February 8, 2021 | Reflections
Source: Sao Paulo State Government.
Brazil’s Health Regulatory Agency, ANVISA, recently granted approval to two vaccines for emergency use. One of these is the so-called CoronaVac, a partnership between Butantan Institute and the Chinese company Sinovac Biotech, and the other is the AstraZeneca-Oxford vaccine. Although Brazil is a global reference point in international debates on mass public vaccination, with important public institutions developing vaccines and a Unified Health System (SUS), emerging and increasingly visible anti-vaccine sentiment is growing in the country[3]. This mood predates the current COVID outbreak but has become more visible following anti-vaccination commentary from President Jair Bolsonaro and some federal authorities. In this blog post we discuss the politics of COVID-19 vaccinesand how a science and technology studies (STS) approach can help understand recent events.
The race to take the lead
On Sunday, January 17th, 2021, ANVISA broadcasted a meeting on news channels, giving the green light to vaccines. The broadcast conveyed a public celebration of its own expertise with veiled critique of denialists and even the Federal Government. Minutes after the approval, the first person was vaccinated publicly by Bolsonaro’s main political rival João Doria, São Paulo’s governor, using CoronaVac. As this was happening live, Minister of Health Eduardo Pazuello also went live and gave a very awkward interview to the media, visibly upset, accusing governor Doria of pulling a publicity stunt. Social media went crazy with memes about the ‘race for the vaccine’, and there was much comment about the role of the federal versus the state in the rollout of Brazil’s mass vaccination plans.
The political dispute that developed around the authorisation and rollout of vaccines has its origin in the political rupture between Doria and President Jair Bolsonaro. Former allies, Doria was elected in 2018, receiving votes from many Bolsonaro supporters. However, this alliance did not last. Doria changed his political tone in 2019 and has moved away from Bolsonaro to possibly become his main opponent in the next presidential elections in 2022. Among the main issues of contention were disputes about the rules and regulations of COVID-19, about who has the authority to issue orders to stay at home, to close and reopen businesses and schools, amongst others.
Recently, Bolsonaro declared that “no country in the world is interested in CoronaVac” and that “we will not be anyone’s guinea pig”, clearly further straining relations with João Doria but also contributing to public distrust in the scientific methods and technologies used by Butantan Institute and Sinovac Biotech. Aside from these official statements, conspiracy theories have gained ground in social media, including that of the alleged presence of a 5G nanochip in vaccines as part of a grand plan masterminded by Bill Gates to control human bodies. The circulation of such conspiracies has put public trust in Brazil’s consolidated vaccination programs into question, further helping to fuel extremist groups aligned with Bolsonaro’s ideological agenda.
It is undoubtedly necessary to scrutinise and open up the practice of science rather than blindly following the experts, even more so because of the non-transparent and non-inclusive way traditional science has been developed, including in Brazil. However, what is at stake in this pandemic period In Brazil is, firstly, the question of ‘what’ has contributed to public distrust. Secondly, the impact of such mistrust on social solidarity and the sense of community necessary for mass vaccination rollout. Geoffrey Kabat (2018) provides some insight: “the controversy surrounding vaccines is purely one involving a widespread misunderstanding of the science by a vocal minority”. Hence, this lack of public knowledge is an open door for malicious minorities to spread absurdities, especially because the efficacy of CoronaVac is lower than previously expected (barely 50%). The fact that President Bolsonaro says that vaccination will not be mandatory, questioning the scientific efficacy of vaccines, contributes to a dissolution of a sense of community necessary to immunize the largest number of people.
This story shows that the hard truth is that social factors are key to understanding technology in this vaccine race scenario. The sense of urgency posed by the pandemic, as well as the political disputes involved in vaccine rollout, seem to put technological choices on the back burner. The lack of transparency in social and political dimensions underpinning the government of São Paulo’s technological choice in CoronaVac and of the Federal Government in AstraZeneca opens a new space for debate.
New global compact: Brazilian fragility
A recent report published by the project ‘Comparative Covid Response: Crisis, Knowledge, Politics‘ suggests a new ‘social compact’ emerging at the global level in ethical and scientific terms, particularly surrounding the production and distribution of vaccines. What seems important to point out is that Brazil’s international reputation has not been good recently, mainly due to repeated diplomatic errors and a questionable populist agenda led by President Bolsonaro. The Federal Government has been betting on a good relationship with India, especially after Trump’s defeat, by signing an Oxford vaccine purchase agreement while creating constant tensions with China. On the other side, São Paulo’s government has generated a cooperative atmosphere with China from the Butantan-Sinovac partnership.
It is here that the politics of technology transfer has emerged. Labelling the CoronaVac a ‘Brazilian vaccine’ can be seen as a good marketing move by Doria. Despite previous criticism, President Bolsonaro has used this slogan to say now that the development and rollout of the vaccine has also been an achievement of the Federal Government and that no one ‘owns’ the vaccine. On the one hand, this is true, as the Butantan Institute’s agreement to produce and distribute millions of doses is on national territory. On the other hand, according to CNN Brazil, a document signed by both Butantan and Sinovac Biotech says: “The Butantan Institute has a full understanding that Sinovac develops the vaccine and that Sinovac owns the intellectual property rights and interests of Sinovac in the vaccine”. In another passage, the document says that Butantan must destroy the “Product Dossier” and its copies in case of partnership rupture.
In spite of the marketing war, Brazil is very much dependent on the delivery of crucial raw materials (including active pharmaceutical ingredients) to begin the production of the immunizing agent. So far their delivery is delayed. Recently, India also delayed the delivery of the Oxford vaccine causing diplomatic embarrassment. The politics of the vaccine war exposes Brazil’s fragility internally and externally and puts at risk the continuity of mass vaccination throughout the country.
All the authors are members of the research group Comparative Covid Response: Crisis, Knowledge, Politics (CompCoRe), funded by the National Science Foundation.
Alberto Matenhauer Urbinatti is a sociologist and PhD in Public Health. He is currently a postdoctoral researcher at the Department of Science and Technology Policy, Institute of Geosciences, State University of Campinas. He is also a member of the Brazilian Covid-19 Humanidades.
Marko Monteiro is an anthropologist, focusing on STS and anthropologies of science. He is currently an Associate Professor at the Science and Technology Policy Department, University of Campinas, Brazil and member of the Brazilian Covid-19 Humanidades.
Ione Mendes has a master in public communication of science, technology and health. He is currently a doctoral student at the School of Public Health – University of São Paulo – USP.
Gabriela Di Giulio is a journalist and PhD in Environment and Society. She is Assistant Professor in the Environmental Health Department, School of Public Health, University of São Paulo.
Phil Macnaghten is a sociologist and science and technology studies scholar. He is Professor of Technology and International Development at the Knowledge, Technology and Innovation Group at Wageningen University and Research.
Published: 02/08/2021