Expert Speak Health Express
Published on Sep 14, 2020
Brazil and COVID19: A Cautionary Tale

Six months after the World Health Organization (WHO) officially declared COVID-19 a global pandemic, it is time to come to terms with the tragic fate of South America’s largest nation. Things would have gone far better for Brazil had some erroneous decisions not been made. The over 130,000 lost lives and four million infections were not inevitable, and the country did not have to put into practice an incredibly failed approach to deal with the novel coronavirus.

First, Brazil had a three-week headstart to prepare for and cope with a worst-case scenario. As the situation began to spiral out of control in Europe in February, Brazil had the opportunity to learn from those mistakes and enact public policy intervention at the central level. But this did not happen. There was time, but no political will whatsoever. Shockingly, President Jair Bolsonaro’s health ministry had no contingency plan to deal with epidemiclike events even when the crisis sprung up.<1>

Second, airports across the country should have been shut as early as March when the global health emergency was worsening elsewhere. International flights to and from Brazil are concentrated in two cities—São Paulo and Rio de Janeiro—making it possible to seal Latin America’s air hubs and introduce a China-inspired ‘cordon sanitaire’ strategy. But, again, there was not much governmental interest in blocking this menace.<2> As a consequence, the first batch of COVID-19 cases were mostly imported from Italy, quickly spreading throughout Brazil.<3>

Third, Brazil was expected to resist the overwhelming pressure on its public health apparatuses due to the Sistema Único de Saúde (SUS), a mechanism introduced in the 1988 federal constitution to provide the population with the widest universal coverage health system on earth. SUS mobilises around three million health workers and is territorially widespread, reaching even the most inhospitable places and assisting more than 150 million citizens who cannot rely on private health insurance. While it should be a reason for national pride, SUS has been underfunded for many years now, which poses serious challenges to its proper functioning.<4>

Brazil has been hard hit by the COVID-19 pandemic. As of late August, it had the second highest cumulative deaths and confirmed cases, behind only the US. The Brazilian economy may contract by 6 percent to 10 percent this year, and the pace of recovery is not the most encouraging. Of all South American nations, only Venezuela is bound to deliver worse economic results in the aftermath of the pandemic.<5> Unemployment in Brazil has reached an all-time high (more than 12 million people are unemployed, as of July) and more than 100 million citizens are believed to depend on governmental financial relief programmes to survive this crisis.<6>

"Unemployment in Brazil has reached an all-time high (more than 12 million people are unemployed, as of July) and more than 100 million citizens are believed to depend on governmental financial relief programmes to survive this crisis"

This despairing public health scenario was aggravated by two pre-existing ‘co-morbidities’—an economic depression that led the Brazilian economy to shrink and return to the levels of the early 2010s,<7> and an ongoing process of social polarisation and struggles to win control of the country, in a fierce dispute against the presidency by two other federal branches (the legislative and the judiciary) and sub-national authorities (mayors and state governors). A lack of leadership and political coordination, serious shortcomings in the rule of law, economic underperformance, and Bolsonaro’s gross misconceptions about the epidemiological situation have severely impaired the ability of Brazilian public authorities and civil society to properly fight the pandemic and restore international confidence in the country.

Laying the groundwork

Brazil’s economic mismanagement is a case worth studying, especially given the country’s promising route just a few years back. Considered one of the sparkling emerging nations of the 21st century, Brazil was faced with social and economic unrest since the year 2013, a trajectory that culminated with left-wing President Dilma Rousseff’s removal from office in 2016. As fiscal and monetary indicators soon deteriorated, Rousseff’s deputy Michel Temer took over as president and put into effect a plan of action to promote fiscal austerity and inflationary control, but failed to reactivate economic growth. Unemployment soared and paved the way for the election of right-wing populist Bolsonaro in 2018.

