Maria Berta Ecija Salgado – PhD candidate in global health diplomacy (King’s Brazil Institute and African Leadership Centre)
Throughout the pandemic management, we have seen periods of hope and desolation around the globe. However, as the world starts to move towards a renewed optimism due to several vaccines’ approvals and subsequent rollouts, we witness Brazil running in the opposite direction. The leading question in the minds of millions of Brazilians and citizens worldwide is: How did we get to this point?
The Covid crisis we see nowadays in Brazil probably had its roots even before the pandemic existed. It started when throughout the 2018 elections, the population was encouraged by their President, Jair Bolsonaro, to question the role of science and research—even connecting the idea of scientific advancement to Leftist ideologies, building a considerable stigma around universities and research institutions. With the outbreak announcement, we just saw the consequence of allowing science to be stigmatised in the political discourse in any of its fields. Science left the spotlight, leaving a space for conspiracy theories and negationist speeches.
To combat any health-related threat, trust in science and health-related institutions that provide the population with the necessary knowledge to shield itself is fundamental. In Brazil, the confidence in science was replaced by the confidence that the international community exaggerates this problem. Furthermore, even weird conspiracy/racist theories (towards China, for example) were raised by the Federal Government so as to deviate the population’s attention, which in turn was not concerned with what was being done to save their lives but to follow the thread of misinformation being spread. As a result, the health institutions and the information that should have been released by the Government and transformed in social policies lost its protagonism. This misinformation pattern never stopped, and resulted in catastrophic figures in Brazil, with an average number of 4000 deaths a day due to COVID.
Interestingly enough, this is the country internationally recognised for its value-oriented approach to health, which is embedded in its own 1988 Constitution, in article 196. It claims that health is a fundamental human right for every citizen and that it is a duty of the government to provide it to its population. Many public campaigns have taken place successfully in Brazil. Nevertheless, at the core of most achievements in Brazilian public health, there was an evident pattern being followed: Prevention instead of intervention. Prevention is an ethical duty of the State and a matter of adhering to the Constitution. The government’s obligation is to save lives.
However, if this is not enough to convince several negationists, another argument might move them: prevention is cheaper. Healthy populations are more productive. Thus, they are more profitable. Furthermore, in the case of the spread of diseases, the expenses incurred in dealing with treatment, hospitalisations, management, and infrastructure are incredibly high, especially in a country with the urban characteristics and large population of Brazil. When we talk about prevention here, by no means, is it about the usage of uncertified and unsafe drugs – such as those recommended by the Brazilian Presidential Office.
Brazil, throughout the past decades, developed many large-scale social policies to prevent people from getting sick. An example of this can be drawn from the outbreak of Dengue fever in the early 2000s. There were many social policy initiatives to contain its spread. For instance, information campaigns. These initiatives aimed to inform about the transmission of the disease, identify the mosquito, the symptoms, and prevention. It counted on a massive effort from the sanitary agents, who would go from door to door, to verify if there was any spot in people’s houses and across their communities that could serve as a proliferation focus. It is also valuable to remember the charismatic figure of ‘Zé Gotinha’, a character created to attract the public attention, especially children, to get vaccinated against polio. Many initiatives account for the success of Brazil in the past. However, they are currently being forgotten. Instead of prevention and protection, the government encourages people to use unreliable drugs in case of infection.
The administration of the COVID-19 crisis under the Jair Bolsonaro government has been disastrous. There are many suspicions about a deliberate attitude to not care for the Brazilian people, especially minorities. Brazil has detached itself from its traditional behaviour as a national and international health player. By sticking to denial over the value-oriented approach that it has consistently raised regarding the right to live.
Nevertheless, some aspects can bring us some hope going forward. The Brazilian health-related institutions are powerful and competent. They can rely on decades of experience in developing research, medicine, and articulating social policy together with the government to diminish health risks. Throughout the Covid-19 crisis, this has not been different. It is natural that the anti-life discourses now absorb most of our attention. However, if we look closely at Butantan and FIOCRUZ, we can have some hope for Brazilians again. These institutions created partnerships to absorb know-how in collaboration with other international laboratories, such as Sinovac and AstraZeneca, to produce vaccines. There are even talks about a 100% Brazilian vaccine being developed by Butantan. Moreover, some cities developed creative ways of encouraging protective measures. Such as Campinas-SP, which established a rule? that those who do not wear a face mask would have to pay a fee or donate food to the food banks for those in need.
These advancements are slow but are being undertaken by some governors, senators, mayors, and other politicians – who finally understood there is no economic prosperity without good health practises?. Consequently, the way forward is to revitalise the trust of Brazilians in these health institutions. They have been working on the development of vaccines and their rollout. Moreover, to look for more examples on the role of social distancing measures in saving lives. Instead of focusing and circulating negationist articles and affirmations, the answer should be to help disseminate the work developed by these health institutions. This will give hope to Brazilians, as the country has all the institutional capacity necessary to move forward, especially under the umbrella of SUS. The population needs to defend its public health system and accept no less from the government. Reliable information and cooperation across different national and international institutions are the only way out of this.