RIO DE JANEIRO, Brazil - When Brazil’s President Jair Bolsonaro was diagnosed with COVID-19 in July last year, he appeared in a video on social media ingesting hydroxychloroquine, an anti-malaria pill that is not proven to work against the coronavirus. Like former U.S. President Donald Trump, who also praised the drug, Bolsonaro said that despite the lack of scientific evidence “it’s working for me,” adding “I believe in hydroxychloroquine, what about you?”
Now, Bolsonaro says he is tired of being called “Captain Chloroquine” and in a live transmission last week announced that if the pill “turns out to be a placebo” then “at least I didn’t kill anyone.” The episode is the latest in the president’s cavalier attitude towards COVID-19, which has killed more than 200,000 people in one of the world’s worst-hit nations.
The drug is part of what Bolsonaro calls the “early treatment kit.” It includes other medications like ivermectin and azithromycin and is marketed by the government as a treatment for patients with preliminary coronavirus symptoms. The government already spent over $16 million on medicine for the kit, even though neither the World Health Organization nor Brazil’s health regulatory agency, Anvisa, recognizes any of the treatments as effective against the disease.
Meanwhile, slow moving vaccination efforts have reached less than two percent of the country’s 200 million people so far. Brazil has surpassed nine million confirmed coronavirus cases. Despite this, Bolsonaro is still betting on his kit, and last month he compared using the so-called treatment to tending to a wounded soldier in a battlefield. “If they waited for scientific approval, think of how many lives they would have lost,” said Bolsonaro in a live transmission.
Other Brazilian politicians have been following his lead. Sebastião Melo, the newly elected mayor of the southern city of Porto Alegre, kicked off his term in January announcing that he would be securing a new shipment of 100,000 pills from Bolsonaro’s kit. The supplies are set to hit public pharmacies and clinics all over the city by the end of this month. Outrage from Brazil’s medical community prompted a group of leftist congressmen to start a civil lawsuit against the distribution of the medication.
Located in the state of Rio Grande do Sul, Porto Alegre wasn’t the only city in the region to embrace the controversial kit. Another 27 municipalities in the state are being audited for using it, and in the south western state of Mato Grosso, the local government prided itself in a public statement on having distributed over 12,000 kits at the public clinic “Centro de Triagem.”
The government even launched a nation-wide app that has since been taken down, with a step-by-step procedure on how to use the kit. Legal threats and ample criticism from the scientific community led the health ministry to stop recommending the use of hydroxychloroquine on their website. But without a proper campaign to warn people that the drugs in the kit aren’t effective, the damage has already been done, says prominent pulmonologist and health care researcher in Rio de Janeiro, Margareth Dalcolmo.
“I see heaps of [patients] at the ICU whose bellies are filled with the nonsensical drugs because they buy into the illusion that if they take them, they are protected [from Covid-19],” Dalcolmo said. She calls Bolsonaro’s kit a “little bag of illusions,” adding that a preventative medical treatment against COVID-19 does not currently exist.
The mixture of drugs pushed by Bolsonaro aren’t likely to produce severe side-effects but are causing people to pump “unnecessary chemicals into their bodies,” said Dalcolmo. Ivermectin, for instance, is used to treat parasite infections like lice and is also typically administered on animals by veterinarians.
“I would love to say these drugs work against COVID-19, but they don’t. I have to tell the truth,” said Dalcolmo. “This misinformation is very detrimental to the population. People fall for it because the example comes from up top, from a figure of authority.”
And at the same time that Bolsonaro endorses the use of unproven treatments, he has publicly positioned himself against the vaccination campaign. Not long before Brazilians began getting vaccinated in mid-January, a maskless Bolsonaro discouraged a room full of supporters from having it. He said that pharmaceutical companies like Pfizer will not come to your aid if “you turn into a crocodile” or develop other side effects like “a woman growing a beard” or a man “suddenly talking in a high-pitched voice”.
Bolsonaro has also specifically targeted a vaccine produced by Chinese pharmaceutical company Sinovac, in partnership with the state of São Paulo. The president and others in government have backed fake theories shared on the internet about vaccines coming from China not being effective. This stance muddied relations with China and delayed new shipments of raw materials needed to make new doses. To top it off, the government received three offers from São Paulo to secure millions of doses of the Chinese vaccine for national distribution, but never responded.
“He’s created a cult-like following that has ended up dividing the country between those who fight for the early treatment and those in favor of the vaccine,” said researcher Gustavo Cabral, who leads the group at the University of São Paulo that is developing Brazil’s own coronavirus vaccine. This pushed him to join “#TeamHalo” a project spearheaded by the United Nations to spread awareness about how the vaccine hopes to end the pandemic.
Doctors and scientists all over Brazil have signed on to similar campaigns to debunk mistrust around the vaccine. The country needs to react, or things could get much worse, according to Cabral.
“Bolsonaro has sparked an ‘early treatment’ movement online around his unproven kit that gives the anti-vaxxer movement a voice,” Gustavo warns. The researcher believes Brazil's strong history of running successful vaccination efforts is at risk and that is why doctors and scientists all over the country are also joining campaigns to debunk mistrust around the vaccine. "We face the possibility that we won't vaccinate the two thirds of the population that we need to be able to control the pandemic. That is our greatest fear."