Bolsonaro came to power under the promise that his economy minister Paulo Guedes—an academic and private investor who had previously been a part of Chilean dictator Augusto Pinochet’s economic team— will deliver a major overhaul of the Brazilian economy, giving leeway to his ‘Chicago boys’ to do their job. Pension system, administrative and tax reforms were assumed to be the only way out of this monumental crisis. But very little was achieved in Bolsonaro’s first year. Economic growth was baffling and, apart from a timid pension system reform, chiefly conducted by the Brazilian Congress, no other consistent structural reforms were introduced.

From a political viewpoint, the wounds of a long battle initiated in 2013 had not yet healed. Rousseff’s ousting, barely one year after her reelection for a second fouryear presidential term, triggered a process of social polarisation at a level never seen before in Brazil. Lula da Silva, the highly popular former president who had planned to run for the presidency in 2018, was found guilty on charges of corruption and imprisoned in July 2017. These events have divided the country into two strands of opinion—one made up of those who believed that Rousseff’s impeachment process and Lula’s jailing were a travesty of a ‘judicial-congressional coup d’état’ put forth to keep the leftist Workers’ Party away from the presidency; and the other comprising right-wing forces and anti-establishment movements that ended up supporting Bolsonaro’s candidacy and serving as his main electoral constituencies. Reconciliation is not an option for the two warring sides.

Brazil also has a unique three-level federative institutional design, which makes the task of coordinating policies over 5,500 municipalities, 27 federal states and the Union ‘mission impossible’, given that all enjoy some degree of constitutional autonomy for administrative matters and, in 2020, were authorised by the Supreme Court to craft their own strategies to fight the COVID-19 pandemic amid Bolsonaro’s negligence and denialism.<8> If it were not for the Supreme Court ruling, Brazil’s catastrophe could have been far more profound.

"Brazil also has a unique three-level federative institutional design, which makes the task of coordinating policies over 5,500 municipalities, 27 federal states and the Union ‘mission impossible’, given that all enjoy some degree of constitutional autonomy for administrative matters"

Bolsonaro’s follies

Bolsonaro proudly fits the ‘Trump of the Tropics’ moniker and keeps mimicking the American president. It was not any different with the advent of COVID-19. Bolsonaro first attributed the pandemic to a media conspiracy, then downplayed its importance by dubbing it a “little flu”. As the death toll rose and an effective governmental response was being demanded, Bolsonaro responded with a disconcerting “so what?,” adding that he was not a gravedigger and not the one to blame. After Bolsonaro himself and some of his ministers were infected and survived the disease, he adopted a new mantra—the coronavirus will contaminate every single person in Brazil sooner or later, so resisting it is worthless.<9>

During the pandemic, two of Bolsonaro’s health ministers with backgrounds in the medical sciences were dismissed, allegedly because they insisted on science-backed prescriptions such as social distancing. An army general and parachutist, who had no training in the health sciences, took over as an interim minister, replacing many technical staff members with military personnel. It has been three months since Eduardo Pazzuelo came to office and Brazil does not have a full-fledged health minister yet. But this provisional condition has not kept Pazuello from embracing a controversial protocol to treat COVID-19 patients with chloroquine/hydroxychloroquine, even though the WHO does not endorse the medical move.<10>

Curiously, there was no ‘rally around the flag’ cookie for Bolsonaro. While many world leaders have witnessed a surge in their popularity ratings, the Brazilian president lost almost 10 percent of his approval.<11> His handling of the crises was seen as one that favoured businesses and businesspersons to the detriment of the common people and public health concerns. Business unions have actively engaged in lobbying and propaganda to reopen the economy at any cost, under the claim that company bankruptcies rather than direct exposure to the virus would be the true engines of massive destruction, leading to higher levels of unemployment, hunger and social chaos. Such discourse has always found support in Bolsonaro.<12>

There is one final aspect to be highlighted—Brazil’s anti-globalist foreign policy. Since Bolsonaro’s coming to power in January 2019, his foreign minister Ernesto Araújo has been more of an ideological agitator than the country’s top diplomat, going as far as to affirm that “the virus of communism,” not the novel coronavirus, was the real problem in the world today—in a hostile, albeit indirect, reference to China.<13> His eccentric approach to global affairs never granted any tangible rewards, but brought opprobrium instead—Brazil has been kept from joining important forums where the future governance of the global economy and the development of COVID-19 vaccines were being discussed.<14> This isolation of Brazil comes as a surprise for a nation that always bragged about practicing universalist diplomacy.

