Will the solution to the health crisis that has shaken the planet since the start of the year come from a Russian-Brazilian alliance? As the Covid-19 continues to spread, Vladimir Putin assured the whole world last week: the “first” vaccine available will be Russian. Before signing, last Thursday, a memorandum of understanding with the government of the Brazilian state of Parana (South) to test and produce its vaccine against the coronavirus.
Game over? Nothing is less sure. First, because the effectiveness of "Sputnik V" (V as a vaccine) remains questionable. But also because it would seem that Vladimir Putin has moved forward a bit. Far from having crossed the finish line in the vaccine race, Russia would actually have simply caught up with China and the United Kingdom, already in their final phase of testing. Who will win the frantic race that has started? Impossible to say, for the moment. But the answer may well lie in Brazil. Because Russia is not the only one to have chosen the largest country in South America as a testing ground ...
"Ideal scenario"
If health workers are raising their sleeve in Brazil, it is not only to stem the epidemic, which has killed more than 100,000 people according to official figures. Five thousand guinea pig doctors are already testing ChAdOx1 nCoV-19, the vaccine developed by the University of Oxford and the British laboratory AstraZeneca. Further trials are being carried out in South Africa and the United Kingdom. China, too, has turned to the South American country, which was the first to test the Coronovac vaccine from the Sinovac Biotech laboratory, in its last phase before approval. This Wednesday, Brazil also gave the green light to tests of the vaccine that Janssen Pharmaceutica, Belgian subsidiary of the American company Johnson & Johnson, is developing.
The choice of Brazil is not trivial, notes Carlos Henrique Paiva, researcher at the FioCruz Foundation. “Unfortunately (for us), the country presents the ideal scenario for testing vaccines, especially for phase 3 studies,” he said. And for good reason: this final phase is carried out on a large scale, requiring many infected people. However, three million positive cases have been detected in this vast state of 212 million inhabitants, despite insufficient tests. In the second most damaged country in the world after the United States, volunteers are thronging. In addition to the 5,000 doctors called to test the British vaccine, 9,000 other health professionals are to serve as guinea pigs for its Chinese equivalent.
"Little flu"
The choice of Brazil is however surprising, while its president, Jair Bolsonaro, has continued to minimize the disease he describes as "little flu", encouraging his supporters to take to the streets. Himself contaminated by the virus last month, he has joined the action to the word during multiple walkabouts, unmasked, to better smile at the selfies of his followers.
VIDEO. Jair Bolsonaro greets supporters without a mask, as he has the Covid-19
In disagreement with his policy, two health ministers successively resigned. A soldier took their place. “The fight against the virus cannot do more damage than the virus itself,” Jair Bolsonaro repeated in May. A fatalistic vision that has led to an acceleration in the rate of contamination in recent weeks in the countryside and in regions where the virus arrived later, like the South and the Center-West. "We have lost control of the disease", alarms Carlos Henrique Paiva, criticizing the management of the epidemic by the government.
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Paradoxically, it is however by becoming an epicenter of the pandemic that Brazil has also emerged as an opportunity for laboratories. Evil and its remedy, so to speak.
Vaccine tradition and public health: the learned duo
If Brazil is today a field of experimentation, it also owes it to one of its strengths: its expertise in medical matters. China chose to develop its vaccine within the Butantan Institute in São Paulo, while the United Kingdom turned to the Oswaldo Cruz Foundation (FioCruz) in Rio de Janeiro, named after this bacteriologist trained in the 'Institut Pasteur in Paris. On his return from Europe at the start of the 20th century, this researcher had embarked on a health campaign to eliminate plague, smallpox and yellow fever from the capital. Recognized as "the conqueror of yellow fever", Oswaldo Cruz had been erected to the rank of national hero. Since then, the country has been renowned for the quality of its vaccination specialists.
“Brazil is characterized by a strong tradition in public health”, confirms Rômulo de Paula Andrade, researcher at the FioCruz Foundation. In 1988, the Federal Constitution thus established health as a fundamental right of citizens. The single health system ensures universal and free access to immunization services. For routine care, 25% of Brazilians have decided to take out private insurance. “The massive vaccination campaigns associated with free health care have made the country proud,” enthuses the researcher. The National Immunization Program (PNI) has made it possible to eradicate, among others, polio, measles and rubella. A model country in 2011 with a vaccination rate of 100%, Brazil however saw its vaccination coverage drop to 84% in 2018.
"I go it alone"
Brazil also finds its account there. "The deal is for the country to provide a privileged field of experimentation for its vaccines and, in exchange, it will be one of the first served when the vaccines are produced", explains François-Michel Le Tourneau, research director at the CNRS. In this “Formula 1 race” -168 vaccines are being tested around the world, according to the WHO! - Brasilia is therefore keen to stay ahead of the pack.
Among its continental competitors, Mexico and Argentina are in charge of producing and distributing throughout Latin America a potential vaccine developed with the British laboratory AstraZeneca and the University of Oxford. Everywhere, except in Brazil. An absence of coordination which is explained by the culture of the country but also, once again, by the personality of its president, according to François-Michel Le Tourneau. "Bolsonaro claims to go it alone, we are in the logic of every man for himself," he says.
Defiance and "miracle vaccine"
We could therefore smile at the idea of seeing the Brazilian head of state bet on science, after having shown skepticism towards the virus and then praised the merits of hydroxychloroquine despite the controversy. But the situation does not at all amuse Rômulo de Paula Andrade and his colleagues from Fiocruz. "It's a very bad time to have a pandemic: we live in an era of denial", he warns. His fear: that mistrust of health measures, in Brazil as elsewhere, will extend to vaccines against the coronavirus.
VIDEO: Jair Bolsonaro films himself taking hydroxychloroquine
"We should make public how the vaccine was developed," recommends the researcher. And to quote the Russian vaccine, whose data have not yet been published. The trial carried out so far included only 38 participants. And no one over 60. Experts agree on two points. To win the race for the cure, there is no need to rush, no step should be skipped. Victory against mistrust will be achieved through scientific rigor, worthy of Brazil's historical heritage and its motto: order and progress.