RIO DE JANEIRO – The chaotic response to the coronavirus in Brazil, which killed more than 105,000 people, made the country's experience a cautionary story that many people around the world have watched with alarm.
But as the number of cases increased in the country, vaccine researchers saw a unique opportunity.
With ongoing, widespread contagion, large numbers of immunization professionals, robust medical manufacturing infrastructure, and thousands of volunteer vaccination trials, Brazil has become a potentially important player in the global fight to end the pandemic.
According to the World Health Organization's Report on Progress in Vaccine Research, three of the most promising and advanced vaccine studies in the world rely on scientists and volunteers in Brazil.
The embattled government hopes its citizens will be among the first in the world to be vaccinated. And medical experts envision the possibility that Brazil could even manufacture the vaccine and export it to neighboring countries, a prospect that fills them with something that has been in short supply this year: pride.
"I'm very optimistic," said Dimas Covas, the director of the Butantane Institute, an internationally renowned biopharmaceutical manufacturer who is working with China's Sinovac on one of the studies that has reached the third stage of research, testing potential vaccines on 9,000 people .
"Brazil will be one of the first countries to receive the vaccine."
Around 5,000 Brazilians were also recruited to support a vaccine study carried out by AstraZeneca, a British-Swedish pharmaceutical company in partnership with Oxford University. Another 1,000 volunteers in Brazil were recruited to test a vaccine developed by New York-based Pfizer.
Researchers need countries with sufficiently large outbreaks to be able to assess whether a vaccine is working. Some volunteers will receive the potential vaccine while others will receive a placebo. However, you need to be in a place where enough virus is circulating to test the vaccine's effectiveness.
Brazil, where the virus has infected more than three million people, has clear terms for these trials. And it will be the only country other than the United States to feature prominently in three of the leading studies, as an unprecedented search for a vaccine has resulted in unusually rapid regulatory approvals and hastily brokered partnerships.
However, according to experts, it is far from certain that the vaccine trials under way in Brazil will win the race.
Countries around the world are trying to be among the first to gain access to a vaccine that is in demand by billions of people. In India, one of the richest families in the country is attempting to mass-produce the Oxford vaccine in hopes that it will be the first to overcome safety and regulatory hurdles.
Russia this week approved a homemade vaccine that has not yet passed final tests for safety and effectiveness. If it works, it could enable the country to claim it developed the world's first effective coronavirus vaccine.
Brazil's explosive drop load has made it the second most affected nation in the world after the US. While other countries in the region have higher per capita rates, experts have attacked President Jair Bolsonaro's careless handling of the crisis.
The president, who caught the virus in July, has called it a "bad flu" and sabotaged requests for quarantine and lockdown. He also appointed an army general with no medical experience to head the Ministry of Health after two ministers clashed with the president over his contempt for science-based approaches.
Due to the country's disorganized response to the virus, Brazilians have been banned from traveling, neighbors militarized border crossings, and unions representing medical workers recently asked the International Criminal Court to charge Mr Bolsonaro with crimes against humanity on the grounds that he gave so virus free.
Brazil has a universal public health system with one of the best vaccination programs in developing countries that has made it possible to contain outbreaks of yellow fever, measles and other pathogens.
In recent years, when the economy has shrunk, the program has suffered from budget cuts. It also had to tackle disinformation campaigns that have found enthusiastic audiences on social media.
For the first time in 25 years, Brazil did not meet its vaccination target for any of the routinely administered shots in 2019.
A coronavirus breakthrough could give the country's vaccine sector a boost. It could also strengthen its scientific facilities, which employ world-class scientists but are on the verge of faltering after years of budget cuts that have weakened the public health system and damaged the country's reputation as a research powerhouse.
Katherine O'Brien, Director of Vaccinations at the World Health Organization, welcomed Brazil's investment in manufacturing vaccines against Covid-19, the disease caused by the virus. But she said bilateral deals like the one Brazil is involved in are still a gamble.
"Some countries will be lucky enough to have contracts with a candidate who will demonstrate effectiveness," said Dr. O & # 39; Brien. "Other countries will do deals with candidates who will fail and get nothing."
Brazil has a population of around 210 million and can produce around 500 million vaccines annually. Under the current coronavirus vaccine agreements, in which Brazil is a party, Brazilian vaccine factories would first handle the final phases of vaccine production after importing the raw materials and then produce them in full.
Brazil signed two contracts to get preferential access to a vaccine. One between São Paulo State's Butantane Institute and Sinovac would provide Brazilians with 120 million doses of the vaccine by early 2021. The second between the federal government's Bio-Manguinhos and AstraZeneca guarantees access to 100 million doses of the vaccine through early next year.
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- Many schools are unlikely to return to a normal schedule this fall, which will require online learning, makeshift childcare, and stunted work days to continue. California's two largest public school districts – Los Angeles and San Diego – announced on July 13 that classes will only be held remotely this fall, citing concerns that the rise in coronavirus infections in their areas is too great Poses risk to students and teachers. Together, the two districts enroll around 825,000 students. They are the largest to date in the country, abandoning plans for a partial physical return to classrooms when they reopen in August. For other districts, the solution is not an all-or-nothing approach. Many systems, including the largest in the country, New York City, are developing hybrid plans where some days are spent in classrooms and some days online. There is still no national guideline on this. Therefore, check regularly with your city school system about what is going on in your community.
Both deals include a technology transfer agreement that would allow Brazil to manufacture vaccines at a later date. Government officials hope to start vaccinating some Brazilians in the first semester of 2021. However, an exact date will depend on the results of ongoing studies and a future approval process with the local regulatory authority.
Carla Domingues, an epidemiologist who ran the country's vaccination program until last year, said disinformation campaigns about vaccination had hampered efforts to protect people from HPV, a sexually transmitted infection.
"Unfortunately, that trend that we've seen in other countries for many years is now here in Brazil," she said. "And we haven't been able to turn it around."
Recruiting volunteers for the ongoing studies in Brazil wasn't a challenge, however, said Soraya Smaili, president of the Federal University of São Paulo, who is involved in the AstraZeneca and Oxford study.
"It wasn't difficult to find volunteers," she said. “People have moved forward and everyone wants to be part of the solution. This was a nice social move. "
Denise Abranches, a dentist who spent months treating coronavirus patients with mouth pain in intensive care units, was one of the first to volunteer for a vaccine. She said her only fear was not to be in line early enough to get a shot.
"I see this as a way for us to regain leadership," she said in the global scientific community. "The world is looking for answers and this is a vaccine that could help anyone in the world."
Maurício Zuma, the director of Bio-Manguinhos, one of the manufacturers that plans to make Covid-19 vaccines in Brazil, said after the country met its internal demand, he hoped to export vials to neighboring countries, which are also facing major problems case numbers would have to fight.
"Our intention is to participate in a solidarity movement," he said. "If we can make the vaccine here and get a surplus, we will of course make sure that it is used in other Latin American countries."
As researchers celebrate Brazil's role in the global vaccination race, they have also felt compelled to remind citizens that the good news won't single-handedly end the suffering the virus has caused in the country.
"You shouldn't assume that it is and you're done," said Maria Elena Bottazzi, vaccine developer at Baylor College of Medicine. "Brazil still has a lot to do to strengthen its public health infrastructure and reduce the transmission of the virus."