Joaquim E. C. Toledo Jr. :Sanitary collaboration in global health emergencies: Brazil, China, and the covid-19 pandemic

Author:Joaquim E. C. Toledo Jr. Release date:2020-04-28 22:11:28Source:复旦发展研究院

Joaquim E. C. Toledo Jr.

Researcher, University of São Paulo and Cebrap (Brazil)

Visiting scholar, Fudan Development Institute



Brazil was once internationally renowned for its free universal health care system and for successfully battling emerging infectious diseases such as HIV/AIDS, in the 1990s. But now the country is part of a small group of nations whose leaders have been slow in acknowledging the severity of the covid-19 pandemic.

The international press has rightly characterized the pandemic as a global test of governance quality. The promptness and effectiveness with which governments respond to the sanitary crisis are directly related to levels of morbidity and mortality among its citizens. China, New Zealand, Taiwan, and South Korea are the forerunners on this global contest of best practices, and their weapons, as we all know by now, are testing, contact tracing, and lockdowns.

But rulers of countries such as Nicaragua, Belarus, Turkmenistan, and also Brazil, have explicitly minimized the seriousness of the situation and opposed prevention and contention measures that have proved successful in other countries. In Brazil, the federal government has decided to fight reasonable actions that state and local-level governments took to combat the spread of the coronavirus and the collapse of their health care systems.

In his response to the pandemic, Brazil is following the wrong playbook, and federal authorities insist on opposing sanitary measures that have been successful in China and other countries in Asia. They have tried to prevent states from restricting movement; attempted to keep churches and temples open, even though these are places of crowding; the president himself has downplayed the severity of the illness, and urged to the population to “face it like a man and get back to work. His supporters have taken to the streets, countering the advice of sanitary authorities to stay at home.

A hardcore group around the president questions the efficacy of social distancing and isolation, and, very recently, the federal government was successful in getting the judicial system to forbid the use of mobile technology for monitoring and tracking movement. Also, they insist on the existence of a magic bullet that could cure the afflicted by covid-19, laying their bets on the clinical success of hydroxychloroquine even though the scientific evidence is, at this point, very meager.

This stance, which included a campaign on TV and the internet stating that Brazil cannot stop (and thus must get back to normality), has generated tensions with state and local governments. Even the health minister, who responds directly to the chief of the executive branch, has urged the public to follow social distancing and isolation practices, fueling the sensation of lack of consensus and coordination in the government.

To add to the internal difficulties of coordination between federal and state and local governments, authorities with ties to the Brazilian federal government have committed unforced diplomatic errors with China, Brazil's leading trade partner, and a global model for dealing with the covid-19 crisis. Even though the strains have been dealt with and resolved, the Brazilian government seems to be sending the wrong signals by underestimating the importance of good diplomatic relations with countries that can offer great help in dealing with the pandemic, most notably China. Brazil is badly in need of resources such as ventilators and personal protection equipment, and negotiations for the provision of such goods by China are in course.

Fortunately, Brazil's administrative structure confers relative autonomy for states and municipalities in taking sanitary measures during public health emergencies. On April 15, the Supreme Court reinforced its interpretation that grants them the freedom to enforce restrictive norms as long as the pandemic lasts. The court also decided that states and municipalities can determine what economic activities can be temporarily suspended and which services will not be interrupted.

State governors have turned to China for material resources and public health strategies in dealing with the imminent spread of covid-19 in their regions. In March, at least eleven state governors contacted the Chinese embassy in Brazil to inquire in which ways the Chinese government, which was at the forefront of the response to the epidemic, could help.A group of state governors from Northwestern Brazil specifically requested help in the provision of ICU units and ventilators.

The governors stressed their admiration for the form that the Chinese people have dealt with the epidemic and the immense friendship that unites both countries and their people. The state of Pernambuco has directly negotiated the acquisition of 350 thousand test kits for SARS-Cov-2 from China. More recently, the federal government itself has toned down its politically motivated statements and is purchasing millions of masks from China. But some states are still needing to bypass federal measures (and international competition for scarce supplies) to get medical equipment such as ventilators from China.

International cooperation is the keyword in handling the covid-19 pandemic. As we all well know, value chains today are spread around the globe, and it is in every country's best interests to cultivate good diplomatic relations with their commercial partners. In the present situation, Brazil has a lot to learn from China's experience in dealing with the pandemic and is fortunate to be able to rely on China's industrial capacity. Right now, we need all the help we can get.