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Although the coronavirus is beginning to give some small sign that infections in Brazil are multiplying at a slower rate, it still causes about 1,000 deaths each day and around 50,000 infections. As some science popularizers often recall, it is as if three planes full of Brazilians crash every 24 hours. But the virulence of the outbreak, the second worst in the world after the United States, has another effect. It is one of the factors that has made Brazil an attractive laboratory for scientists and companies embarked on the frantic race to get a COVID-19 vaccine. Four of them are being tested in this continental country with 210 million inhabitants.
President Jair Bolsonaro's constant sabotage of governors' initial efforts to contain the virus has marked a health crisis in which states have long ceased to act in a coordinated manner. The result is 107,000 deaths and 3.5 million infected since the first case was detected, just after the Carnival ended. They are large numbers, although the absence of massive tests to the population indicates that underreporting is enormous. With official figures, the death rate is lower than that of several countries in the region and Europe.
Demand
The country is a test bed in demand because, in addition to the fact that the virus has been expanding rapidly for months, it has a consolidated and extended national vaccination program, prestigious biomedical research institutes and has obtained thousands of volunteers willing to inoculate them with the vaccine ( or placebo). Brazil has the capacity to produce 500 million vaccines per year.
One million people signed up on the web to recruit volunteers, although not all met the required criteria. It is essential to be health personnel who work directly with covid patients and who have not been infected in these months. But the number of registered gives an idea of the level of enthusiasm.
This week the agreement was announced to test a fourth experimental vaccine here, the one developed by Janssen, the Johnson & Johnson pharmaceutical company, with about 7,000 volunteers who will be recruited by a score of research centers spread over several States. This initiative joins the clinical trials that are already running: that of the vaccine designed by the University of Oxford and the AstraZeneca company, which is in the last phase of testing with 5,000 volunteers in Brazil, and that of the Chinese pharmaceutical company Sinovac, with 9,000 people. Both are being carried out at various points in a territory that is twice as large as the European Union and where the virus is advancing at different speeds. A fourth vaccine, designed by Pfizer, will be tested in a thousand health professionals in the State of Bahia.
The infectologist Nancy Bellei details the reasons why Brazil is a good laboratory. Better, for example, than the United States. “We are a country that has one of the best vaccination programs in the world, immunization is widely accepted by the population. In addition, we have experience both in public-private collaborations to produce them, as well as in technology transfer and in the design of clinical trials ”, lists this professor from the Federal University of São Paulo (Unifep) who is involved in the Oxford trial. He explains that he is part of the group of doctors in charge of testing volunteers who fall ill after receiving the experimental vaccine against covid (or the one they use as a placebo, in this case the one for meningitis).
Political and scientific rivalry also explains why Brazil is hosting four clinical trials without ruling out that it could host several more. Rulers and scientists, everyone wants to have theirs. It turns out that, in parallel to the race between countries to be the first to find, commercialize and distribute the vaccine, within Brazil itself a race has been unleashed in which politicians, on the one hand, and the main research centers participate.
As a backdrop, the confrontation between Bolsonaro and governors such as those of São Paulo and Bahia over what is the most effective way to manage the disease (and its economic consequences); or the rivalry between two scientific institutions founded in the early twentieth century: the Butantan Institute, dependent on the São Paulo state government and manufacturer of most Brazilian vaccines, and the Fiocruz foundation, based in Rio de Janeiro and linked to the federal Executive .
Specialist Bellei points out two other reasons that in her opinion have weighed for choosing Brazil, which has a well-established system for the distribution of vaccines, which reach the most remote corners while respecting the cold chain, and there are no shortage of applicants to participate in the essays. "There is a waiting line to be a volunteer," says the infectologist before recalling that "when the H1N1 (influenza A) epidemic arrived, people queued at dawn to get the vaccine." Anti-vaccine movements have also reached Brazil, but here they have taken root less than in countries like the United States.
Uncoordinated political management
The uncoordinated political management of the health crisis derived from the coronavirus is a catastrophe for many of the professionals of the Unified Health System, the largest public health system in the world, struggling in the battle against Zika, yellow fever, dengue or AIDS.
"If all goes well, in Brazil we will have vaccines for priority groups in the first quarter of 2021," explained Ricardo Palacios, medical director of clinical research at the Butantan Institute, in an interview with the Brazilian edition of this newspaper. “Before the end of the year we must have some effective preliminary study. Which is absolutely incredible if we take into account that we learned about the existence of the new coronavirus in the last days of 2019. It is something unprecedented and that shows that the global coordination of scientists is working ”, the researcher highlighted.
Preference agreements with pharmaceutical companies
The agreements signed by the Brazilian authorities give them preference. The firms have pledged to sell them tens of millions of doses of their vaccines.
The commitment to Sinovac obliges the Butantan Institute, which depends on the São Paulo state government, to invest 16 million dollars (13.6 million euros) in research. In return, it will receive enough doses to vaccinate 60 million people, a number that far exceeds its population.
That of the federal government with AstraZeneca implies the disbursement of 100 million dollars in exchange for 30 million doses even if the tests fail. If they are successful and an effective immunization is achieved, the Bolsonaro government will have priority to buy an additional 70 million doses. Insufficient figures to vaccinate the entire population of the country.
Earlier this August, Bolsonaro announced that the Brazilian government has set aside 1.9 billion reais ($ 335 million) to process and produce the Oxford vaccine.
Brazil has just finally received the first good news since the start of the pandemic. The latest report from Imperial College London on the speed of contagion places it below 1, which means that each infected transmits the disease to less than one person, that is, its progress slows down. The region of greatest concern is the South and Southwest, with five states where deaths have doubled in the last month. But the situation has stabilized in the most populated states, São Paulo and Rio de Janeiro, where normality is advancing, traffic returns and companies and shops reopen with some limitations. Schools and museums are still closed. The outlook has also improved in the north and northeast, the areas where the coronavirus has caused proportionally greater damage because the health network is much weaker. In places like Manaus (Amazonia), both the hospitals and the funeral network collapsed.