"Brazil has been kept from joining important forums where the future governance of the global economy and the development of COVID-19 vaccines were being discussed. This isolation of Brazil comes as a surprise for a nation that always bragged about practicing universalist diplomacy."

All in all, Brazil’s four-pronged crisis—sanitary, economic, politico-institutional and foreign affairs— definitely makes the country one of a kind. It is probably the only country where COVID-19 looks like a chronic disease, being on average the main cause of death for Brazilian citizens among all different types of diseases (as of July 2020).<15> Brazil’s COVID-19 infection curve is also very peculiar—having reached the emblematic threshold of over 1,000 casualties a day almost four months ago, the situation today remains pretty much the same.<16> The Brazilian response to COVID-19 is a complete failure, yet Bolsonaro and his acolytes seem committed to their unreasonable choices.


This essay originally appeared in Rebooting the World


Endnotes

<1> Rubens Valente, “Brasil não tinha um Plano de Contingência para um novo coronavírus,” Portal UOL, May 2, 2020.

<2> Servio Pontes Ribeiro, Alcides Castro e Silva, Wesley Dáttilo, Alexandre Barbosa Reis, Aristoteles Góes-Neto, Luiz Carlos Junior Alcantara, Marta Giovanetti, Wendel Coura-Vital, Geraldo Wilson Fernandes, Vasco Ariston C. Azevedo, “Severe airport sanitarian control could slow down the spreading of COVID-19 pandemic in Brazil,” PeerJ, June 25, 2002.

<3> Elton Alisson, “54,8% dos casos importados de Covid-19 para o Brasil até 5 de março vieram da Itália,” Agência Fapesp, March 26, 2020.

<4>Brasil é único país acima de 200 milhões de habitantes com saúde universal,” Portal UOL, October 17, 2019.

<5> Douglas Gavras, “Retomada do Brasil no pós-covid deve ser mais lenta que em 90% dos países,” O Estado de S.Paulo, June 16, 2020.

<6> Wellton Máximo, “Em dois meses, 107 milhões de pessoas pediram auxílio emergencial,” Agência Brasil, June 3, 2020.

<7>PIB encolhe e economia brasileira volta ao patamar de 2012, aponta IBGE,” Portal UOL, May 29, 2020.

<8> Ana Pompeu and Luiz Orlando Carneiro, “STF reafirma competência de estados e municípios para tomar medidas contra Covid-19,” Jota, April 15, 2020.

<9>COVID-19 in Brazil: ‘So what?’,” The Lancet (Editorial), Volume 395, Issue 10235, p. 1461, May 9, 2020.

<10>Ao lado de Pazuello, Bolsonaro volta a insistir no uso da cloroquina para COVID,” Estado de Minas, August 6, 2020.

<11>Covid-19 has given most world leaders a temporary rise in popularity,” The Economist, May 9, 2020.

<12> Guilherme Mazui and Marcio Falcão, “Bolsonaro vai a pé com ministros e empresários ao STF e apela por redução de medidas restritivas,” Portal G1, May 7, 2020.

<13> Ernesto Araujo, “Chegou o Comunavírus,” Metapolítica 17, April 22, 2020.

<14> Jamil Chade, “Brasil não foi convidado para a principal cúpula da OMS,” Portal UOL, July 6, 2020.

<15>Covid-19 foi principal causa de morte no Brasil em julho; nos EUA, foi a 3ª,” Poder 360, August 11, 2020.

<16> Sandy Oliveira, “Pela 1ª vez, Brasil ultrapassa mais de mil mortes pelo novo coronavírus em 24h,” O Estado de S.Paulo, May 19, 2020.

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Author

Dawisson Belm Lopes

Dawisson Belm Lopes

Dawisson Belm Lopes is a professor of international politics at the Federal University of Minas Gerais (UFMG) a researcher of the National Council for Technological ...

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