The importance of science and public policy in Brazil’s Covid-19 fight

and . May 26, 2020
The importance of science and public policy in Brazil's Covid-19 fight Photo: Take Photo/Shutterstock

Overcoming Covid-19 in Brazil is as much a matter of public policy as it is a medical and scientific endeavor. The same could be said for any country and almost all diseases, even those that have yet to be discovered. It is understandable that we, as a society, forget how much public policy and science affect our daily lives. Both can be confusing, take years to implement, and are often conducted behind closed doors. Appreciating how much the two are interdependent is equally elusive.

But the Covid-19 pandemic is shedding new light on this important relationship.

</p> <p>Our health and our lives are dependent on scientific advances. Without science, we would never have discovered vaccines, treatments, or understood the healthy behaviors that prevent sickness and cure disease. Without the best-trained scientists or the investment in the education, infrastructure, and global exchange of scientific discoveries, Brazil would not have access to the latest medical advances, data, or the knowledge to translate such advances to the patient’s bedside. Hospitals would be useless without well-trained doctors and nurses. And these in turn would be useless without medicines, medical equipment, and practices. Policy decisions directly impact the resources for all the above.&nbsp;&nbsp;</p> <p>The safety of the water we drink, the food we eat, the air we breathe, and education about the healthy lifestyle we should all live are dependent on good science. But, the evidence behind this knowledge would be useless unless policymakers — read, elected and appointed officials — put it into practice. In the words of Dr. Marcia Fournier, President of Dimensions Sciences, “The translation of advancements in science to the public is highly dependent on policy and legislation to enable it.”</p> <h2>Covid-19 requires public policy in Brazil</h2> <p>We see this in the Brazilian government’s current response to Covid-19. Epidemiologists know that physical distancing will prevent the spread of the virus. We know that testing vulnerable populations will allow the government to make informed policy decisions about opening or closing business, where to allocate limited medical resources, and how much protective equipment must be procured and deployed to where it is needed most.&nbsp;&nbsp;</p> <p>The tests that are being invented in rapid speed are dependent on the research by Brazilian scientists that <a href="">mapped the genome of the coronavirus</a>. This research was dependent on the education of the scientists, received in Brazil and abroad. That education was dependent on the financial investments made years ago in Brazilian universities and the primary educational systems before that. The relationship here between science and policy decisions is symbiotic, and so is the relationship between the health of a nation and the wealth of a nation. In that order.</p> <p>A recent economic decision by the Brazilian government to waive import duties and other taxes will allow the free flow of medicines, protective gear, and devices to meet local demand. This smart measure will ensure faster procurement and distribution of much needed medical equipment. According to Brazil-based international trade experts Sidera Consult, import duties on medical devices and other hospital products were <a href="">temporarily reduced to zero percent</a>, cutting the price significantly for final users. Good news, and good policy.</p> <p>Elected officials — chiefly the president — can model and influence public behavior. Legislated public policies won’t work alone without the cheerleader effect of the executive and political leaders. In the absence of this support, compliance with laws can wither on the vine. In a 2009 report, the Lancet Medical Journal wrote “the challenge is ultimately political, requiring continuous engagement by Brazilian society as a whole to secure the right to health for all Brazilians.” It’s not a stretch to say that just as many decisions about our health are made by our legislators than by our own doctors.</p> <h2>Brazil using policy to fight disease</h2> <p>Covid-19 is the current crisis, but Brazil is no stranger to pandemics. Zika, HIV-AIDS, chikungunya, dengue fever, measles, and yellow fever are not just diseases we read about in history books, they are real today. Scientific discovery and subsequent promulgation of effective public policies are critical to managing these public health crises as well.</p> <p>HIV-AIDS is a <a href="">prime example</a>. Brazil is frequently cited as a model of success for its management of the pandemic. While the medical and scientific community was scrambling to get ahead of the curve or flatten it, the Brazilian government quickly passed legislation providing universal provision of free antiretroviral drugs and progressive social policies toward risk groups. Here, once more, science and public policy were complementary.&nbsp;&nbsp;</p> <p>The list of public health issues and enabling public policies to address them is too long for this article. But, one only needs to consider the positive impact that comprehensive tobacco control policies had in Brazil to appreciate the partnership between policy and science. Tobacco harms the health, the treasury, and the spirit of Brazil. According to the American Cancer Society’s Cancer Atlas, the <a href="">rate of smoking by males</a> in Brazil dropped to 15.4 percent in 2015, a dramatic decrease from ten years prior, when it sat at 20.4 percent. We can credit the federal political decisions to ban indoor smoking and regulate advertising. Nevertheless, more must be done.</p> <p>The science and related policies behind cancer control is also compelling. Some cancers are preventable with certain vaccines (HPV, HBV) and by changing our behavior. Others are treatable with early detection and treatment. In 2019, Brazil enacted the “<a href="">60-day law</a>” that requires the public health system to initiate treatment for all cancer patients within 60 days of their diagnosis. While this law is too new to evaluate, science tells us that early detection of many cancers results in longer survivorship and in many cases, control of cancer.&nbsp;&nbsp;</p> <p>In the words of Dr. Louis Pasteur, the famed French microbiologist, chemist, and pioneer of the germ theory of disease, “chance favors the prepared mind.” The same can be said for the wonderful country of Brazil. It will require a healthy partnership between science and public policy to make it happen. We can’t deny it.

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Bob Chapman

Bob Chapman is the co-founder of Dimensions Sciences, a non-profit organization that works to foster minority inclusion in scientific environments. He has worked with public policy and grassroots advocacy for over 25 years.

Maira Caleffi

Maira Caleffi leads the Breast Health Service of Moinhos de Vento Hospital in Porto Alegre. She also serves as chair of the Executive Committee of the City Cancer Challenge and of FEMAMA, a nationwide coalition of women's cancer NGOs in Brazil

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