COVID-19: Why is Brazil Emerging as the New Global Epicentre of the Pandemic?

The term necropolitics was coined by Professor Achille Mbembe of South Africa’s University of the Witwatersrand. In his 2003 essay of the same name, Mbembe reflected on the notion of death as state policy. Necropolitics is the only word I can think of to describe the Brazilian government’s dreadful handling of the multiple convergent crises currently unfolding on its watch.

In May, Brazil became the world leader in daily coronavirus deaths, even without accounting for the fact that official figures vastly underestimated the scope of the problem. The real number of COVID-19 cases in Brazil was estimated to be 10 to 15 times the reported figures—due to paltry diagnostic testing—and the real death count 3 to 5 times the official tally. The government recently adopted the criminal strategy of misinforming the public and hiding the real number of deaths. The preposterous decision to restrict the release of data on COVID-19 cases drew harsh criticism all across society, prompting the government to reverse course.

In a 9 May editorial entitled “COVID-19 in Brazil: ‘So what?’” —in reference to President Jair Bolsonaro’s response to a journalist asking about the country’s soaring COVID-19 death toll—the British journal The Lancet declared that “perhaps the biggest threat to Brazil’s COVID-19 response is its president”; that “Brazil as a country must come together to give a clear answer to the ‘So what?’ by its President”; and that Bolsonaro “needs to drastically change course or must be the next to go”. It was a clear, forceful message from the scientific community to a president who has repeatedly positioned himself as anti-science, anti-human-rights and a climate-change denier. The editorial also exposed the harsh reality of millions of Brazilians living in extremely vulnerable circumstances and fearing the possibility of genocide against the country’s indigenous population.

In May, Brazil became the world leader in daily coronavirus deaths, even without accounting for the fact that official figures vastly underestimated the scope of the problem. The real number of COVID-19 cases in Brazil was estimated to be 10 to 15 times the reported figures—due to paltry diagnostic testing—and the real death count 3 to 5 times the official tally

At this terrible juncture, it is obvious that Brazil’s president is sabotaging the fight against the pandemic; at war with rival governors, the press, the parliament and the Supreme Federal Court; and reliant on the military and a small yet radical percentage of the population fed a constant diet of fake news—a scourge from which no one is safe, not even the World Health Organisation (WHO) and its director-general, Tedros Adhanom. To make matters worse, Brazil has relinquished its position as a regional leader in South-South cooperation and now even poses a risk to its neighbours.

At the height of the pandemic, Brazil’s government has prevented the most vulnerable communities and local governments from accessing financial resources and has failed to prioritise the purchase of ventilators, diagnostic tests and intensive care equipment. Two ministers of health have exited the post in rapid succession: the first was fired for attempting to follow WHO guidelines, and the second resigned after objecting to the widespread distribution and use of the controversial drug hydroxychloroquine. An army general specialised in logistics, with no training or experience in health care, is currently leading the Ministry of Health. A further 20 military officials—also without health training—have been appointed to strategic positions within the ministry. No doubt the general/minister knows what to do with the victims’ bodies, but he seems to have no idea how to save lives.

At the height of the pandemic, Brazil’s government has prevented the most vulnerable communities and local governments from accessing financial resources and has failed to prioritise the purchase of ventilators, diagnostic tests and intensive care equipment

And yet, Brazil has a free, universal, public health system—the Sistema Único de Saúde (SUS)—which is where I work as a family and community doctor. The SUS has been under constant construction—and constant attack—since its creation in 1988. Inadequate funding has long posed a major challenge. Nevertheless, Brazil’s health care workers have persevered in the face of precarious employment conditions and privatisation attempts. As in other universal health systems, the COVID-19 pandemic has reoriented the public debate. Whereas budget cuts and privatisation were once the order of the day, it is now clearer than ever that the SUS must be strengthened and better funded, and that political decisions must be based on scientific evidence and put into practice by qualified health care workers.

The constant threats of military intervention and institutional disruption emanating from Bolsonaro and his government are prompting groups from across the political spectrum to join forces in the name of democracy and freedom.

As health workers, we will continue to serve a population facing an extremely vulnerable situation—high unemployment and shambolic social policies—that has only been exacerbated by the pandemics. We live in the hope that we can put this political, socioeconomic and health crisis behind us, that society will come to understand the importance of strong science and a robust health system, and that health will finally be seen as a right, not a commodity.