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Argentina y Paraguay refuerzan respuesta sanitaria fronteriza con simulacro internacional
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En un ejercicio sin precedentes, autoridades de Argentina y Paraguay pusieron a prueba, del 2 al 5 de junio de 2025, sus capacidades conjuntas para enfrentar emergencias sanitarias en la zona fronteriza de Posadas–Encarnación. El simulacro, realizado bajo el Plan de Contingencia Posadas–Encarnación y con el apoyo técnico de la Organización Panamericana de la Salud (OPS/OMS), evaluó la coordinación interinstitucional, la respuesta hospitalaria, la vigilancia epidemiológica y la comunicación de riesgos, marcando un hito en la integración operativa de los sistemas de salud del MERCOSUR.
Contexto y objetivos del simulacro
El primer ejercicio de campo bilateral Posadas–Encarnación se enmarca dentro de la estrategia de Cooperación Sur-Sur del MERCOSUR para fortalecer la salud pública en las fronteras de la región. Bajo la tutela de la Dirección General de Vigilancia de la Salud y la Dirección General de Relaciones Internacionales de Paraguay, y en coordinación con pares argentinos, brasileños y uruguayos, se diseñó un plan de contingencia binacional que respondiera a los lineamientos del Reglamento Sanitario Internacional (RSI).
Entre sus principales objetivos figuraron:
- Evaluar la eficacia de los protocolos de control sanitario en puntos de entrada fronterizos.
- Probar la capacidad de derivación y atención de casos sospechosos de enfermedades de importancia internacional en centros hospitalarios.
- Activar el sistema de vigilancia del Programa Ampliado de Inmunizaciones (PAI) ante un posible evento prevenible por vacunación.
- Analizar la comunicación de riesgos y las vías de articulación entre distintas entidades de salud y organismos de defensa civil.
El simulacro se desarrolló simultáneamente en varios puntos neurálgicos: pasos fronterizos formales (Puente Internacional San Roque González de Santa Cruz y Puente del Comité Internacional de la Cruz Roja) y el Hospital Regional de Encarnación como centro de referencia para atención en caso de sospecha de enfermedad de importancia internacional. De igual modo, los equipos técnicos de Brasil y Uruguay participaron como observadores y evaluadores, asegurando una mirada regional amplia.
Participantes y ámbitos de acción
La conducción de la fase final del simulacro estuvo a cargo de la ministra de Salud Pública y Bienestar Social de Paraguay, Dra. María Teresa Barán, y de la representante de la OPS en Paraguay, Dra. Haydee Padilla, junto a autoridades sanitarias de Argentina. Además, participaron referentes de las direcciones generales de Vigilancia de la Salud y Relaciones Internacionales de ambos países, el equipo técnico del Hospital Regional de Encarnación, y delegaciones de Brasil y Uruguay para la supervisión y asesoría.
En el ámbito operativo, se conformaron unidades móviles de vigilancia epidemiológica, brigadas de atención hospitalaria y equipos de comunicación de riesgos. Estas unidades incluyeron personal de salud fronterizo, autoridades de organismos de control y defensa civil, y recursos logísticos como ambulancias y equipamiento de protección personal (EPP). Adicionalmente, se emplearon las redes de comunicación locales para alertar a la población de manera preventiva y evitar confusiones con maniobras reales.
Por su parte, la coordinación técnica de la OPS/OMS supervisó la correcta implementación de los protocolos del RSI y facilitó talleres previos al simulacro, enfocados en el intercambio de buenas prácticas y el fortalecimiento de la atención intercultural en zonas fronterizas. Este componente formativo incluyó la revisión de normativas internacionales y la actualización de los manuales de actuación para Eventos de Salud Pública de Importancia Internacional (ESPII).
