The death of a former major league baseball player in his native Venezuela this week is renewing concerns over the Latin American country’s growing health crisis amid ongoing economic and political turmoil.

Marcos Carvajal, a 34-year-old former pitcher for the Colorado Rockies and Florida Marlins, died of pneumonia on Tuesday. He fell sick in December, but the antibiotics needed to treat the illness were hard to find. Drugs for Carvajal eventually were sent from abroad but he relapsed, returned to the hospital on Monday and died the next day.

The Pharmaceutical Federation of Venezuela estimates the country is suffering from an 85 percent shortage of medicine amid an economic crisis also marked by severe hyperinflation and food scarcity.

The entire Venezuelan health care system is on the verge of collapse, says Francisco Valencia, head of the public health advocacy group Codevida. Some hospitals lack electricity, and more than 13,000 doctors have left Venezuela in the past four years in search of better opportunities.

“They don’t give food to the patients in the hospital,” Valencia tells Here & Now’s Peter O’Dowd. “They don’t have the proper medical supplies to take care of the people who go to the emergency [room] like gloves, like every basic thing they need for an emergency.”

According to the pharmaceutical association, there is also a 90 percent deficit of other medical supplies and drugs used to treat more serious conditions like cancer.

The shortage has forced Venezuelans to go looking for medicine on the black market, Valencia says. Even if they find the right medicine, which is often smuggled from Colombia and Brazil and could be expired, most people can’t afford it.

The crisis affects Valencia personally, who relies on medication for a kidney transplant.

“I haven’t received my medicine since August last year,” he says. “Right now, I’m taking medicines that [have] expired, and my transplant is at risk.”

Venezuela’s President Nicolas Maduro has refused to accept humanitarian aid, blocking shipments of medicine and first aid supplies. Government data shows infant mortality rose by 30 percent in 2016 and malaria infections shot up 76 percent, Reuters reports.

“So most countries when they’re hit by a crisis, they’re taking aid from other countries, from NGOs,” Associated Press reporter Hannah Dreier told NPR in 2016. “But Venezuela keeps refusing to take donations that other countries are offering and is actually turning back shipments of donations that people have given in places like the U.S., not letting medicine in.”

Drug prices have skyrocketed along with those for food and other basic necessities. The International Monetary Fund predicts inflation will soar to 13,000 percent this year and the economy will shrink by 15 percent.

Earlier this week, the government announced it would abandon one of its two official foreign exchange rates, which had been used for food and medicine imports, Reuters reports. The policy change could encourage businesses to import more goods, but critics say it won’t be very effective due to the lack of hard currency in Venezuela.

The elimination of the exchange rate was “a step in the right direction because it helps correct foreign exchange distortion,” Asdrubal Oliveros of local consultancy Ecoanalitica told Reuters. “But without dollars, things will continue to be more complicated.”

Since the collapse of Venezuela’s oil-rich economy in 2014, the country has struggled to raise hard currency. The monthly minimum wage for many Venezuelans is now equal to $3, according to the AP.

Maduro blames the country’s growing crisis on foreign economic sanctions, claiming that the U.S. is leading an effort to wipe out socialism in Venezuela, according to Reuters. Presidential elections are set to be held by April 30, which is much earlier than usual, but Venezuela’s pro-government Supreme Court last week banned the main opposition party from running.

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What happens after a cancer diagnosis?

That’s the question investigated by a study published by the CONCORD program on cancer survival published on Tuesday in The Lancet. The study looks at patient records for adults and children diagnosed with a variety of cancers in 71 countries. The records are from 2010 to 2014. The goal is to compare five-year survival rates, a number used to assess effectiveness of treatment.

The overall message is that there is improvement in cancer survival rates but with a caveat. As lead author Dr. Claudia Allemaninotes, “That is particularly true in developed countries and less so in developing countries.”

Case in point: Childhood cancers in upper–income countries — like the U.S. and much of Europe —are treated so successfully that the five-year survival rate often reaches 90 percent or even higher. That was reflected in the data for acute lymphoblastic leukemia, the most common childhood cancer. By contrast, in some middle-income countries — China, Mexico and Brazil, for example — it’s less than 60 percent.

But there are some surprising revelations. Some countries in Asia do a far better job diagnosing and treating stomach and esophageal cancers than the United States does. Five-year survival rates in South Korea and Japan are 68 percent and 60 percent, respectively, versus 33 percent in the U.S.

To learn more, we spoke with Allemani from the Cancer Survival Group at the London School of Hygiene & Tropical Medicine and Michel Coleman, professor of epidemiology and vital statistics at the same institution. Here are some of the topics we discussed.

Why are children diagnosed with leukemia in Mexico and Brazil not faring as well as children with the same diagnosis in countries like the U.S.?

First, says Coleman, remember that in the 1950s and ’60s, in Western countries, the survival rate for children diagnosed with leukemia was five percent or lower after five years. “There was really no treatment available,” he says.

Today, largely because of chemotherapy as well as some other treatments, like stem cell transplants, survival rates have soared in the West.

But that doesn’t mean that having the right drugs is the solution for countries still struggling with these cancers. “The treatments are quite aggressive and repress the immune system so a child’s ability to defend against infections can be drastically reduced,” he says. “It isn’t simply a question of buying more drugs but a broader upgrading of the health service” to provide supportive care for the child during chemo.

What’s behind the stomach cancer success in parts of Asia?

Countries like South Korea, Japan and Taiwanhave historically had high rates of stomach and esophageal cancer. So local governments as well as companies have set up annual screenings. “They are very skilled at diagnosing very early and at very aggressive surgical techniques to manage those cancers,” says Coleman. But as Allemani points out, the survival rates for other cancers — melanoma and leukemia, for example — “are really quite low.”

Middle-income countries can be as effective in treating cancer as high-income countries.

Allemani points to Costa Rica: “Generally speaking we found very good survival for some cancers” in this upper middle-income nation. It’s one of the countries in the group with a five-year survival rate of 85 percent or higher, including the U.S., Canada, Japan and 16 European countries.

Getting cancer data is harder than you think.

The information in the report comes from registries that cite cancer diagnoses and deaths from cancer. Of the 85 countries contacted, “more than 20 wanted to participate but could not,” says Coleman, because registries have closed or lacked resources to keep reliable data — or did not have legal permission to link data from registries of diagnosis to registries of deaths from cancer. And these problems cropped up in a variety of countries, from low-income to high-income. For example, there is no data from any country in Africa in the childhood cancer section. And, Coleman says, “four of the 13 jurisdictions in Canada were not able to provide data in time for this study.”

That lack of data is “lamentable,” he says.

Without such data, Allemani says, “health ministries are flying blind on cancer control.”

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