Brazil Is Brilliant at Vaccinations. So What Went Wrong This Time?

SÃO PAULO, Brazil — When it comes to Covid-19 vaccination programs, there are some countries that have exceeded expectations and others that have fallen surprisingly short. And then there is Brazil.

Vaccinating over 210 million people may sound daunting, but for Brazil it really shouldn’t be. With one of the largest universal, free-of-charge public health systems in the world, the country has a distinguished track record of vaccinations and disease control. The National Immunization Program, founded in 1973, helped to eradicate polio and rubella in the country and currently offers more than 20 vaccines free in every municipality.

Along with the infrastructure to distribute vaccines, there’s also the expertise to do so: In 1980, the country vaccinated 17.5 million children against polio in a single day. In 2010, over 89 million doses of the swine flu vaccine were administered in under four months. And last year, more than 70 million Brazilians received their annual shot against influenza.

We take immunization so seriously here that we even have a mascot for vaccination campaigns, an adorable six-foot smiling white blob named “Zé Gotinha,” Joe Droplet. (This glorious national hero apparently refused to shake hands with President Jair Bolsonaro during an official event in December.)

But despite these advantages, Brazil’s vaccine rollout has been painfully slow, inconsistent and marred by shortages. The nationwide program began on Jan. 18, later than over 50 countries, and at its current rate will take more than four years to complete. Several major cities, such as Rio de Janeiro and Salvador, have already had to stop their campaigns because of problems in supply.

In a country where the pandemic has wrought terrible damage — 250,000 people have died, the second-highest total in the world, after the United States, as cities along the Amazon River like Manaus have been abandoned to their fate — the failure amounts to a disaster.

So what went wrong? Perhaps we should look to Joe Droplet: He seems to know exactly who to blame.

From the beginning, Mr. Bolsonaro’s government downplayed the seriousness of the pandemic. The president fought against masks and social distancing measures, comparing the coronavirus to rain that would fall on most people while drowning just some of them. (“It’s no use staying home crying,” he recently said, after the country registered 1,452 deaths on a single day.) In the middle of the outbreak, he managed to get rid of two health ministers — both doctors — who threatened to contradict him, replacing them with an army general.

What’s more, not only did Mr. Bolsonaro spend emergency funds to purchase and distribute unproven drugs against Covid-19, even after they had been shown to be ineffective, he also refused many offers of vaccine doses. In August, Pfizer offered Brazil 70 million doses, with delivery starting in December — but the government was not interested. The company made two other proposals, to no avail.

When pressed for an explanation, Brazil’s Health Ministry claimed that the terms of the contract — the same that applied to all countries — were “abusive.” Pfizer, Mr. Bolsonaro complained, wouldn’t take responsibility “if you turn into Superman, if a woman grows a beard or a man starts to talk with a high-pitched voice.” Instead, he kept up his efforts to discredit vaccination, promoting an imaginary “early treatment” for Covid-19.

Mr. Bolsonaro even found time to oppose a proposal, brought to the World Health Organization by India and South Africa, to temporarily lift patent restrictions on coronavirus vaccines. Allowing developing countries — including Brazil — to manufacture vaccines sooner and at much greater scale apparently held no interest.

Eventually the federal government, under public pressure, started to plan a vaccination program. But it focused on a single manufacturer, AstraZeneca, whose vaccine trials ended up taking longer than others. Other difficulties surfaced later. After the approval of the vaccine in January, there was a shipment delay. And the flight bearing two million doses from India was postponed for a week.

Mr. Bolsonaro also spent months attacking the other vaccine now available in Brazil — CoronaVac, developed by the Chinese company Sinovac — because it had been backed by São Paulo’s governor, a political rival and likely competitor in the 2022 presidential race. (Mr. Bolsonaro even celebrated the death of a participant in the CoronaVac trial, later deemed to be unrelated to the vaccine.)

When the AstraZeneca vaccine failed to materialize quickly, Mr. Bolsonaro had to turn to the supply of the CoronaVac that São Paulo’s governor had managed to amass. There were no words of thanks.

Brazil is now gradually expanding local production, while more doses are on their way from India and the Covax Facility, a küresel vaccine distribution program. But everything is happening in slow motion. Two million doses now, four million a month later.

The shortage of vaccines at least conceals the fact that the government probably hadn’t secured enough syringes to administer them. Truly, it’s little wonder that the government’s handling of the pandemic was judged by the Lowy Institute, a research institute in Australia, to be the worst in the world.

Mr. Bolsonaro, through ineptitude and malice, has squandered the country’s resources to ruinous effect. Joe Droplet was right to ignore him. If only the rest of us could, too.

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