Sidelining experts, Brazil bungled its immunization plans

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RIO DE JANEIRO (AP) – Like many Brazilian public health experts, Dr Regina Flauzino has spent most of 2020 watching in horror as COVID-19 devastated Brazil. When the opportunity to join the government’s vaccination effort arose, she was elated: she would be able to share her decades of experience in the field.

But his excitement quickly died down. Flauzino, an epidemiologist who has worked on Brazilian vaccination campaigns for 20 years, became frustrated with what she described as a rushed and chaotic process.

The government has yet to approve a single vaccine, and health ministry officials have ignored advice from outside experts. Soon after the government presented its vaccination plan, more than a quarter of the 140 or so experts involved called for their names to be cut.

“We weren’t listened to,” Flauzino told The Associated Press. The creation of the plan “has been postponed too long and now it is rushed.

Brazil has suffered more than 200,000 deaths from COVID-19, the second highest total in the world after the United States, with infections and deaths rising again. Despite a half-century of successful immunization programs, the federal government lags behind its regional and global peers in both vaccine approval and the development of an immunization strategy.

The AP interviewed four members of the expert committee and four former officials of the Ministry of Health. They criticized the government’s unwarranted delay in formulating a vaccination plan, as well as the months spent on a single vaccine maker.

They also complained that President Jair Bolsonaro has undermined the effectiveness of the ministry, highlighting the withdrawal of highly qualified professionals from senior positions, who have been replaced by appointed military personnel with little or no public health experience. . Experts also accused the president, a former captain of the far-right army, of fueling anti-vaccine sentiment in Brazil, undermining the mass vaccination effort.

‘STILL WAITING’

The government’s COVID-19 vaccination plan, finally released on December 16, lacked essential details: How many doses would be sent to each state and how would they be refrigerated and delivered? How many professionals would it take to hire and train – and, most importantly, how much funding would governors receive to run the campaign? The plan did not include a start date.

“How is each state going to organize its campaign if it does not know how many doses it will receive and the delivery schedule?” said Dr Carla Domingues, an epidemiologist who oversaw the logistics of the H1N1 vaccination campaign in Brazil in 2009, and worked on more than a dozen other vaccination efforts.

Bolsonaro’s press office and the health ministry did not respond to PA requests for comment on Brazil’s immunization campaign or why other contracts with vaccine manufacturers have failed. not signed in 2020.

The Ministry of Health’s national immunization program has a long history of success. Created over 40 years ago, it has enabled Brazil to eradicate polio and significantly reduce measles, rubella, tetanus and diphtheria. This effort has been recognized by UNICEF for reaching the most remote corners of the country and has helped increase the life expectancy of Brazilians from 60 to over 75 years.

The program “is the central focus of all vaccination campaigns in the country,” said Flauzino.

This is no small task in a country of 210 million people, the sixth largest population in the world. The program provides a complex plan for immunization campaigns in more than 5,500 municipalities in 26 states and the Federal District.

In a December 1 …

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