Matters have deteriorated considerably since the emergence of a new and more contagious variant in the country, known as P1. The death toll in Brazil has been rising relentlessly, reaching 4,250 on April 8 – the highest number of daily fatalities from the disease on Earth.
The health system has collapsed in numerous cities. There, oxygen supplies are rationed, ICU beds are fully occupied, and both staff and equipment are lacking.
There are reports of patients being tied up in order to be intubated, for want of anaesthetics. Hundreds have died on trolleys, hospital floors or at home, even when their families could procure much-needed oxygen tubes in the parallel market.
Three factors have converged to create this living hell.
First, Brazil is one of the most unequal countries on Earth, and deep and overlapping inequalities have created vulnerabilities among disadvantaged populations. These vulnerabilities have become more entrenched since 2016, when president Dilma Rousseff was removed from office in an impeachment that amounted to a parliamentary coup d'état.
The pandemic provides further evidence of the country’s inequality: COVID-19 disproportionately affects black Brazilians, the poor and the unemployed.
Second, Brazil has always suffered from acute political and institutional limitations, which have gotten worse since Rousseff was ejected from office. The two governments since 2016 have sponsored neoliberal reforms that increased labour precarity, eroded social security, and left public services dramatically underfunded. These reforms were underpinned by a constitutional amendment, which froze non-financial expenditures of the federal government in real terms for 20 years.
The new fiscal regime has legitimised brutal funding cuts in the name of an arbitrary fiscal rule. Brazil’s universal health system, inspired by the British NHS, has been degraded in recent years under this programme of austerity.