SAO PAULO — Brazilian marketing executive Eduardo Menga is extra cautious when it comes to his health. During the pandemic, he consulted a slew of doctors to ensure he was in good shape and uprooted his family from Rio de Janeiro to a quiet city in the countryside where he works remotely. His wife Bianca Rinaldi, an actress, hasn’t worked since March.
Menga and Rinaldi are among a minority of Brazilians who will pay for a COVID-19 vaccine if an association of private clinics can close a deal to bring 5 million shots to Latin America’s most unequal country. President Jair Bolsonaro, under fire for his government’s handling of the pandemic, has promised not to interfere.
“When I go to a restaurant and I pay for my own food, I’m not taking anyone else’s food,” the 68-year-old Menga said from his home in Jundiai in Sao Paulo state. “I don’t think getting a vaccine from a private clinic will take it from someone else waiting in the public system. It could be an alternative line, and those who have the chance should take it.”
Amid the government’s stumbling vaccine rollout, many moneyed Brazilians want to find a swift path to vaccination, sparking backlash from some public health experts and igniting debate on social media, editorial pages and talk shows.
There has been concern globally that the privileged could game the system to get themselves vaccinated before others. When the connected have been caught leapfrogging ahead, in countries like Turkey, Morocco and Spain, they have faced criticism, investigations or forced resignations.
Brazil has had its reports of line-jumpers, too, but the nation stands apart because manoeuvring isn’t only done in the shadows. Some is out in the open, with the prosperous co-ordinating efforts that the government endorses, according to Roberto DaMatta, an emeritus anthropology professor at the University of Notre Dame.
“The pandemic makes Brazil’s inequality more obvious, because the virus doesn’t choose social class, but the cure just might,” said DaMatta, who authored the book “Do You Know With Whom You’re Speaking?” a portrait of Brazilian privilege. It was inspired by episodes during the pandemic, including a judge who refused a policeman’s order to don a mask, then called the state’s security chief to protest and ripped up his 100 reais ($20) fine.
“Brazil’s wealthy normalized slavery for ages. Now, they accept that more poor and Black people die of COVID, and put little pressure on a government that has sabotaged the rollout. Taking the vaccine in this scenario might depend on organization, so the well-off are organizing,” DaMatta told The Associated Press.
Business leaders and some authorities defend attempts to secure a vaccine as boosting Brazil’s economic reboot. And anyway, they argue, why shouldn’t the well-heeled buy vaccines if government efforts are falling short? So far, Brazil has 13.9 million shots available for a population of 210 million people, and has given the first of two shots to just 1% of citizens since immunizations began Jan. 18.
Health experts, for their part, view such efforts as unethical given vaccines are scarce globally and at-risk groups are in more immediate need to avoid death; already nearly 230,000 Brazilians have died from COVID-19, the second-highest tally in the world.
And while people over 65 like Menga are near the top of the list, Brazil’s slow rollout, which could take up to 16 months, means it could be a long time before he gets a shot, and even longer for his wife, who is 46.
Debate over unfair vaccine distribution in Brazil first flared after Supreme Court employees reportedly manoeuvred to set aside some 7,000 COVID-19 vaccines for themselves and their families; the government laboratory that will make and distribute AstraZeneca shots declined, saying it cannot reserve shots. Sao Paulo state prosecutors also lobbied for inclusion in priority groups, alongside health professionals.
After those efforts floundered, Brazil’s private health clinics stepped in to try to bypass government procurement plans. Executives from Brazil’s association of private clinics negotiated directly with Indian pharmaceutical company Bharat Biotech for its COVAXIN shot. The association of about 30,000 private clinics is registering would-be clients on a waiting list.
Brazil has no deals with Bharat and its health regulator has yet to approve COVAXIN, but in a sign of what the future may hold if the deal does go through, Rio Grande do Sul state’s association of judges asked its members last month if they were interested in buying shots from the clinics association.
Gonzalo Vecina, who headed Brazil’s health agency between 1999 and 2003, says such private-sector efforts pose a major problem, not only on ethical and legal grounds, but also to public health.
“The private network doesn’t have to follow the Health Ministry’s priority protocol. So, if this goes ahead we will have a line for people who have $200, where you can get a shot next week, and another that won’t move for months,” Vecina said.
“What everyone needs to understand is that the pandemic doesn’t end if it doesn’t end for everyone.”
Most of the planet is relying on public health care networks to administer vaccines, and few countries with large populations are using private channels for distribution. A notable exception is the U.S., where Americans can get their shots at pharmacies, clinics and other private institutions. Hospitals in at least eight U.S. states have been accused of favouring board members, trustees, relatives and donors who should have waited their turn.
On Jan. 26, Bolsonaro said he had signed a letter to bolster a bid from a group of Brazilian executives to score 33 million doses of the AstraZeneca shot, with half for them to use as they like and half donated to the country’s public health system.
Brazilian media reported at least 11 companies were in the group, including state-run oil company Petrobras, steelmaker Gerdau and phone carrier Oi, all of which declined to comment.
“That would help the economy a lot, and also those who might want to get vaccinated,” Bolsonaro said of the companies’ effort. Economy Minister Paulo Guedes labeled the effort “evidently very good.”
By contrast, a council of business leaders in neighbouring Colombia hit a roadblock when it sought permission to purchase COVID-19 shots. Colombia’s health minister said the possibility would only be considered in the second phase of immunization, after all health professionals and people over 60 years old have received their shots.
Bolsonaro’s support notwithstanding, AstraZeneca declined the Brazilian executives’ effort, saying in a statement that it wouldn’t supply Brazil’s private sector, at least for now. Sao Paulo’s industry federation released a statement two days later denying such negotiations ever were pursued.
A former governor of Brazil’s central bank, Armínio Fraga, said he opposes the moves by wealthier Brazilians and fears vaccine prices could surge if companies are allowed to bid for them.
“We are living in a moment of global scarcity,” Fraga, a partner at investment firm Gavea Investimentos, said in an online interview to newspaper Valor. “We need some co-ordination so that priority groups are respected.”
Mauricio Savarese, The Associated Press