Principales escenarios y resultados
- Control sanitario en pasos fronterizos
Uno de los escenarios clave simuló la detección de un viajero con síntomas compatibles con una enfermedad potencialmente grave de transmisión respiratoria. Equipos de inspección sanitaria debían aplicar protocolos de tamizaje clínico verificando temperatura, antecedentes epidemiológicos y señales clínicas para luego activar el traslado seguro del presunto caso al hospital de referencia. Esta fase permitió medir la rapidez de respuesta en el tamizaje inicial y la eficacia de la cadena de comunicación hacia los servicios hospitalarios. - Respuesta hospitalaria ante caso sospechoso
En el Hospital Regional de Encarnación, se simuló la recepción de un paciente con criterios de alerta por una posible enfermedad de importancia internacional (por ejemplo, fiebre hemorrágica o un brote de arbovirus). El personal de emergencia debió emplear EPP completo y aplicar protocolos de aislamiento, mientras que el laboratorio clínico ejecutó pruebas rápidas de descarte según las guías emitidas por la OPS/OMS. Este ejercicio evaluó tanto la disponibilidad de insumos y equipos como la capacitación del personal para manejar casos críticos sin comprometer la seguridad de otros pacientes. - Activación del sistema de vigilancia del PAI
Simultáneamente, se ensayó la implementación del PAI en contexto de posible evento inmunoprevenible, ejemplo de un brote de sarampión en zona fronteriza. Las brigadas de vacunación móvil se desplazaron a los puntos designados para verificar coberturas y aplicar dosis de refuerzo. Además, se activó la notificación inmediata de casos sospechosos a través de las plataformas de información epidemiológica compartidas entre Argentina y Paraguay, validando la interconexión de datos en tiempo real.
Identificación de fortalezas y áreas de mejora
Durante la evaluación final, la ministra Barán destacó “fortalezas importantes” en la articulación de los servicios de salud y la movilización de recursos, pero también subrayó áreas críticas para mejorar:
- Coordinación interinstitucional: Se observó un seguimiento adecuado de los protocolos de comunicación, aunque se identificaron retrasos en la transmisión de información epidemiológica entre las jurisdicciones de Misiones (Argentina) e Itapúa (Paraguay).
- Uso correcto del Equipo de Protección Personal (EPP): Si bien el personal aplicó correctamente el EPP en la mayoría de las instancias, se detectaron brechas puntuales en el aseo y desinfección de áreas críticas, lo que podría comprometer la bioseguridad.
- Logística de derivación y transporte de pacientes: Las ambulancias y unidades médicas móviles cumplieron con los tiempos esperados, aunque se requirió reforzar la planificación de rutas alternas para evitar congestiones en puntos frágiles de la frontera.
- Comunicación de riesgos a la población: La estrategia de comunicación preventiva funcionó, pero se recomendó ampliar los canales de difusión, incluyendo redes sociales y emisoras de radio locales, para alcanzar comunidades rurales y étnicas con acceso limitado a medios convencionales.
Por otro lado, los evaluadores de Brasil y Uruguay destacaron como fortaleza la integración operativa de los cuatro Estados Parte del MERCOSUR, pues las lecciones aprendidas podrán replicarse en otras zonas fronterizas de la región. Asimismo, la OPS/OMS resaltó la importancia de mantener ejercicios regulares para no perder destrezas y actualizar los protocolos de acuerdo con hallazgos científicos y cambios en el contexto epidemiológico internacional.
Importancia regional y perspectivas futuras
El simulacro Posadas–Encarnación representa un precedente crucial para la salud pública del MERCOSUR. Según la OPS/OMS, la cooperación técnica Sur-Sur es esencial para enfrentar con éxito Eventos de Salud Pública de Importancia Internacional (ESPII), dada la alta interconectividad de las poblaciones fronterizas y el flujo constante de personas, mercancías y servicios.
En el cierre de la actividad, la ministra Barán afirmó: “Los límites geográficos no existen para los vectores, las enfermedades ni las emergencias sanitarias. Este simulacro es un paso concreto hacia una respuesta más coordinada y efectiva en momentos críticos.
Debemos continuar fortaleciendo nuestras capacidades locales y consolidar una estrategia regional que se sustente en la cooperación efectiva de los cuatro Estados Parte del MERCOSUR”. Entre las metas a mediano plazo se incluye la institucionalización de ejercicios bianuales en la frontera, la expansión de la cobertura de vacunación en zonas limítrofes con enfoque intercultural, y la creación de una red de intercambio de datos epidemiológicos en tiempo real que involucre laboratorios de diagnóstico compartidos. Estos avances tendrán un impacto directo en la detección temprana de brotes, la disminución de la mortalidad por enfermedades reemergentes y la optimización de recursos sanitarios transfronterizos.
Este simulacro binacional no solo representa un hito operativo para Argentina y Paraguay, sino que sienta las bases de una respuesta sanitaria conjunta y resiliente en el MERCOSUR. El compromiso de los gobiernos, junto al acompañamiento técnico de la OPS/OMS y la participación activa de todos los Estados Parte, marca un avance significativo hacia la seguridad sanitaria regional y la protección de millones de personas que conviven en las zonas fronterizas.
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