Brazil: Case Study of How NOT to Handle a Pandemic

By Ingrid Fontes*

A health professional from the Special Indigenous Health District (DSEI) prepares a dose of the CoronaVac vaccine/ International Monetary Fund/ Flickr/ Creative Commons License

Most of the blame for Brazil’s inept response to the COVID‑19 pandemic – including the highest per capita death rate in the world (214 per 100,000) – falls squarely on the shoulders of President Jair Bolsonaro. Some of the severe criticism of the President – including some in an ongoing Senate investigation – is surely politically driven, but government foot-dragging and bad decisions, compounding the country’s political economy of corruption, have worsened the 15-month crisis.

  • The country has recorded 16.2 million cases and 452,000 deaths, according to Johns Hopkins University’s COVID‑19 Dashboard. Since early May, Brazil has had a moving average of more than 2,000 deaths per day.
  • Vaccinations have lagged even though Brazil has a competent infrastructure for administering conventional flu shots. As of this week, Brazil has administered a total of 63.7 million doses, with nearly 14.74 percent of the population receiving at least one dose, and 7.15 percent receiving both doses (13.2 million) – out of a population of more than 212 million. That’s below Chile (41 percent fully vaccinated) and Uruguay (28 percent); more than Mexico (9 percent); and well ahead of Peru (3 percent) and Ecuador (3 percent), according to a tracking website.

Government efforts ran into some longstanding obstacles, but many problems directly resulted from Bolsonaro policies that, according to many observers and experts, were minimalist if not obstructionist.

  • The country’s health system has long been underfunded, but the chaos has been the result of government actions. Four ministers of health have cycled through the job during the pandemic. The President and his administration have willfully disseminated information about the pandemic and vaccines, including that some shots will “turn you into a crocodile,” that have been roundly debunked. Bolsonaro has hosted large events without masks and social distancing.
  • Initially calling COVID a “little flu,” the government failed to begin arranging the purchase of vaccines in mid-2020 and later refused several offers by Pfizer that would have guaranteed it millions of vaccines. It rejected a liability waiver that the United States, EU, UK, Japan, and other Latin American countries had accepted.
  • The government also refused public calls to develop an immunization plan and delayed training healthcare professionals to administer the vaccine. When Brazil received its first batch of Pfizer/BioNTech vaccines last month, the government stated it would distribute them to its 27 capitals in a “proportional and equal” division, but the lack of a detailed plan has led to wasted doses, shortages, and the suspension of vaccinations.

Corruption has also hampered efforts. Congress authorized US$50.8 billion in April 2020 and allowed all levels of government to purchase ventilators, intensive care beds, masks, and other supplies without bids and the usual bureaucratic review. By August, auditors were already warning that less than 8 percent of funds expended had gone directly to fight the disease. Of seven field hospitals the ex-governor of Rio de Janeiro ordered, five never opened. State and public prosecutors have already developed various cases of companies bilking more than US$70 million in each of various schemes. A lot of key equipment, such as respirators, and protective gear, never reached patients.

  • The government was slow to crack down on scams, such as the sale of bogus cures, that stole citizens’ money and undermined their confidence. The resident of a luxury building in Belo Horizonte, for example, told police that both the nurse and vaccine he paid US$100 for turned out to be false.

Other Latin American countries have struggled with the pandemic, of course, but Brazil’s performance falls far short of what it could have achieved with effective leadership and transparency. The harm has been magnified by the country’s interconnected and problematic political economy, specifically corruption. which has created a perfect storm of government ineffectiveness.

  • The President’s personal role is not to be underestimated, both in his deeds, such as undermining state and local governments’ efforts to contain the disease, and his inaction. Ironically, even communities that oppose Bolsonaro, or at least have no reason to heed him, have been heavily influenced by his example. Indigenous leaders report, for instance, that his refusal to accept the Chinese vaccine has contributed to vaccine hesitation among the 410,000 adults in indigenous villages. His rhetoric has made thousands of supporters refuse taking the vaccine.

* Ingrid Fontes is a student in the School of Public Affairs and School of International Service, with a particular focus on Brazil.

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