Miguel Andrade
Brazil is seeing a rapid surge in COVID-19 infections and deaths following the complete abandonment by federal and local governments of any restraint on economic activity. Even with summer approaching, the back-to-work drive has brought the average daily death toll to 600, a two-month high. Daily new infections stand at 40,000, and six Brazilian states are close to a health care system collapse, with more than 80 percent of COVID-19-dedicated ICUs occupied, and hospital beds filled with patients being treated for diseases that had been neglected and aggravated during eight months of the pandemic.
At the same time, plans for mass vaccinations over the next year are being systematically undermined by the conflict that is gripping the Brazilian ruling class and drawing lines between the government of fascistic President Jair Bolsonaro and the Congressional opposition led by the Workers Party (PT) over Brazil’s attitude towards the US-led imperialist offensive against China.
Since his presidential campaign in 2018, Bolsonaro has sought to exploit the impact of Chinese industrial imports and investments in Brazil to make a nationalist appeal epitomized by the slogan “China is not buying from Brazil, it is buying Brazil.” This chauvinist campaign has served as a cover for his plans to shift Brazilian foreign policy towards a total alignment with Washington.
At the beginning of 2020, with barely a year in office, Bolsonaro solidarized himself with the reactionary anti-Chinese campaign of US President Donald Trump, who blamed the Chinese government for the pandemic and promoted fraudulent claims originating in far-right circles that the pandemic was part of a deliberate Chinese plan to undermine the US.
Bolsonaro is now working to impede the use by federal and local authorities of the Chinese-developed CoronaVac vaccine which has just ended phase-three clinical trials conducted in Brazil by one of the country’s leading vaccine research facilities, the São Paulo-based Butantan Institute. The Butantan Institute is part of the São Paulo state Health Department and is one of the two main infectious diseases centers in the country, together with the federal Oswaldo Cruz Foundation (Fiocruz), based in Rio de Janeiro. The institute produces 75 percent of the vaccines used by the Health Ministry in annual vaccination campaigns.
As Brazil emerged as an epicenter of the worldwide COVID-19 pandemic, Butantan partnered with the Beijing-based Sinovac Life Science biotechnology company to conduct clinical trials in Brazil and secure the rights and an initial capacity to produce 100 million doses of the CoronaVac vaccine a year.
Phase-two trials of the vaccine in Brazil have produced promising results, with 97 percent of participants developing antibodies. Emergency use of the vaccine for health care and other essential workers has already been carried out in China, with hundreds of thousands vaccinated. Chile, Turkey and Indonesia are also conducting trials of the vaccine.
The CoronaVac vaccine has also already proved to be safe, although those results are hardly surprising, given the traditional approach taken by Sinovac. CoronaVac uses a physically degraded—or “inactivated”—form of the SARS-CoV-2 virus, the same approach used worldwide for influenza vaccines and, most famously, for the landmark Salk vaccine for polio.
This approach contrasts with the recent messenger RNA vaccines developed by Moderna and Pfizer, and is also usually less effective, demanding a wider coverage of the population to guarantee a halt in the spread of the virus. Typical influenza vaccines using the same technique are usually around 60 percent effective. At the same time, however, this type of vaccine has the advantage of requiring only normal refrigeration, as opposed to the expensive super cooling demanded by the new messenger RNA vaccines.
CoronaVac has nonetheless been vilified by Bolsonaro, solely because of its Chinese origin, with the president casting a shadow over the whole scientific community in China, as well as those involved in the Brazilian trials.
On October 21, after his Health Minister, Gen. Eduardo Pazuello, told the 27 Brazilian governors that the ministry would prepare the National Health System to use the CoronaVac vaccine, Bolsonaro told the media that his government “would buy no Chinese vaccine.” In his characteristically ignorant fashion, he stated that he didn’t “believe a Chinese vaccine inspires trust, due to its origin.” He added that “China is already discredited within the population because, as many said, the virus came from there.” On the same day, he wrote on Facebook in capital letters that Brazilians “wouldn’t be anybody’s guinea pigs,” and that the lack of “scientific evidence” would be an obstacle to investing in the vaccine.
