Pandemic response in Brazil: faltering state capacity and erosion of social solidarity

Mariana Lima Maia

On the 7th of March, tone day after Brazil first surpassed the terrifying threshold of 4,000 deaths from COVID-19 in one day, the Chamber of Deputies approved a project that allowed private entities to buy vaccines to inoculate their employees provided that they donate the same quantity acquired for private use to SUS (Sistema Único de Saúde), the Brazilian national public health system. According to the project, the donation will be compensated by tax waivers. Since reputed manufacturers do not sell the vaccines to private entities, the Ministry of Health would have to step in as an intermediary between companies and laboratories.

The prominent voices defending the project claim that it will increase the number of available shots without hurting the government’s supply – a questionable affirmation, given the global scarcity of vaccines. In political terms, the project dismantles the universal and equitable nature of National Vaccine Program, one of SUS’s biggest policy successes. SUS was conceived at the dawn of the Military Dictatorship by public health social movements, based on the tenants of solidarity and cooperation. Under the guidance of Bolsonaro, Brazilian Public Health has turned into a grim prisoner’s dilemma in which the biggest pay-offs go to the virus. His dismantling of state capacity asphyxiates social solidarity itself. It should come as no surprise that the idea was first envisioned inside the Federal Executive Branch. SUS’s decentralized functioning requires that the Federal Government acts as a coordinator through funding, regulation, orientation, and capacity-building. Since the beginning of the pandemic in the country, the federal government has not only neglected its role, but also has sabotaged the fight against the virus by refusing to sign vaccine contracts. The government sacked ministers and bureaucrats who took the crisis seriously, and promoted ineffective “alternative treatments” such as hydroxychloroquine.

The real surprise is how President Jair Bolsonaro, although weakened by a loss of popularity, is able to impose his vision upon the political landscape. At the federal level, he has managed to rig institutions by placing his allies in the Supreme Court, the Presidencies of the Senate, and the Chamber of Deputies. The military, now trying to distance itself from President Bolsonaro, still holds 6,000 positions in the civil government. Bolsonaro’s account of the inevitability of the country’s death toll – to him, a logical consequence of the necessity of keeping the economy afloat – resonates across all sectors of the population. Businessmen who do not want to face losses, empowered by the presidential discourse, oppose restriction measures, however light, placed by intimidated and disoriented mayors and governors. The ones closer to the federal government go further: they articulate a private vaccination scheme funded by public money. Meanwhile, a population left to fend itself against the threats of starvation or dying in a hospital without oxygen cannot afford to practice isolation. For them, the existential choice posed by Bolsonaro feels very real, so they swallow hydroxychloroquine pills and go on with their jobs.

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About the author


Mariana Lima Maia is a first-year MPP candidate specializing in socio-economic and development policies and international and global public policy. She holds a bachelor’s degree in law and has worked in the intersection of human rights law and public policy. She currently volunteers for the Oxford Covid Response Government Tracker and is interested in sustainable development, human rights, and democracy.

~ The views represented in this blog post do not necessarily represent those of the Brandt School. ~