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What the US can learn from a successful vaccination campaign against COVID in Brazil

What the US can learn from a successful vaccination campaign against COVID in Brazil

During the COVID-19 media pandemic, health experts and scientists explained the division of COVID-19 vaccines in the United States as guerrilla, educational, racial or socio-economic. As of now, a common US adult vaccination rate for several months fluctuates about 65 percent. But this division may return to the founding ideals of democracy in the United States: Americans are simply not used to expecting much from their government.

Vaccination of each depends not only on the availability of vaccines; it depends on the health infrastructure woven into the fabric of society. If preventing further pandemics is indeed the goal of the U.S. public health system, then instead of investing in private health care and subsidizing private research to develop vaccines, the U.S. should invest in health care systems and develop strategies to incorporate social rights into principles its democracy.

Brazil, our homeland, is a prime example of how this can be done and how the adoption of a vaccine can become a matter of course.

In July 2021, a group of drug traffickers approached the staff of a public vaccination point in a Rio de Janeiro slum called Mare. Our friend, who works in Mare, shared a story: armed with guns, drug dealers demanded to be vaccinated against COVID-19, although at that time in Rio only people over 50 were vaccinated (most drug traffickers are teenagers or 20 years old).

“We know there is this Delta option, and we want to be protected,” they told vaccination staff, who had no choice but to vaccinate everyone.

At first, the desire of drug traffickers to vaccinate may seem strange, but the truth is that Brazilians from all walks of life welcome vaccines as a public health right. In 2020, during the H1N1 pandemic, for example, Brazil vaccinated more people than in any other country. Citizens are accustomed to standing in lines at state health centers for routine vaccinations, despite the anti-wax rate of its president, Jair Bolsonar.

Although vaccines against COVID-19 are slowly arriving in Brazil, as of March 2022. almost 100 percent of the adult population in Rio and Sao Paulo fully vaccinated. This is a stark difference from the US. In New York, one of the most vaccinated cities, 78.2 percent of the adult population received two doses, although there is no shortage of vaccines. Brazil has about two-thirds of the U.S. population, but in November 2021. Brazil is ahead of the United States. in a proportion of its population that is fully vaccinated. And this gap continues to increase.

The reason why most Brazilians take vaccines, and about a quarter of Americans oppose them, is deeply rooted in how these two democracies have evolved.

Since the 19th century, political scientists such as Alexis de Tocqueville have noted a decentralized democratic structure in the United States that has pushed the role of the state to the periphery and relied heavily on associations among civil society. During the formation of the United States, the emphasis was on civil and political rights with an emphasis on freedom and individual liberty.

While Brazil is also a democracy and a federation, with its own political associations, Brazil’s political history emphasizes the role of the state in ensuring social rights. In short, Brazilians expect medical and other services to come from the government. Even before the adoption of the current 1988 constitution, which established health as a human right, previous governments had provided labor rights and social security for all in the country.

The development of the Brazilian democratic process has created the infrastructure for a free nationwide health care system. This, in turn, has supported people taking top-down health measures – even among drug traffickers. Even though this system is often shaky and threatened with dismantling by the Bolsonar government, people still expect the government to provide free health care. This is very different from the US, where state-funded health care focuses mainly on people living below the poverty line and the elderly.

Many years ago, when one of us (Arauha) worked as a teacher in the Vidigal slums in Rio, his students shared stories of visiting a health center to greet a doctor on the way to school. This daily interaction has created a trusting relationship. When someone felt bad, they didn’t hesitate to ask for help; help was within their community. This trust in the health care system has now evolved into public recognition of COVID-19 vaccines.

These health care providers are part of SUS, Brazil’s public health system, established in 1988 as a human right with the intention of serving everyone in the country. The service, which includes a decentralized network of providers including doctors, hospitals and emergency centers, is free. Most favelas and low-income populations in Brazil are completely dependent on SUS for health care, and many middle-class citizens use SUS for routine vaccinations and emergency care.

SUS is not perfect. Public hospitals, for example, deal with a lack of funding and long queues for treatment. But everyone has access to basic health care. SUS providers represent an ongoing institution and are often themselves members of the community. More than an inconvenient step to obtain a prescription, SUS providers are trusted liaisons, connecting community members with health researchers, government officials and local interventions.

There is no such system in the United States. For many Americans, regular health care is not financially available. Half of Americans have medical debts– and the government has no role in providing access to health care. Healthcare is obviously a luxury, not a right.

For months during this pandemic it was clear that vaccine adoption was not only a scientific problem but also a health and communication problem. However, it was less clear how the adoption of health measures is deeply rooted in the historical political process of each country. We cannot change history, but we can learn from it to make policy changes that improve people’s lives.

This is an article of opinion and analysis, and opinions expressed by the author or authors are not necessarily opinions Scientific American.

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