The Washington PostDemocracy Dies in Darkness

Brazil’s unexpected plan to vaccinate the homeless, prisoners and descendants of enslaved Africans first is coming undone

May 9, 2021 at 10:05 a.m. EDT
The quilombo of Santa Rita do Bracuí, once a tranquil traditional community along the Atlantic Ocean, has been overrun by land speculation and irregular housing. (Terrence McCoy/The Washington Post)
correction

A previous version of this article misstated the number of Brazilians who have received coronavirus vaccines. More than 35 million Brazilians have received at least one shot. The article has been corrected.

ANGRA DOS REIS, Brazil — After a lifetime of feeling invisible, the family was told they’d suddenly become one of Brazil’s top priorities. As the country began rolling out coronavirus vaccines early this year, officials said communities like theirs, founded by Africans who escaped slavery, would be among the first to receive shots.

But then weeks passed, the vaccines never came and one day late last month, the phone rang. The voice was faint, but the words were clear: “He’s dead.”

“For the love of God,” Maria Lucia de Morais responded. “How could this have happened?”

Delays in the vaccination rollout had left her 70-year-old cousin defenseless against the virus that has devastated Brazil. Within four days of his hospital admission, he was dead.

Now de Morais views his death as the result of one more broken promise Brazil has made to the people of the historic Black villages known as quilombos.

“There is a gap between the commitment and the action,” de Morais said. “We feel like we don’t have rights to anything.”

Earlier this year, in recognition of the extraordinary and historic inequalities etched into Brazil, the federal government released a vaccination plan that prioritized people in what it called situations of “elevated social vulnerability.” Indigenous people, quilombo residents, the homeless and the incarcerated: In a reversal of the everyday social hierarchy, they would join health-care workers and the very elderly at the front of the vaccination line.

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But months into Brazil’s beleaguered vaccination campaign, and amid record death numbers, the government is struggling to keep that commitment. More than 35 million people have gotten at least one vaccine dose. Nearly 11 percent of Brazilians have received two. But research shows only 1 percent of quilombo residents have similarly been fully vaccinated. Rates are higher in Indigenous villages, where roughly half have been fully vaccinated, but are lower still among homeless and incarcerated people. Brazil’s overcrowded prisons are crammed with nearly 754,000 inmates. But only 1,000 vaccine doses have been administered to what the government calls a priority group.

The sluggishness in the campaign has undercut the predictions the government made in its national vaccination plan, which said some vulnerable groups were so small that officials shouldn’t have to stagger vaccinations.

“It’s a situation of chaos,” said Felipe Freitas, a researcher with the Observatory of Crisis Human Rights and Covid-19. “There is a lack of vaccines, a lack of planning, a lack of logistics and a lack of specialized teams to get the vaccines to these priority groups.”

Brazil’s health ministry, which created and is carrying out the country’s national vaccination plan, didn’t respond to repeated requests for comment.

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The struggles have underscored Brazil’s broader failure to secure enough vaccines to control a disease that has killed more than 421,000 people, the largest toll outside the United States. Rather than purchase millions of doses of Pfizer last year when it had the chance, the federal government bought ineffective medications and placed heavy bets on vaccine doses it has struggled to produce or import on a mass level. Nearly every day seems to bring another government prediction of a vaccine delivery, only for it to be downscaled, delayed or scuttled completely.

The result: Months after the first Brazilian was immunized, vaccination remains a maddening waiting game not only for the vast majority of Brazilians, but for the many promised priority access. This, in a country that inoculated 10 million people against polio in a single day and has won international acclaim for its vaccination programs.

“When there isn’t enough of the vaccine, you can’t reach your goals,” said Guilherme Werneck, an epidemiologist who has been tracking priority groups. “You could vaccinate 1 to 2 million people per day in Brazil, but there isn’t the vaccine for that.”

The failures to vaccinate the vulnerable have exposed their historic marginalization. Informal, impoverished communities have always been a part of the Brazilian landscape — climbing up mountainsides, tucked into forests, often beyond the reach or interest of government agencies. So when the time came to start vaccinating people in harder-to-access communities, researchers and advocates say, the government didn’t have the data it needed. People of Indigenous and quilombola communities are often transient, passing in and out of rural and urban settings. Finding them, let alone confirming their eligibility, has become a challenge.

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“People older than 80 years old, for example, are very easy to find,” Werneck said. “It’s a very specific target, easily prioritized, and easy to confirm eligibility. But going to other subgroups defined by different criteria — things become more complicated.”

“There’s no policy to map these populations, which aren’t very large, but are very spread out across remote areas,” he said. “To be prioritized on paper doesn’t mean the same thing as to be prioritized in practice.”

In the stunning oceanside city of Angra dos Reis, 100 miles from Rio de Janeiro on Brazil’s southeastern coast, more than 90 percent of people over 60 — nearly 24,000 people — have received at least one vaccine dose. But only a small fraction of the city’s vibrant quilombola community — 147 people — has had an immunization.

The community’s size is unclear. The federal government estimates there are more than 4,200 members. Community leaders say it’s around 600. The city didn’t respond to emailed questions asking why it has struggled to inoculate the priority group.

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In the uncertainty, quilombo leader Emerson Luís Ramos, 35, has perceived a pattern of discrimination: “They’ve always tried to deny our existence.”

The history of his community, called the Quilombo de Santa Rita do Bracuí, is one of slavery and dispossession. At the end of the 19th century, as Brazil was becoming the last country in the Americas to end slavery, a coffee baron named José Joaquim de Souza Breves left behind large tracts of the land along the coast to the Africans he had enslaved. But in the 1970s, amid the military dictatorship’s frenetic quest to develop the vast country, a new highway cleaved their territory in two, bringing with it unregulated real estate speculation and land grabbing.

“After a long period of land conflicts, the Quilombos de Santa Rita do Bracuí lost a considerable part of their ancestors’ territory, above all lands along the sea,” one federal prosecutor wrote in his recommendation last year that the community receive land rights. “The slowness of the state has only encouraged more conflicts, which was unacceptable.”

Residents of the quilombo said they once worried that state inaction would cost them their land. Now they fear it could cost them their lives.

So Ramos, who has received the first dose of the AstraZeneca vaccine but not the second, has gone into the community to learn how many people need the vaccines.

“I’m doing the work the state should be doing: putting families on the map, going door to door. It’s humiliating,” he said. “It’s frustrating that, in 2021, we are living this way. The state has a historic debt with us.”

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And now his journey was taking him up another steep, unpaved hill to visit one more family. At the top of the impoverished community, Maria Lucia de Morais and her husband, Benedito Nunes de Morais, 56, emerged from their squat home, put on masks and sat down to look out at the sea below. Neither had received a dose of the vaccine, a source of great frustration.

“The Indians have been vaccinated,” Benedito said. “What’s the difference between an Indian and someone of the quilombo?”

“I’m scared,” said de Morais. “I’m scared every day.”

“We’re all scared,” Ramos told her. “We are seeing people who are dying who didn’t need to die. I don’t know how we much more we can wait.”

Read more:

Brazil has become South America’s superspreader event

Mexico is vaccinating its poorest citizens first — against the advice of health experts

Exasperated Canadians watch Americans getting vaccinated faster

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