergency departments becoming overwhelmed, and training programs for specialist doctors being shut down.
It also quoted the Colombian president as stating that health companies were being “run by crooks”, even as the his government’s interventions triggered a slew of complaints by patients suddenly finding their health care a lot worse.
For patients with chronic ailments reliant on monthly checkups and regular medical supply, the decline was becoming an existential threat, said Colombia’s ombudsman, Iris Marín, this week.
Kevin Acosta was “yet another victim of the failures in the availability and access to medicines that thousands of Colombians face today, in order to access timely treatments that are crucial for their health”.
According to documents released by Nueva EPS, Pico had tried to transfer her son’s care from Huila to Santander department, then switched back to Huila, suggesting a paperwork logjam had delayed the treatment. In another statement, it denied suspending the prophylaxis.
Need for treatment
This was “a big lie” said Pico, talking to Semana, since even before the administrative switch the local clinic treating Kevin had told her in early January that Nueva EPS had ended its contract. Without payments from the EPS, the clinic was forced to suspend treatment.
“By January we had no medication, no appointments, nothing,” said Pico.
Her position was supported by the fact that, across the country, other chronic or rare disease sufferers – including hemophiliac suffers in Pico’s same family – were reporting the same shortages, in many cases linked to contractual or payment problems with health suppliers.
ACHOP, the Colombian Association of Pediatric Hematology and Oncology, warned in a public communication that children and adolescents “were not receiving in a timely and continuous manner the essential medicines to preserve their lives in conditions of dignity”.
These shortages fell mostly on patients with the state-intervened Nueva EPS, confirmed hemophilia specialist Dr Jorge Peña, who said he regularly treated dozens of children with the condition.
Talking to Caracol Radio, Dr Peña said that children with other insurers were receiving their prophylaxis on time and were “happy, free from bleeding, and going to school as usual”.
“In comparison Nueva EPS patients are not getting the medicines, and I see them every day with bleeding. They can’t go to school.”
Leaked records
Meanwhile attempts by the government and President Petro to push back on Pico even while grieving her son’s death caused condemnation across the political spectrum, particularly since the state had taken over Nueva EPS.
“The responsibility is clear: when the state intervenes and controls, it is held accountable,” said Senator Jorge Robledo on X.
“The healthcare system already had problems, but under this government it’s worse. And meanwhile, more and more Colombians are suffering from illnesses that medicine knows how to treat.”
More criticism piled on President Petro after he leaked details from the Kevin Acosta’s medical records during a speech in La Guajira. Patient spokesperson Denis Silva called on the government to respect patient confidentiality
“These are confidential in Colombia,” said Silva. “By law the EPS insurer should guard the medical records, and no-one should access them without permission from the family”.
The leaks came even as the state agency overseeing the system, the Superintendency of Health (also known as Supersalud), announced an investigation into the Kevin’s care, including looking at “administrative barriers and the delivery of medication by Nueva EPS and the service provider”. This audit should clarify differences in accounts from the family and Nueva EPS.
But even with results pending, President Petro again doubled down in a speech claiming the family was primarily responsible for Kevin’s health outcomes.
“It’s the family that first of all cares for its children,” he said, “Not everything is the responsibility of the state, because the state can’t respond to everything, otherwise we lose our liberty”.
Colombians living with hemophilia might want those liberties to include the right to life-saving drugs – and to ride a bike.