With Brazil’s public health crisis dramatically worsening, the country’s business leaders and their allies in government are rewriting the rules to secure preferential access to scarce Covid-19 vaccines. Both Congress and the judiciary, with the support of President Jair Bolsonaro, have taken steps in recent weeks to allow private corporate purchases and distribution of vaccines.
On Tuesday — the same day Brazil saw a record 4,211 coronavirus deaths — the lower house of Congress passed a bill that would allow corporations to directly purchase vaccine doses from international suppliers and give them to employees, even before priority groups like the elderly and medical workers are fully vaccinated. “We are at war,” the leader of the chamber, Arthur Lira, argued, “and in war, anything goes to save lives.”
The bill was the latest in a series of efforts to chip away at the primacy of Brazil’s public system for distributing vaccines. The Brazilian public system is widely considered to be one of the most effective vaccine programs in the world, but failed to rise to the occasion under Bolsonaro’s leadership.
“Brazil’s vaccination campaigns are world renowned,” said Mellanie Fontes-Dutra, a biomedical scientist and researcher at the Federal University of Rio Grande do Sul who also works with the Covid-19 Analyst Network. “In this moment of crisis, we need ample, free, and universal access to Covid-19 vaccines.”
While private buyers will have a difficult time finding vaccine suppliers, corporations are setting themselves up to skip the line once doses do become available. Fontes-Dutra said the criteria for vaccination should be determined by public health authorities “and not by monetary power.”
The collapse of the public health system and the worsening crisis have shaken up Brazilian politics.
“In this moment of crisis, we need ample, free, and universal access to Covid-19 vaccines.”
In March, 66,868 Brazilians died from Covid-19, more than doubling the previous record. Now nearly 1 in every 3 deaths from the coronavirus worldwide occurs in Brazil. Intensive care unit occupancy rates are above 80 percent in almost every state, with the majority above 90 percent, and supplies of oxygen and intubation kits are critically low in many parts of the country. The Fiocruz public health institute has called the situation the “greatest sanitary and hospital collapse in the history of Brazil.”
For more than a year, far-right President Jair Bolsonaro downplayed the risk of the virus, resisted proven public health measures, promoted disproven treatments, and actively sabotaged Brazil’s vaccination program.
The dire situation, though, has softened Bolsonaro’s strident rhetoric. He has even been forced to temper his public aversion to vaccines as public pressure has mounted and death tolls have spiraled out of control. Now Bolsonaro and his allies are begrudgingly backing vaccines — but with a rollback of the public system that allows corporations to address their own interests rather than wider societal needs. A pair of the president’s billionaire backers had supported Lira’s push for a private vaccination bill behind the scenes.
Bolsonaro’s early missteps, however, are still hanging over the crisis. “The real tragedy is that Brazil is among the few vaccine-manufacturing countries in the world blessed with world-class vaccine research and production facilities,” said Achal Prabhala of accessibsa, who works on increasing access to medicines and previously advised the Brazilian government. “If there had been a coordinated federal strategy early on to support the local production of vaccines, Brazil would have been in a very different situation today.”
With the crisis worsening and hopes for a rapid and effective public campaign dwindling, the private vaccinations were initially justified in two ways: First, companies would be paying for the doses themselves, alleviating the cost on the public system. Plus, prescribed amounts of their private purchases would be put into the public system.
A private vaccination bill similar to the one pushed by Lira was already signed into law two weeks ago, but it included restrictions intended to shore up the lagging supply of vaccines going to the public health system. In the initial phases of private vaccine purchase, companies would need to donate their entire supply to the government’s vaccination drive; once vaccine levels rose, the firms would donate half their vaccine purchases to the public system.
The Lira-backed bill would let companies skip the requirement to donate their full purchases during the priority vaccination stage, when groups like the elderly and medical workers are supposed to be the focus. Instead, the companies are required to donate half their supply, but can also immediately begin vaccinating employees.
Lira and his allies also sought to use public means to defray the costs of vaccines for private companies. The initial draft bill provided a full tax write-off for the costs of vaccination, but the provision was quickly removed after objections from left and center-left opposition, who characterized the proposal as the public footing the bill for VIP vaccinations.
“Vaccines should be a public good. Opening up the possibility of private sector purchases may be another aggravating factor for inequalities in the country,” said Alessandro Molon, leader of the opposition in the lower house of Congress. “No country in the world has allowed this. Why should Brazil do this?”
Congress isn’t the only public institution seeking to make it easier for the wealthy and well-connected to skirt the public vaccination backlogs. Judges have allowed unions and large corporations, including an oil refinery, to import and administer thousands of vaccine doses, exempting them from the requirement to donate any of their supply. Some of the decisions have been overturned by higher courts, but others are standing. In a ruling last Thursday, federal Judge Ronaldo Valcir Spanholo argued that the donation requirement was an unconstitutional hindrance to the “complex (and already exaggeratedly slow!) immunization process.”
Brazilian corporations may still face one major hurdle, though: supply. Major Western vaccine producers have said that they do not intend to sell to private buyers while governments face major shortages.
