In Ecuador, the implementation of neoliberal policies developed in the last two years have systematically decreased the response capacity of the State, which has generated an increase in socio-economic gaps (inequality, poverty and exclusion) in a population majority that is far from the government. the construction of policies that guide the common good. This article analyzes from a comparative perspective (cholera epidemic 1991-COVID-19, 2020) the relationship between social inequality, poverty and the negative effects on vulnerable populations in health crises, placing emphasis on the priorities of governments, whether economic, social or policies.