By Mafa Gaspar
The Australian Lowy Institute conducted a research comparing how 98 countries are dealing with the pandemic. The institute analysed the quantity of confirmed Covid-related deaths and cases, proportion of cases per one million citizens, proportion of confirmed cases to tests conducted, and tests per one thousand citizens. The data was compiled into a ranking system. Brazil ranked dead last.
In late March of 2020 Brazil accounted for no more than 10 Covid related deaths. Hospitals in Italy were over capacity, the situation in Spain was getting out of control, and the U.K. had just imposed a national lockdown. “It’s just a little flu,” said Jair Bolsonaro, Brazil’s far right president. Over a year later, the country has recorded over 370,000 Covid related deaths, second only to the U.S., and while the rest of the world seems to be finally seeing the light at the end of the tunnel, Brazil is reaching record death counts on a weekly basis. Bolsonaro’s response to the pandemic was not only ineffective and inappropriate, but also irresponsible and outwardly atrocious.
Had the government taken a different approach to dealing with the pandemic, Brazil would not be sitting last in Lowy’s rank. The horror stories coming from the Covid crises in China and Europe served as examples to the rest of the world as to what could happen if governments ignored the matter. The World Health Organization was pushing for social distance measures, and most countries were entering government mandated lockdowns. Meanwhile, Bolsonaro was firing the first of three Health Ministers in the last year for disagreeing with his handling of the situation.
Throughout the Pandemic, Bolsonaro’s rhetoric revolved around outward denial, minimization of the disease, and the promotion of preventative measures with no scientific background, most notably the use of chloroquine in treatment, for which the government has invested over 90 million Reais (around $16 million). To top it all off, Bolsonaro actively discouraged the use of masks, participated in various agglomerations, and publicly dismissed the need of vaccination.
What is more disheartening is that, had the government been any more sensible, Brazil had the potential to be among the countries with the best response to the pandemic. Its first cases appeared when the world was already in an alarming state, a time when preventative actions could have still been somewhat effective in mitigating the situation. Furthermore, contrary to its neighboring countries, the Brazilian National Health System, SUS, is a reference around the world for its accessibility and quality. Despite budget cuts, frozen salaries, and a leadership that does not admire nor support the tremendous work the system has been put through, the SUS has been at the forefront of the battle.
The system’s supply of medicines, innovations obtained in partnership with public universities, rapid tests and laboratory surveillance have been essential to keeping Brazilian society standing throughout the pandemic, even if the SUS is barely coping with the Covid surge. Its universal accessibility has supported and received Brazilians from all backgrounds, and it is the SUS that is conducting and promoting vaccination programs despite the government’s resistance. In addition, the SUS has helped develop one accredited vaccine with the Butantan Institute and the Chinese biopharmaceutical company Sinovac, and is in the process of approving a second vaccine completely developed on Brazilian soil. The number of deaths in Brazil is aggravating, and it is hard to imagine where that number would be without the SUS.
The influence of Bolsonaro on how well the SUS could respond to the pandemic can be analysed in contrast with previous health crises in Brazil. The country went through a major epidemic in 2014 under the presidency of Ms. Dilma Rouseff. The Zika epidemic was nowhere near as contagious or devastating as Covid, however, comparing the governments’ reactions and their consequences portrays a scenario of the SUS’s ability to address the health crisis under an efficient and expedient leadership.
At the beginning of the Zika outbreak, Ms. Rouseff’s government launched a campaign with three lines of work: the mobilization of SUS resources towards the health crisis, the support of treatment against the disease, and the promotion of technological development, education, and research on Zika. Communication between the government and the people was constant, and additional resources towards the SUS and funding of research institutions were quickly administered. The result was an epidemic put under control and a case study for health organizations across the world on how to manage a health crisis.
Political rhetoric matters. It induces behaviour, and has the potential to promote social chaos or cohesion. Throughout the Covid-19 pandemic, its impact on the Brazilian socioeconomic environment was evident. Bolsonaro’s discourse actively propagated the dispersion of Covid across the country, and the consequences are what looks like a never ending nightmare of an overcrowded health system, a dismantled economy, and a despairing government division that gets in the way of any efficient legislation to combat the pandemic to get passed.
It doesn’t come as a surprise that the lethal rate of Covid-19 was higher among lower income and marginalized groups. According to the Brazilian National Household Research Center (PNAD), drawing from the population of people who faced serious conditions and had to be hospitalized due to Covid-19, the situation was lethal to 71.3% of the people with no schooling, 59.1% to the people with basic education (up to fifth grade), and 47.6% to the people who stopped education in high school. The percentage drops dramatically to 22.5% among people who attended higher education. Additionally, the aforementioned analysis shows that when considering the race of intubated inpatients, the lethality rate was 56% among whites and 79% among Black and Pardo (mixed race) individuals. The percentage is likely to be even more dramatic as there is a trend throughout the Brazilian Census where Black and Pardo individuals voluntarily identify as white. The health crisis in Brazil reveals the pre-existing sociopolitical inequalities.
Bolsonaro’s dismissal of the pandemic has continuously been prompted by the well being of the economy. The prospects of an improved investing environment is one of the reasons he got elected in the first place, appealing to low and middle class brazilians who envisioned rich spendings and a more glamorous life. The Brazilian economy saw tremendous growth under Lula’s presidency and the Workers’ Party (PT), reaching a currency exchange of $1.71 between 2002 and 2010, year on year decrease in the unemployment rate, stable inflation, and a total average GDP growth of 5%. Growth rates started to decrease after Lula’s presidency and reached negative levels in 2015 and 2016. An economic recession alongside a politically unstable situation fuelled by excessive government spending and corruption set the stage for Bolsonaro’s rise.
Yet the promises have not delivered. The Real’s currency exchange is reaching all time highs, currently at almost $6 per dollar, the unemployment rate has increased by 7% since 2010 to 14%, GDP growth rate has averaged little more than 1%, not counting for the predicted drop of 5.8% in 2020 despite anti-lockdown efforts promoted by the national government, and inflation has been constantly increasing since the beginning of the pandemic to the point where a minimum salary worker’s day of work is not worth one kilo of meat.
So why has Bolsonaro rhetoric not changed? Taking the argument of protecting the economy versus protecting people’s lives aside, the economy and the national healthcare system alike are collapsing. It’s a lose-lose situation, and no efforts have been done to reverse it.
The situation is critical, but Brazil is not a helpless country. Far from it, in fact. There needs to be more global media coverage and foreign pressure on the Brazilian government to act rationally and put some breaks on Bolsonaro’s disparity, and Bolsonaro himself should be held responsible on a national and international stage for his deadly conduct of the pandemic.
The views expressed in this article are the author’s own and may not reflect the opinions of the St Andrews Economist.