On January 17 nurse Monica Calazans became the first person vaccinated against COVID-19 in Brazil. The procedure took place during a much-awaited ceremony in São Paulo. However, after months of denial and heel-dragging from the government of President Jair Bolsonaro, Brazil’s late entry into the global race for vaccines could prove to be fatal for thousands of Brazilians.
To date, over 260,000 people have died of Covid-19, a disease that Brazil’s far-right president, Jair Bolsonaro, once called a “little flu”. Since the start of the pandemic, Bolsonaro denied scientific evidence and refused to comply with basic health measures, including wearing a mask in public or avoiding crowds. Even after he and several members of the cabinet came down with the virus, Bolsonaro continued to oppose all measures to contain the pandemic and to hinder efforts to start the vaccination in the country. Moreover, he argued that the lockdown would affect the economy.
Now, faced with popular pressure and the insistence of the Governor of São Paulo, João Dória, the president finally decided to talk to several laboratories and acquire COVID-19 vaccines to immunize the entire Brazilian population. Meanwhile, the Butantan Institute, supported by the São Paulo government, is now in charge of producing locally the CoronaVac, developed by Chinese company Sinovac Biotech, with inputs imported from China. Also, Brazil’s National Health Surveillance Agency (ANVISA) gave the green light on March 12 for the importation of the Oxford-AstraZeneca vaccine as well as the local production by the Oswaldo Cruz Foundation (Fiocruz).
However, there are still numerous uncertainties on the horizon as to whether the country will be able to produce or to import the necessary doses of vaccines to immunise the entire population.
The president previously declined offers of 70 million doses from laboratories such as Pfizer and he Ministry of Health refused to explain the reason behind such decision. When Bolsonaro finally did begin talks to purchase vaccines, the delay brought uncertainty about the real possibility of a broad vaccination campaign in the country. To date, the government is still negotiating to buy doses from several different laboratories, but no agreement was reached so far. The Butantan Institute can only produce so many vaccines and it’s struggling to import supplies from China.
Part of the reason for the Institute’s difficulty in acquiring supplies is due to the tensions between Brazil and China, as well as a power struggle between the president and João Dória.
These delays are taking their toll. So far, less than 12 million people have been vaccinated in a country with 210 million people as the number of daily deaths is on the rise and the country has surpassed the US in number of daily deaths. 1954 people died of Covid on March 10 alone.
The situation on the ground
Mellanie Dutra, a biomedical practitioner currently doing postdoctoral research in neuroscience at the Federal University of Rio Grande do Sul (UFRGS) and a member of the Covid-19 Analysis Network,, stated in an interview that “among the main criticisms [towards the government] is the lack of communication. Especially because we should have started campaigns on TV already, showing the benefits of vaccines since the beginning of the pandemic.”
Dr. Dutra said, “since 2018, we have seen a drop in vaccine coverage of already approved vaccines, and we were already observing that Covid’s vaccine was being politicised, denied. So, it was very important to have started this clarification on vaccines with scientific backing a long time ago, back when clinical trials started, and people started to pay more attention to these Covid vaccines.”
For some years now, government campaigns about the need for vaccination for various diseases have been side-lined by denialism from broad sectors that support Bolsonaro regarding the benefit and effectiveness of vaccines, have created a scenario of reduced vaccine coverage and distrust.
But, thanks to the efforts of activists, scientific disseminators, and health professionals such as Dutra, the population has increased access to information on the disease and vaccines – particularly through online campaigns, memes shared on social media and a larger presence on TV shows to debate the pandemic. And this effort is reflected in opinion polls. In December last year, 22% of the population said they would not get vaccinated. Today the figure is about half that 11%.
Bolsonaro himself had stated that the actual number of those who would not get vaccinated was more than half of the population). Now, even the President himself seems to have changed his mind, claimingthat “I have never been against the vaccine” and going so far as to promote the campaign, albeit timidly.
Part of the issue stems from a lack of qualified experience by those managing the crisis. The current minister of health, Eduardo Pazuello, comes from the logistics area of the army, but has no training in health management nor even in logistics. Overall, his management as head of the ministry has been disastrous. In October of last year the minister tried to buy doses of CoronaVac from China, but Bolsonaro disallowed it.
Pazuello also advocates what the Ministry calls “early treatment” for Covid-19 with remedies without proven efficacy such as the use of Ivermectin and Chloroquine. André Watts, an anaesthesiologist at warns that the indiscriminate use of some of these “leads to greater resistance to the effect to treat bacterial infections of the respiratory tract and gonorrhoea, for example.”
“Bolsonaro is the worst leader in pandemic management in the world,” stated Celso Rocha de Barros, doctor in sociology and op-ed writer for the newspaper Folha de São Paulo. He adds that “no other country put a military minister in charge of the pandemic without any relevant qualifications, who was then publicly disallowed when he tried to buy vaccines. Bolsonaro’s Brazil is completely outlier in incompetence in crisis management– nobody compares.”
Conflict with international allies
São Paulo’s Butantan Institute pledged to produce millions of vaccine doses locally, but there is a lack of supplies for vaccine production. Additionally, the government of Jair Bolsonaro, has alienated almost all possible international allies that could cooperate in producing and exporting the vaccine. China, for example, created several obstacles to exporting supplies for vaccine production and the close relationship between Bolsonaro and Trump has jeopardized Brazil’s relationship with the new Democrat administration.
Mauricio Santoro, professor of international relations at the State University of Rio de Janeiro (UERJ) explains that “Bolsonaro’s foreign policy has focused on a preferential relationship with Trump rather than with the US. The Brazilian government has indisposed itself with the Democratic Party and was in a difficult situation when Biden won the elections.” With China, Santoro adds, “there is a contrast between the growth of trade (even with the pandemic) and the tensions arising from the government group that is hostile to the Chinese political system.”
India also delayed the export of millions of Oxford/AstraZeneca doses to Brazil for almost a month before allowing a plain with 2 million doses leave the country.
Even though both India and China ultimately agreed on resuming exports of supplies and vaccines to Brazil, the growing international isolation of the country is noticeable. “Brazil is not a priority for any of these countries. It has its importance in economic issues or regional affairs in Latin America, but it is not a country of great strategic prominence,” Santoro points out.
Milton Deiró Neto, an international relations researcher at Brazil’s SENAI-Cimatec Defence and Public Security Research Centre, agrees that Brazil’s isolation on the international stage, exacerbated by Bolsonaro’s chumminess with Trump, his refusal to act to save the Amazon and his racist and misogynist public remarks, is costing the country vaccine access.
“Brazil has lost much of its diplomatic leadership in the past and is today in a relative position of global pariah because of [Brazil’s foreign minister] Ernesto Araújo’s absolute lack of competence in managing Brazilian foreign policy,” says Deiró.