Reservations about “scientific evidence” are ludicrous coming from Bolsonaro, who has defended every quack cure for the COVID-19 pandemic put forward by the most backward forces—most prominently hydroxychloroquine—while denying the need for basic preventive measures such as the use of masks and social distancing. The attitude toward the CoronaVac vaccine also contrasts with federal funding for the vaccine being developed by the British-Swedish pharmaceutical giant AstraZeneca together with Oxford University scientists, which was tested in Brazil and is to be produced by Rio de Janeiro’s Fiocruz at a rate of 160 million doses a year, initially.
Complete clinical data on the AstraZeneca vaccine was published just yesterday in the authoritative Lancet medical journal. It is the first time any of the authorities and companies responsible for the development of the most advanced vaccines internationally—including Pfizer, Moderna, Sinovac and the Gamaleya Institute in Russia, producing the Sputnik V—have done so. AstraZeneca’s effort has been questioned, however, over apparent mishandling of the tests, most significantly its obtaining higher efficacy with a smaller dose, and the lack of elderly patients in its trials.
Amid its anti-Chinese campaign, Bolsonaro reacted with joy on November 10 over the death of one of the participants in the CoronaVac trials four days earlier, which led the federal drug and health agency, Anvisa, to suddenly order a halt to the Butantan trials.
It was immediately revealed that the death was a suicide. The Butantan Institute went public claiming it had informed Anvisa four days earlier that the death had nothing to do with the vaccine. Responding with a claim that it had problems with its computers and had not seen Butantan’s report, Anvisa allowed the tests to be resumed. While the real reason for Anvisa’s halting the trials is still unclear, and its explanation is still viewed with skepticism in Brazil, it gave Bolsonaro another opportunity to rail against the “Chinese vaccine” and go on social media to declare, without any substantiation: “death, disability, anomaly. That is the vaccine [São Paulo Governor João] Doria wants all of São Paulo’s population to take. The president has always said vaccination shouldn’t be mandatory. One more win for Jair.”
This declaration, and Anvisa’s unexplained move to halt the trials, has raised concerns that Bolsonaro will interfere in the agency’s evaluation of CoronaVac. On Monday, São Paulo’s Governor Doria announced that his administration intends to start vaccinations with CoronaVac on January 25 of health care workers, the elderly and the indigenous population—a total of 9 million out of the state’s 44 million inhabitants.
On Tuesday, the Health Minister announced at a hastily convened meeting with Brazil’s governors that the government would buy Pfizer vaccines and had already secured 300 million doses guaranteed from various sources for 2021, without presenting any coherent vaccination timetable.
A state-based vaccination campaign is unprecedented in Brazil, and many Bolsonaro-allied governors left the meeting accusing Doria, Bolsonaro’s former key political ally and now national political rival, of opportunism for attempting to bypass the Health Ministry and negotiate with governors and even mayors in promoting CoronaVac. Flávio Dino, the Communist party governor of the state of Maranhão, has already petitioned the Supreme Court to allow the importing of vaccines without Anvisa’s approval, based on emergency legislation passed by Congress in March allowing the emergency use in Brazil of drugs approved by any of Anvisa’s counterparts in China, the European Union, the United Kingdom or the United States.
Far from solving the crisis, if successful, Dino’s petition will only aggravate the desperate search for a vaccine in Brazil, with governors already warning of the chaotic potential of a state-based vaccination campaign provoking a run on states where vaccinations are taking place.
Health experts are also warning that the country is not prepared to vaccinate the whole population in the next year due to the lack of protective equipment for the 110,000 workers manning the 38,000 vaccination stations of the National Health System, and even of syringes, not to mention super-cooled freezers, along with potential additional shortages caused by massive vaccinations next year.
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