He said vaccination campaigns for diseases like polio, measles, whooping cough, tetanus, meningitis and H1N1 are effective. The government’s Family Allowance scheme, which gives a basic income to poorer families, is conditional on children being vaccinated and attending school. And he praised Brazil’s use of health agents from its public healthcare system, who visit homes and supply information about vaccines, healthy eating, and healthcare.
“This one of the most relevant things in health practice,” Ferreira said.
But policy can be patchy and inconsistent. This year, vaccination failures helped a sylvatic yellow fever outbreak spread from remote rural areas of Minas Gerais state where vaccinations were recommended but had not been done, even though Brazil sees cyclical outbreaks of the disease. Since January there have been 797 confirmed cases and 275 deaths.
An outbreak of the Zika virus in 2015-2016 was blamed for an explosion of cases of the birth defect microcephaly. A mass mobilization involving the army focused on the dangers of leaving still water around – breeding sites for the Aedes Aegypti mosquito that spreads Zika, as well as Dengue and Chikungunya. The Zika public health emergency has been officially declared over. But plans to start distributing free mosquito repellent free to pregnant women receiving the Family Allowance benefit, announced in January 2016, only began in March 2017.
“Our investment in public health in Brazil is inadequate, so the response to these problems is always less than we would hope,” Ferreira said.
Brazil faced a potential AIDS epidemic in the 1980s and 1990s, which it faced down with extensive education campaigns promoting condom use and free combination antiretroviral drugs given to all AIDS patients. The country produced generic versions of antiretroviral drugs and haggled down prices of expensive imports, an important factor, a 2006 study by the New England Journal of Medicine found.
“We have had various successes,” said Gabriel Andreuccetti, a research associate in epidemiology at the Department of Preventive Medicine at the University of Sao Paulo’s Medical School.