Brazil’s disastrous pandemic response

Issue 
Brazilian president Jair Bolsonaro has compared COVID-19 to a mild cold.

The “COVID Performance Index” compiled by the Lowy Institute ranks 98 countries’ handling of the COVID-19 outbreak.

Brazil performed the worst, occupying the last position. Anti-science attitude and uncurbed neoliberalism account for the country’s dismal pandemic response.

Anti-science attitude

Ever since the first case of SARS-CoV-2 infection was diagnosed in Brazil on February 25, 2020, President Jair Bolsonaro has made anti-science statements regarding the pandemic. Throughout December, he made 61 statements about COVID-19 containing information that was deemed fake or distorted. In November, more than 70 statements made by Bolsonaro on the global pandemic were found to be incorrect or misleading.

In one of his first public comments on the disease on March 9, last year, at an event in Miami, he stated the press was exaggerating its severity. “There is … the issue of coronavirus, which, in my opinion, is oversized, the destructive power of this virus.”

In a televised statement on March 24, last year, when the country had already recorded more than 10 deaths from the virus, Bolsonaro criticized the closure of schools and businesses. He even compared the contamination by coronavirus to a mild cold and said that if he got sick, he would not suffer.

At the end of March, after a trip that caused crowding, he said: “This is a reality, the virus is there. We will have to face it, but face it like a man. Not like a kid … Let’s face the virus with reality. It’s life. We will all die someday.”

While hospitals were overflowing with corpses, elders were being sent to die at home, cemeteries were being built, coffins were being purchased and graves were being dug, Bolsonaro was busy revealing his inability to coordinate an adequate health strategy. On April 28, when asked about the 474 deaths recorded that day, he replied: “So what?” “I’m sorry. What do you want me to do?”. “My name’s Messiah”, he added in reference to his middle name, Messias, “but I can’t work miracles”.

At the beginning of June, the Bolsonaro government reported that it would change the method of sharing information about the pandemic. Its presentation of accumulated cases and deaths was stopped, and only new cases were reported on the official website.

According to the federal government, this would facilitate the communication of data to the public. However, this was a way of hiding information about the real magnitude of the pandemic. As a response to this lack of transparency, media organisations O Estado de S. PauloFolha de S. PauloO GloboExtraG1, and UOL decided to organise a network to continue to have timely, quality data.

With rising complaints about underreporting, the Supreme Court of Brazil determined on June 8, that the federal government should continue to present the accumulated figures of cases and deaths.

The attempted fudging of statistics reflects the absence of science-based approach in the Ministry of Health. Luiz Henrique Mandetta, a children’s orthopedic doctor, was sacked by the president on April 16.

Nelson Luiz Sperle Teich, a medical oncologist, who defended the lockdown as a measure to control the pandemic and resigned on May 15, 2020. Since May 16, 2020, Army General Eduardo Pazuello has held the position of Minister of Health without having experience in the health sector.

Ravages of neoliberalism

The Bolsonaro government has actively engaged in policies of austerity, choosing to continue with and consolidate an extremely predatory neoliberal model. It has allocated very low level of resources to combat the pandemic.  As of May 12, spending on the pandemic response was negligible, corresponding to only $1.5 billion or 5.4% of the total budget of the Ministry of Health for 2020.

Data related to the federal budget of 2019 ($534.7 billion) show that 38.3% of this budget is spent on interest expenses and debt principal expenditures, while only 4.2% refers to the Ministry of Health expenditure.

More than 38 million Brazilians work in precarious jobs, and the three-month, US$120 "stay home" payment promised by the Bolsonaro administration has proven to be insufficient. Excluding meagerness, 41% of all families living in the favelas (shanty towns) did not even get the aid. When no payment is provided, how are workers expected to stay at home and prevent the spread of Coronavirus? The present-day paradigm of austerity is part of a wider historical context where Brazil was steered toward the direction of Washington Consensus.

Brazil's Unified Health System (SUS) was created through Law 8080/90 in 1990. The basic principles of SUS are universality, comprehensiveness, equity, decentralization and social participation.

From its inception, it came under attack from the World Bank, which criticised the constitutional guarantee of comprehensive health care for all Brazilians. It defended scaling back this guarantee and advocated greater involvement of the private sector in the provision of services on the assumption that the latter would be more creative and efficient. Most Brazilian governments have followed the WB's  destructive recommendations.

