How Brazil gambled on unproven drugs to fight Covid-19


After repeatedly selling the potential for chloroquine and hydroxychloroquine to each forestall and mitigate the consequences of Covid-19, Bolsonaro himself examined optimistic final July. “If I had taken hydroxychloroquine as a preventative measure, I’d nonetheless be working,” he mentioned, regardless that the drug, mostly used towards malaria, had not really been confirmed efficient towards the coronavirus and the World Well being Group (WHO) had discontinued a significant trial with hydroxychloroquine.

“I am feeling actually good. I used to be feeling so-so on Sunday, dangerous on Monday. In the present day Tuesday, I am feeling significantly better than Saturday, so indubitably,” he mentioned as he held up a capsule after which swallowed it. “It is working.”

Simply final week, Bolsonaro ​once more admitted that he might be confirmed incorrect and that the drug won’t have any impression on the coronavirus, however added “at the very least I did not kill anybody. Now, if by likelihood, it proves to be efficient down the highway, these of you who criticized, a part of the media, you can be held accountable.”

In response to unique paperwork obtained by CNN affiliate CNN Brasil, Bolsonaro was not solely speaking up the medication final yr, his authorities was actively utilizing emergency funds designated to fight the Covid-19 pandemic to buy and distribute them even after that they had been proven to be ineffective.

In Might, ​Brazil’s Wholesome Ministry formally really helpful chloroquine for early therapy of Covid-19, and in June prolonged the advice for kids and pregnant girls, the identical day that the ​US Meals and Drug Administration revoked its emergency use authorization for hydroxychloroquine and regardless of mounting proof that it was not efficient at stopping ​or curing Covid-19.

Two days later​, on June 17, the Brazilian Society of Infectious Illnesses printed an open letter saying it was “pressing and needed” to halt using hydroxychloroquine within the therapy of Covid-19. The Well being Ministry, nonetheless, didn’t change its suggestions over the next months and docs reported being pressured to prescribe them. (I’ve a PDF of the letter) ​

In September, the Well being Ministry’s strategic medicines workplace confirmed to CNN Brasil that it was within the technique of buying extra chloroquine with sources earmarked for combatting Covid-19 as a result of its stockpile had fallen to 375,500 doses. It didn’t specify how a lot it was ordering or how a lot it will value.

“In 2020 the malaria program has seen a rise within the variety of instances in Brazil, and as has been introduced each day, the variety of instances of Covid-19 in Brazil remains to be excessive,” the division mentioned in a written response. “Subsequently it’s anticipated that the demand from states and municipalities for this drugs will stay excessive within the second half of 2020.”

Inside Brazil's cult of hydroxychloroquine

They didn’t specify what half was used for its malaria program and what half for combatting Covid-19, however based on figures obtained by CNN Brasil, a complete of three.23 million drugs had been produced by the Brazilian military’s pharmaceutical unit in 2020. That compares with 265,000 drugs produced in 2017 and none produced in 2018 or 2019.

And based on the Well being Ministry’s personal figures, the variety of instances of malaria was 60,713 within the first six months of 2020, 16 p.c decrease than the primary half of 2019.

Paperwork obtained by CNN Brasil utilizing Brazil’s Freedom of Info Act present that between the months of April and August, the Well being Ministry’s workplace for the coordination of strategic medicines requested 1.5 million drugs of chloroquine be distributed to state well being departments by the Military’s pharmaceutical lab.

In response to the paperwork, the distribution was aimed toward “combatting the Covid-19 pandemic” and the drugs had been distributed primarily based on the variety of suspected instances in every state.

The distributions continued within the second half of the yr, even after the FDA had revoked its emergency use authorization and several other research had concluded that chloroquine and hydroxychloroquine weren’t efficient within the therapy of Covid-19. The Military instructed CNN Brasil that between September 2020 and January 2021, 420,000 doses had been distributed.

One contract seen by CNN Brasil exhibits that in September, the military spent $144,000 on uncooked supplies wanted to supply chloroquine, paying 167 p.c over market worth — a purchase order that was flagged as suspicious by the Federal Common Accounting Workplace. ​In an announcement to CNN, the military mentioned ​that costs had risen due to fluctuations within the change price and a rise in demand internationally.

Brazil authorizes two Covid-19 vaccines for emergency use

In the identical month, Brazil acquired a letter from the Pfizer CEO Albert Bourla urging the nation to signal a contract to purchase 70 million doses of its Covid-19 vaccine ​and providing to satisfy with the federal government. Pfizer was already in late stage trials with its vaccine at the moment. CNN Brasil first reported on the existence of the letter final month. It was despatched to Bolsonaro and several other cupboard ministers on Sept. 12, when the loss of life toll in Brazil was already the second-highest on this planet at 131,000 and the variety of confirmed instances was 4.three million.

However negotiations with Pfizer sputtered and didn’t finish in an settlement. Information of the letter sparked anger when it emerged final month as the federal government scrambled to roll out a vaccine program.

Brazil’s Well being Ministry responded to CNN Brasil saying the phrases of the provide, which included an settlement to not maintain Pfizer chargeable for adverse unwanted side effects, had been “abusive.” The ministry mentioned it was additionally involved concerning the small variety of doses being provided within the first lot: 500,000, however added that negotiations had been nonetheless ongoing.

Pfizer declined to remark.

A hospital in Manaus, Amazon State, last month.

When Brazil lastly launched its nationwide vaccination program on January 18 after repeated delays, it began with simply six million doses for a inhabitants of greater than 210 million.

Bolsonaro’s authorities had guess on the Oxford/AstraZeneca vaccine because the centerpiece of its program. However resulting from delays, they finally turned to CoronaVac, the vaccine developed by China’s Sinovac and examined in Brazil in a partnership with the governor of Sao Paulo state, who additionally occurs to be Bolsonaro’s political nemesis.

Thus far, 2.2 p.c of the inhabitants has acquired a primary dose ​of the two-dose routine required by each the CoronaVac and Oxford/AstraZeneca vaccines.

However whilst authorities began to roll out vaccines in January, the federal government continued to advertise chloroquine as a therapy on its apps and within the protocol which had not been up to date because it was posted final Might and the place it was ​characterised as a key part of ‘early therapy.’
When requested why the ministry was nonetheless recommending the drug, Well being Minister Eduardo Pazuello instructed journalists final month ​that he had by no means really helpful a selected drug. “We defend, encourage and orient sick individuals to instantly go to their well being clinic, to a physician, and the physician will make a scientific analysis of the affected person. What medicines the physician prescribes, that may be a non-public area with the affected person.”

Bolsonaro appointed Pazuello, a military basic, when his second well being minister give up after declining to situation federal tips for using hydroxychloroquine and chloroquine within the therapy of Covid-19.

“I used to be elected to make choices and the choice about chloroquine goes via me,” Bolsonaro declared final Might. The next day, Nelson Teich resigned. His substitute, Pazuello, issued the rules.

Jose Brito is an investigative journalist at CNN Brasil.



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