As elsewhere, the pandemic created politically divisive discourses in Brazil, pitting the denialists (led by President Bolsonaro) against public health authorities. This article provides an account of how decentralized power and strong institutions ensured vaccination of the entire population.
Brazil has received a lot of international attention since the beginning of the Covid-19 pandemic due to its erratic response. The disconnect between different political authorities and institutions has led the country to face approximately 661,000 deaths due to Covid-19 infection. The pandemic scenario in the country has been dominated not only by the direct devastation caused by Covid-19 itself, but also by a massive wave of science skepticism which has aggravated the crisis. This denialist point-of-view has ranged from questioning the existence of the pandemic, i.e., approaching it as some sort of global conspiracy, to refusing vaccinations in the name of individual freedom. However, despite this appalling scenario, Brazil now has 76.6 percent of its population fully vaccinated. Rio de Janeiro, for instance, now has the lowest infection rate since the pandemic began, an achievement attributed to the vaccination coverage in the city. This article intends to present some of the factors which made these paradoxical results possible: Blatant negligence, hectic political disputes, and the power of technical institutions to carry on with their work even when it directly contradicts political authorities.
The Vaccination Imbroglio
Most of Brazil’s reputation in relation to the Covid-19 pandemic has been constructed around the actions and speeches of the Brazilian President. The far-right politician Jair Bolsonaro cultivated a general attitude towards the pandemic which frequently ranged from negligence to active disruption.
The vacuum of leadership over the issue of vaccinations created by [President] Bolsonaro’s denialist perspective has been filled by other political authorities.
Since 26 February 2020, when the first case of Covid-19 was confirmed in Brazil, President Jair Bolsonaro has affirmed that the Brazilian people were resistant to catching Covid-19; that Covid-19 would be nothing more than a “little flu”; that the pandemic turned Brazil into a country of “maricas” (a derogatory term which refers to men whose behavior is thought to be too sensitive or feminine); that, if infected, he would not be severely affected because he had an “athletic history”; that no one could be forced to take the vaccine; that the CoronaVac vaccine (which he called the “Chinese vaccine” as a pejorative) would bring “death, invalidity, and anomaly” to people; that he would not be responsible if people took the Pfizer vaccine and turned into an “alligator” or into “superman” or even if “women began to grow a beard”; that hydroxychloroquine (heavily advertised by him) was effective as an early treatment; that vaccinated people in the United Kingdom were developing AIDS; that he had no knowledge about the number of deaths caused by Covid-19 because he is “not a gravedigger”; among other things.
The vacuum of leadership over the issue of vaccinations created by Bolsonaro’s denialist perspective has been filled by other political authorities. The first big push for vaccinations in Brazil was made by João Doria, Governor of the state of São Paulo. Announcing a partnership in June 2020 between Instituto Butantan, a São Paulo state government research center, and Chinese pharmaceutical company Sinovac for the development of a vaccine called CoronaVac, Doria brought to the collective imagination an idea that seemed nearly impossible to the Brazilian population given Bolsonaro’s public statements.
It did not take long before the vaccine turned into the greatest political issue being discussed in Brazil. Things became even more dramatic when Doria mentioned that the vaccine would not just be distributed in the state of São Paulo. The move attracted the attention of people all over the country. Governor Doria’s political investment in the vaccination issue has certainly put a lot of pressure on President Bolsonaro. While Bolsonaro attempted to discredit CoronaVac by calling it “the Chinese vaccine” or “Doria’s vaccine,” it became clear that Doria had increased his popularity nationwide.
On 20 October 2020, Health Minister Eduardo Pazuelo, a Brazilian Army General, announced the acquisition of CoronaVac by the federal government – an announcement that would then be denied by Bolsonaro the next day. In December 2020, Governor João Doria requested the Brazilian Health Surveillance Agency (ANVISA), the body responsible for regulating the production and consumption of medication and vaccines, to approve the CoronaVac vaccine. Governor Doria made a public statement asking that ANVISA put political ideologies aside to act as an “autonomous, independent, and scientific regulatory agency.”
On 17 January 2021, ANVISA approved the distribution of both the CoronaVac and AstraZeneca vaccines. Since then, ANVISA has also authorized the Pfizer and Johnson & Johnson vaccines. Although ANVISA had autonomy over the decision, one should not underestimate the role public opinion might have played in providing the support the institution needed to contradict the President’s point of view.
One of the most dramatic events in the Bolsonaro-ANVISA imbroglio is related to the agency’s approval for vaccinating children against Covid-19 which Bolsonaro has openly criticized and advocated against.He even questioned ANVISA’s interests in connection to the vaccine resulting in a very direct and irritated response from ANVISA’s Director-President Antonio Barra Torres in which he challenged Bolsonaro to find any evidence of corruption in his management of the agency.
