How Brazil gambled on unproven drugs to fight Covid-19

Brazilian President Jair Bolsonaro has long been a champion of drugs chloroquine and hydroxychloroquine to cure Covid-19, despite multiple studies that show that they are not effective. Now, documents show that his government spent emergency funds on the medicines and continued to produce and distribute them at unprecedented rates throughout 2020 while rejecting at least one offer to purchase a vaccine already in the final stage of trials because the terms were “abusive.”After repeatedly promoting the potential for chloroquine and hydroxychloroquine to both prevent and mitigate the effects of Covid-19, Bolsonaro himself tested positive last July. “If I had taken hydroxychloroquine as a preventative measure, I would still be working,” he said, even though the drug, most commonly used against malaria, had not actually been proven effective against the coronavirus and the World Health Organization (WHO) had discontinued a major trial with hydroxychloroquine.While in quarantine he posted a video on social media showing him taking what he said was his third dose of hydroxychloroquine.”I’m feeling really good. I was feeling so-so on Sunday, bad on Monday. Today Tuesday, I’m feeling much better than Saturday, so without a doubt,” he said as he held up a pill and then swallowed it. “It’s working.”Just last week, Bolsonaro ​again admitted that he could be proven wrong and that the drug might not have any impact on the coronavirus, but added “at least I didn’t kill anyone. Now, if by chance, it proves to be effective down the road, those of you who criticized, part of the media, you will be held accountable.”According to exclusive documents obtained by CNN affiliate CNN Brasil, Bolsonaro was not only talking up the drugs last year, his government was actively using emergency funds designated to combat the Covid-19 pandemic to purchase and distribute them even after they had been shown to be ineffective.In the same month, Brazil received a letter from the Pfizer CEO Albert Bourla urging the country to sign a contract to buy 70 million doses of its Covid-19 vaccine ​and offering to meet with the government. Pfizer was already in late stage trials with its vaccine at this time. CNN Brasil first reported on the existence of the letter last month. It was sent to Bolsonaro and several cabinet ministers on Sept. 12, when the death toll in Brazil was already the second-highest in the world at 131,000 and the number of confirmed cases was 4.3 million.But negotiations with Pfizer sputtered and did not end in an agreement. News of the letter sparked anger when it emerged last month as the government scrambled to roll out a vaccine program.Brazil’s Health Ministry responded to CNN Brasil saying the terms of the offer, which included an agreement not to hold Pfizer responsible for negative side effects, were “abusive.” The ministry said it was also concerned about the small number of doses being offered in the first lot: 500,000, but added that negotiations were still ongoing.Pfizer declined to comment.When Brazil finally launched its national vaccination program on January 18 after repeated delays, it started with just six million doses for a population of more than 210 million.Bolsonaro’s government had bet on the Oxford/AstraZeneca vaccine as the centerpiece of its program. But due to delays, they eventually turned to CoronaVac, the vaccine developed by China’s Sinovac and tested in Brazil in a partnership with the governor of Sao Paulo state, who also happens to be Bolsonaro’s political nemesis.So far, 2.2 percent of the population has received a first dose ​of the two-dose regimen required by both the CoronaVac and Oxford/AstraZeneca vaccines.But even as authorities started to roll out vaccines in January, the government continued to promote chloroquine as a treatment on its apps and in the protocol which had not been updated since it was posted last May and where it was ​characterized as a key component of ‘early treatment.’When asked why the ministry was still recommending the drug, Health Minister Eduardo Pazuello told journalists last month ​that he had never recommended a specific drug. “We defend, encourage and orient sick people to immediately go to their health clinic, to a doctor, and the doctor will make a clinical diagnosis of the patient. What medicines the doctor prescribes, that is a private domain with the patient.”Bolsonaro appointed Pazuello, an army general, when his second health minister quit after declining to issue federal guidelines for the use of hydroxychloroquine and chloroquine in the treatment of Covid-19.”I was elected to make decisions and the decision about chloroquine goes through me,” Bolsonaro declared last May. The following day, Nelson Teich resigned. His replacement, Pazuello, issued the guidelines.

Jose Brito is an investigative journalist at CNN Brasil 

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