Brazil’s vaccination plan plunged into chaos by political struggles

As countries prepared to vaccinate citizens against the coronavirus, Brazil, with its world-famous vaccination program and strong drug-manufacturing capacity, should have had a significant advantage.

But the internal political struggles, disorderly planning and a fledgling anti-vaccine movement have left the South American giant, which has suffered the second-highest number of deaths from the pandemic, without a clear vaccination schedule. Brazilians don’t know when they can get relief from a virus it brought the public health system to its knees and crushed the economy.

“They’re playing with lives,” said Denise Garrett, a Brazilian-American epidemiologist who studies public health at the Sabin Vaccine Institute, which works to expand access to vaccines. “It’s almost criminal.”

Experts clung to hopes that Brazil’s vaccination capabilities would allow it to better manage the end of the pandemic than it could at the start.

In February, after the detection of the first case of Covid-19 in the country, Brazil became the epicenter of the global health crisis. President Jair Bolsonaro rejected scientific evidence, defined the virus as a “miserable” cold that did not justify shutting down the region’s largest economy, and berated governors who imposed quarantine measures and shutdowns in the region. ‘companies.

As vaccination efforts begin in the UK and US, giving their respective populations a chance to begin imagining life after the pandemic, Brazilian government officials are once again ill-prepared and involved in violent conflicts on immunization policies.

In early December, the Ministry of Health presented a vaccination plan in response to an order from the Federal Supreme Court. The plan set out the order in which vulnerable groups would be vaccinated, but did not detail the schedule or give a clear estimate of the number of doses available. Earlier, the ministry announced its intention to launch the vaccination campaign in March.

A few days after the announcement, the ministry was still struggling to order from already overburdened vaccine suppliers. Government officials were also asked about the insufficient number of syringes and other supplies available in Brazil to embark on the ambitious vaccination campaign necessary to cover a country of 210 million inhabitants, where more than 180,000 have died from the virus.

As if that were not enough, Anvisa, the agency responsible for sanitary control in Brazil, has not approved any vaccine yet against Covid-19 for widespread use.

“People will start to panic if Brazil is left behind without a plan or a clear and objective strategy,” Rodrigo Maia, president of the Brazilian Chamber of Deputies, said on December 7, warning that Congress would take the reins. the question whether the executive branch continued with its clumsy strategy.

Bolsonaro, against the vaccine

The debate over vaccine access and safety has also been embroiled in a partisan dispute. Bolsonaro has consistently criticized CoronaVac, the vaccine developed by Chinese company Sinovac Biotech, and rejected his Ministry of Health’s plan to purchase 46 million doses.

Instead, the government chose the vaccine developed by AstraZeneca and the University of Oxford, which is late in the race to receive approval from health regulators.

The president’s crusade against the Chinese vaccine has created a golden opportunity, politically speaking, for João Doria, the governor of the state of São Paulo, one of his main political rivals. Doria has negotiated directly with the Chinese to obtain doses of the vaccine that they are developing in association with the Butantan Institute in São Paulo.

Doria said state officials couldn’t wait for the federal government, which went through three health ministers during the pandemic, to organize itself.

“We can’t wait until March to start using a vaccine that can start in January,” he said in an interview. “The wait, according to the consensus in São Paulo and in other states, represents a great risk for the population, as it affects death rates and the public health system,” added the governor.

Three weeks ago, Doria promised the state intended to begin vaccination by the end of January, a commitment that depends on obtaining approval from federal regulators who have yet to receive the final results of studies on the efficacy and safety of the vaccine. vaccine.

The Brazilian presidency has rejected Doria’s plan to start vaccinating people in January, calling it “cheap and irresponsible populism”.

Vaccination, a partisan issue

The bitter conflict between Doria, who is likely to run for president in 2022, and the federal government, dangerously politicizing vaccination plans in Brazil.

Carla Domingues, a public health researcher who led Brazil’s immunization program until last year, lamented that the Covid-19 vaccine has become a partisan affair. “This had never happened with the vaccination efforts,” he said. “It’s going to confuse people. It’s surreal ”.

As the number of cases spiked again in December, leaving hospitals in several cities without beds for critically ill patients, the pressure on the federal government from increasingly concerned regional authorities.

In the middle of last month, several governors traveled to the capital, Brasilia, to meet with the Minister of Health andEstablish a national immunization plan. The National Federation of Municipalities, a group representing municipal governments, also issued a statement calling on the federal government to purchase and distribute “all vaccines known to be effective and safe against Covid-19.”

Some governors, including those of Paraná and Bahia, began to try to acquire and eventually produce doses of the Russian-made Sputnik V vaccine.

Carlos Lula, chairman of the national board of health secretaries, said the wave of diplomacy and state-level vaccine deals was hitting a country that has spent decades building one of the world’s most successful immunization programs. most respected in the developing world.

“It is a source of pride for the country because it has become a model for other nations,” he said. “However, all of a sudden, we can’t handle the minimal tasks.”

Although the logistics and supply challenges, health experts say Brazil will face a new problem: a growing anti-vaccine movement that the president and his allies have fueled with lies.

Roberto Jefferson, a former congressman who openly supports the president, said in a Twitter post in early December that “globalists are preparing a vaccine to change our DNA.”

The post, which has been retweeted more than 3,000 times, claimed that Bill Gates, the American billionaire and philanthropist, was behind a “genocidal” plan to “kill millions of people and replace our DNA with the mark of the beast ”. reference to the devil.

Vaccination compulsory?

The growing anti-vaccine movement has led some governors, including Doria, to defend the mandatory nature of certain vaccines.

Bolsonaro said vaccinations should only be mandatory for dogs.

Even if vaccines have never been compulsory for adults in Brazil, its efficacy and safety have never been widely questioned.

A survey released mid-last month by Datafolha found that 22% of those polled said they did not plan to receive the coronavirus vaccine, up from 9% in August.

By Ernesto Londoño, Manuela Andreoni and Letícia Casado, The New York Times

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