It is worth noting that Brazil maintains one of the most comprehensive and well-structured vaccination systems in the world. The National Immunization Program, started in 1973, provides 45 different kinds of vaccines to the entire population at no cost. Not only does Brazil know how to organize and conduct massive vaccination projects, but it also has a very well-established vaccination culture that has been propagated amongst the population for decades in contrast with many other countries where vaccines are seen as taboo.
Bolsonaro’s dissatisfaction with the actions of ANVISA was explicitly exposed when the President said the institution has been acting as “the owner of the truth” or even as a “new power in Brazil” (in addition to executive, legislative, and judicial power). One of the most dramatic events in the Bolsonaro-ANVISA imbroglio is related to the agency’s approval for vaccinating children against Covid-19 which Bolsonaro has openly criticized and advocated against. He even questioned ANVISA’s interests in connection to the vaccine resulting in a very direct and irritated response from ANVISA’s Director-President Antonio Barra Torres in which he challenged Bolsonaro to find any evidence of corruption in his management of the agency. Perhaps one of the most interesting aspects of this dispute is that Barra Torres, who is a doctor and has also held the position of Rear Admiral in the Brazilian Navy, was nominated to a position at ANVISA by President Bolsonaro himself. The nomination, allegedly originating from Bolsonaro’s intention to keep an internal ally to obstruct the approval of cannabis-based products, now seems to be a matter of regret for the President.
Barra Torres’ tension with the President became clear during his deposition at a parliamentary inquiry committee organized by the Brazilian Federal Senate to investigate several public accusations of corruption and negligence in the administration of the Covid-19 pandemic response. Generally recognized as a supporter of the President, Barra Torres presented a different image during his deposition and made it clear that ANVISA’s decisions were taken on the basis of scientific findings. This position has made ANVISA a target for Bolsonaro’s supporters. Since 17 December 2021, UNIVISA, the association of ANVISA’s employees, has registered more than 200 threats and intimidation attempts against its staff. They include a video in which a woman threatens to set ANVISA’s headquarters on fire. The fact that she uses religious expressions to affirm that the institution should be “purified” with “blessed fuel” adds the right amount of absurdity: technical institutions made the target of a 21st century witch-hunt.
What Can We Learn from It?
The events presented here do not even begin to scratch the surface of the complex history of the (still ongoing) pandemic in Brazil. Certainly, there were several other actors, interests, and dynamics at play. However, even a quick look at the surface provides some interesting insights on subjects such as politics and democracy. Firstly, it provides us with solid evidence that the idea of a great divide between technical (the scientific and objective) and political (the ideological and subjective) is nothing more than a myth. The entire vaccination imbroglio was comprised of a mix-and-match of both. Even scientific findings depended on public opinion and support to emerge from the labs’ doors. We must also remember that ANVISA’s approval of the vaccines also came with political ruptures, accusations, and threats.
Second, the case has also provided us with a demonstration of how well-established cultures and well-structured systems are capable of resisting controversial rhetoric. President Bolsonaro’s persistent propaganda against the vaccines has not been effective enough to stop the Brazilian people from taking the vaccine. In this case, the constant presence of experts such as biologists and epidemiologists on traditional communication channels and even on social media has withstood the fake news surrounding the topic. This effort has required not only the ability to state scientific findings but also a responsibility to clarify the severity of the situation. Reporting on the progress of vaccinations around the world has helped to alleviate the general anxiety regarding the vaccine as well.
Third, the disconnect between political authorities demonstrated how dissonant voices are not only beneficial, but essential to a healthy democracy. The fact that local political authorities were able to move forward with the vaccination agenda against pressure and interference from the President of the country reveals how power distribution can save the day when politicians go astray (intentionally or otherwise). The current vaccination coverage in the country is quite impressive when we recognize that it has not been achieved through the efforts of the Brazilian Presidency but despite them.
The fact that local political authorities were able to move forward with the vaccination agenda against pressure and interference from the President of the country reveals how power distribution can save the day when politicians go astray (intentionally or otherwise).
The pandemic is not over, but in Brazil at least it seems we are past its most dramatic phase. The relief is bittersweet as we think of how things could have been different and how many lives could have been spared if the national political authority had acted differently. It is a lot to process. Perhaps this year’s presidential election might be what we need to assess the collective feeling regarding this matter.
Laís Ramalho is a PhD candidate at the International Relations Institute (IRI) of the Pontifical Catholic University of Rio de Janeiro (PUC-Rio) and Visiting Research Scholar at the Observatory on Latin America (OLA), The New School supported by a CAPES-PRINT scholarship granted by the Brazilian Coordination for Higher Education Staff Development (CAPES). Her main research interests are international development, data politics, urban planning, and the politics of emotion.