Health Must Come First in Brazil!

Health Must Come First in Brazil!

  • With 10.5 million cases and almost 260 thousand deaths, the crisis in Brazil due to COVID-19 is aggravated by political decisions and denial of the problem by the authorities.
  • New variants of the virus, due to the uncontrolled increase in infections and the slow vaccination process, configure a regional emergency scenario that must be addressed.

SÃO PAULO, BRASIL. March 8th, 2021. The humanitarian crisis unfolding in Brazil as a consequence of a mismanaged response to COVID-19 is yet another stark reminder of reality’s unforgiving propensity to exact a high cost in lives and livelihoods whenever politicians fail to face the facts in a public health emergency.

With the third largest number of COVID-19 cases in the world, the current outlook for Brazil is grim; however, we are not bound to maintain this course. In fact, we have an obligation to change course before the pandemic claims thousands more Brazilian lives.

Below is a brief overview of how we arrived at this point and what must be done to put the country on a path to recovery and help reduce the impact more broadly among Latin American countries, in a region with highly mobile populations.

In Brazil, the toll from the pandemic stands at over 10.5 million cases and near 260,000 dead. In a country of 212 million, with a robust National Health System and vast experience in carrying out nationwide vaccination campaigns, the current SARS-CoV-2 situation is simply incomprehensible and unacceptable.

Negotiations with companies for vaccines and other critical medical supplies were delayed for far too long, as to date, Brazil is far from guaranteeing sufficient vaccines for the entire population. Additionally, consistent top-down contradictory messaging has only served to confuse communities and make the situation worse.

Brazil has only achieved access to 14.7 million doses of vaccines, to vaccinate less than 4% of its population. Thanks to the Butantan and Fiocruz institutes, who initially imported 8 million vaccines from China and India. And who despite the large pharmaceutical production capacity, the country has only been achieved locally manufacture 6.7 million due to the multiple obstacles imposed for imports of the active pharmaceutical ingredient (API).

As a result of delays and decisions that ran counter good public health practices, Brazil missed out on access to what would have amounted to about 316 million combined vaccine doses between quantities offered by COVAX and Pfizer, or enough to vaccinate approximately 78% of the country. This would have given domestic research institutes Fiocruz and Butantan enough breathing room to produce the remainder of vaccines to cover the entire population.

Teetering on the brink of collapse under the pressure of millions of critically ill patients, the healthcare system has to contend with oxygen shortages, lack of hospital beds, exhausted or sick frontline workers, and the looming prospect of yet another surge in infections—this time with a new variant of SARS-CoV-2 which recently emerged in Manaus, Amazonas.

It is imperative that vaccination efforts are accelerated and strategically targeted first to the hardest hit communities. Our only chance of outrunning and countering the danger of new SARS-CoV-2 variants is to vaccinate the maximum number of people in a minimum amount of time.

Considering the limited supply of vaccines and the wave-like nature of COVID-19 surges across different communities, the decisions on whom to vaccinate, including where and when, should be informed, and directed by epidemiologists, immunologists, infectious disease experts and technical teams from the National Vaccination Program. Until the vaccine supply catches up with the national demand, spreading the available doses too thin across the entire country will not be as effective as zeroing in on hotspots like Manaus and priority populations such as frontline healthcare workers and the elderly.

The international community should join in calling on Brazil’s leaders to do everything in their power to ensure the country has enough vaccines for the entire population – this means being willing to negotiate, collaborate and engage with international partners and global initiatives such as COVAX, while also ramping up investments of capital and human resources into domestic vaccine production capacity.

However, vaccinations alone will not be a panacea for COVID-19. Assuming Brazil obtains sufficient vaccine quantities for the entire population in the coming months, given the size and remoteness of some parts of the country, it will take considerable time to vaccinate a sufficiently high proportion of the population to bring COVID-19 under control. The vaccination campaign has only just begun, and it is becoming increasingly clear that there is a risk that new strains of coronavirus bypass the antibodies produced by current vaccines reducing its effectiveness.

Therefore, in addition to developing a robust vaccination campaign, a national prevention campaign is urgently needed that joins efforts at the three governmental levels of the National Health System, federal, state and municipal, where the government must commit to encouraging, promoting and requiring adherence to evidence-based public health infection control measures. Consistent and universal wearing of properly fitted masks remains absolutely essential to stopping the spread of COVID-19, not least because it is the most cost effective and immediate step people can take on their own to protect themselves and those around them. Masking must be accompanied by rigorous hand washing and social distancing. Collectively, these prevention efforts, along with guidance on diagnostics, treatment and vaccination should be standardize under auspices of a national task force.

Regrettably, so far there is no science-based cure nor a “magic pill” for COVID-19, and magical thinking will not wish the pandemic away. All we can rely on is our resolve to face the dire truth of the moment and commit to a long and difficult fight ahead with the evidence-based tools we do have, namely compassion for our fellow human beings, infection control and prevention measures, vaccines, and trust in science.

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 1.5 million clients in 45 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Europe. To learn more about AHF, please visit our website:, find us on Facebook: and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare


Denys Nazarov, Director of Global Policy &
Communications, AHF
+1 323.308.1829
[email protected]

Terri Ford, Chief of Global Advocacy &
Policy, AHF
+1 323.308.1820
[email protected]