Another blow to the SUS was the approval of Constitutional Amendment 95 (CA-95) during the tenure of Michel Temer who rose to power after President Dilma Rousseff was ousted through a parliamentary coup. CA-95 froze the Ministry of Health’s expenditure at 15% of the 2017 net current revenues of the federal government until 2036. Readjustment is allowed only by adding inflation, as measured by the Extended National Consumer Price Index (IPCA).

CA-95 has caused an unprecedented funding crisis in the health sector. The restriction of primary spending to certain ceilings disregards the needs of the population, the impact of population growth and demographic transition, the effects of technology incorporation and the costs associated with changes related to the prevalence of non-communicable diseases and external emergencies. With the new fiscal regime social spending is decoupled from any revenue growth. Thus, even if the federal revenue increases, there would be no more investments in social areas.

Chaos in Manaus

In Manaus, the capital city of Amazonas state, anti-science attitudes and neoliberal ideology have converged to give rise to criminal negligence. The situation in Manaus is so bad that a Brazilian Supreme Court justice has been forced to launch a probe into the health minister’s pandemic response or the lack thereof.

The scene of one of the world's worst outbreaks in April and May, the health system in Manaus has repeatedly collapsed. Hospitals are overwhelmed and supplies of oxygen are rapidly depleting. Warnings that the oxygen supply was running out in Manaus came to local and federal government officials a week before the onset of chaos and catastrophe.

Local health officials knew in early January this year, that there was going to be an oxygen shortage, but their warnings were not heeded. Six days before the oxygen crisis, a private contractor, too, informed the government of what could happen in the absence of proper management. 

Negligence apart, government officials in Manaus have indiscriminately promoted the theory of herd immunity to relax safety measures and keep the workers toiling in perilous conditions. In this case, neoliberal obsession with economic performance merged with disrespect for science to wreak havoc on the poor.

In September, the Oswaldo Cruz Foundation (Fiocruz), a highly regarded Brazilian research institute for public health, recommended that Manaus impose movement and business restrictions. The city was beginning to experience a second wave of the disease, it said. But the local functionaries did not impose one.

Jesem Orellana, researcher at Fiocruz, said: “We gave 13 alerts, and a very alarming one in mid-December, saying that the situation was getting very serious. Everyone was making fun of the studies and warnings, especially the President Jair Bolsonaro.”

Bolsonaro has constantly used anti-science myths to legitimize the re-opening of the economy. In March, he made a statement opposing restrictions intended to curb the spread of COVID-19: “Our lives have to go on. Jobs must be kept … We must, yes, get back to normal”.

On January 15, he lied about the pandemic response in Manaus, saying the government had done what it could. “The problem is terrible there. Now, we have done our part.”

While giving a Band TV interview on the situation in the city, his trivial attitude toward the pandemic reached its apogee. “I should be at the beach right now,” he said, adding that his health minister was doing an “exceptional job.”

A socialist plan

Neoliberalism has had a deep impact on the Brazilian pandemic response, revealing: a social crisis with a high unemployment rate of 12.2% in 2019 (one in four workers is unemployed); negligible public expenditure, necessitated by CA-95; and exponential growth of 9.5% in public debt in 2019, corresponding to 56% of GDP, having made a payment with interest and charges of this debt of $94.7 billion (almost four times more than the value committed to the Ministry of Health).

Instead of solving the structural problems of a neoliberal economy, Bolsonaro has led an anti-science crusade against the pandemic. What is needed in the current conjuncture is a socialist plan that emphasises science-based measures and puts people before profit.

While the former can be achieved by comprehensively following the guidelines of World Health Organization (WHO), the latter can be achieved solely through a post-neoliberal shift in the economy.

The following are some of the measures which can be undertaken for a post-neoliberal economy : repeal of CA-95; the revocation of the Fiscal Responsibility Law for spending on health personnel and increase in federal public health spending, from 1.7% of GDP to a level consistent with a universal health system, referring to 4% of GDP ($59.0 billion).

Only a genuinely sensitive and compassionate response can save the Brazilian people from Bolsonaro’s toxic mix of neoliberalism and anti-scientism.

[Yanis Iqbal is a student and freelance writer based in Aligarh, India, and can be contacted at yanisiqbal@gmail.com.]

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