As part of his reversal on vaccines, Bolsonaro has supported Brazilian corporations’ push to buy doses directly. The move suits his interests: first, to wash his hands of responsibility for the colossal public health failure and second, to keep in line with the government’s stated mission to gut state organs and “privatize everything.”
Bolsonaro dragged his feet in support for any kind of vaccination drive. In an interview with Veja magazine, Carlos Murillo, country manager for Pfizer Brazil, revealed that last August, the Brazilian government ignored Pfizer’s offer to provide 70 million doses of their vaccine, millions of which would have already been delivered by now. Bolsonaro’s government eventually signed a deal with Pfizer for 100 million doses in March, but under a much later timeline, and agreed to purchase 38 million more from Janssen; 20 million doses of Covaxin, from India; and 10 million of Russia’s Sputnik V.
Since January, Brazil has been administering the CoronaVac vaccine, developed by China’s SinoVac Biotech in partnership with São Paulo’s Butantan Institute, and the Oxford/AstraZeneca vaccine, but supply and logistical shortfalls have forced the Health Ministry to repeatedly reduce distribution projections.
Nearly 12 percent of Brazilian adults have received at least one dose so far. A study by the Federal University of Juiz de Fora concluded that Brazil needed to administer 2 million vaccine doses a day, more than double the current rate, to bring the pandemic under control within a year. At current rates, vaccinating 70 percent of the population, which is required to reach herd immunity, may not occur until the end of 2022. The United States, by comparison, is projected to reach this milestone by mid-June of this year.
As Bolsonaro’s star has fallen with the deepening crisis, the standing of his chief rival, former President Luiz Inácio Lula da Silva, has risen precipitously. The pressure on Bolsonaro has forced the the normally intransigent far-right figure to shake up the way he conducts business.
Last month, while Covid-19 infection rates surged and the situation in Brazil became increasingly desperate, Lula won two important political victories in the Supreme Court, vacating corruption convictions against him and restoring his political rights for next year’s presidential election. Lula has since made a triumphant return to the political scene, even being embraced by former adversaries who now recognize him as the most viable alternative to Bolsonaro.
In addition to a series of well-received speeches and interviews, Lula was central to Brazil’s slowly improving vaccine forecast. He played a key role in negotiations with Russia to acquire Sputnik V doses and has made diplomatic approaches to China, the Biden administration, and the G20, requesting cooperation for dealing with the Covid-19 crisis and gaining glowing headlines along the way. Brazil’s relationships with all three trading partners have significantly deteriorated under Bolsonaro.
On Friday, Lula said in an interview that he intends to run for president again next year.
The former president currently leads the presidential polls and has clearly gotten under the skin of Bolsonaro, whose approval ratings are steadily falling. In one highly publicized speech, Lula said, “Planet Earth is round. It is not rectangular or square. Bolsonaro does not know that.” Bolsonaro responded by prominently placing a globe on his desk during his next weekly livestream. In a March 10 speech, Lula said, “A president who respected the country would have created a crisis committee” to deal with the Covid-19 crisis. Two weeks later, Bolsonaro announced the formation of just such a committee — more than a year after the pandemic began.
“Bolsonaro is the worst possible president at the worst time in Brazil, and the Brazilian people are suffering the consequences of that,” Molon, the opposition member of the lower house of Congress, told The Intercept. He said Bolsonaro’s actions “increase the risk of even more aggressive new variants emerging. Without a doubt, he is a danger to the country and to the whole world.”
Last month, Bolsonaro also finally yielded to mounting pressure, particularly from allies in Congress, to replace Health Minister Eduardo Pazuello, an active-duty army general currently under police investigation for his incompetent handling of the public health crisis. Bolsonaro also agreed to remove far-right, “anti-globalist” Foreign Minister Ernesto Araújo, whose hard-line ideological positions were widely seen to be inhibiting international partnerships to fight the pandemic.
On the same day that Araújo was forced out, Bolsonaro replaced five other important figures: the ministers of defense, justice, and public security; his chief of staff; and the solicitor general. Rather than a gesture away from his extreme positions, the reshuffling was widely interpreted as a move to place staunch loyalists into key positions of power, an ominous sign considering his recent declarations in favor of instituting martial law in states that implemented lockdowns against his wishes. The following day, the heads of all three branches of the military resigned their posts in protest, an unprecedented, coordinated move.
Bolsonaro’s waffling and contradictory stances on how to deal with the coronavirus pandemic may best be illustrated by the mini-drama playing out around his own plans to be vaccinated. Lula and Vice President Hamilton Mourão made photo ops out of their recent vaccinations to encourage the public. Last Thursday, Bolsonaro said he would decide only “after the last Brazilian was vaccinated,” but the following day, his office reportedly informed the Health Ministry that he would get his first shot over the weekend. The president’s Saturday photo op ended up being not a vaccination, but rather him eating a bowl of soup with his new defense minister, where he repeated his attacks against lockdown measures. Bolsonaro’s vaccination records have been classified for 100 years. His office did not respond to The Intercept’s requests for comment.