Battle Ground Brazil: What is the Country Doing to Curb Record COVID-19 Deaths?

Brazil has the third-largest outbreak of COVID-19 with 8 million cases but is second in fatality rate with 200,000 deaths [1]. With just over 3% of its total population infected, Brazil has a strong interest in the purchase, development, and improvement of tests and vaccines [2].

 

Second Hardest Hit Country

Despite the severity of the problem, the COVID-19 response has been ineffective and filled with political strife. The Bolsonaro administration has repeatedly swapped out the leader of the Ministry of Health in Brazil, and the directorships of ANVISA (the Brazilian Health Authority) have been filled with non-medical experts. Irrespective of all the issues associated with the virus, it is still called “uma gripezinha” (little flu) by President Jair Bolsonaro and his supporters [3].

“Anvisa is being stacked with directors who are allied to Bolsonaro’s denialist and irresponsible stance on public health,” said Alexandre Padilha, a former health minister and leftist federal lawmaker [4].  

While all of this is taking place, there are vaccine candidates from both American and Chinese companies being bought and discussed. The governor of São Paulo, João Doria, has mandated that all 46 million residents of São Paulo take the vaccine (CoronaVac) created by the Chinese company Sinovac [5]. CoronaVac has just recently been shown to be effective against the Coronavirus in Brazilian trials [6].

 

Sinovac Partners with São Paulo Research Institute (Butantan)

It is estimated that the cost will be $10.30 per dose of CoronaVac, for Brazilian state organizations outside of Sao Paulo, which is much cheaper than the price charged by many European and US companies [2].  For companies like Sinovac to supply Brazilian institutions like Butantan, they already have the advantage of only supplying the ingredients for the vaccine. The Federal vaccination plan was presented to the supreme court of Brazil in early December with no start date and only vaccinated 25% of Brazilians whereas Joao Doria’s plan begins on January 25th, 2021. To accomplish this plan, the Butantan institute received 600 liters of CoronaVac raw material on December 3rd and is producing 1 million doses per day [5].

In the same news conference that announced the start date Dimas Covas (Director of Butantan) told the public that the organization is negotiating the potential export of CoronaVac to Peru, Uruguay, Paraguay, Honduras, and Argentina.

“Yes, there are plans. Not only plans but also ongoing negotiations. Butantan, jointly with Sinovac, offered the Ministry of Health 100 million doses until May. In parallel, an additional 40 million were announced for all of Latin America,” stated Covas in a press conference at the institute on Tuesday [5].

The Federal Plan and Federal Friction 

The “gripezinha” aside, the federal government has signed a letter of intent to buy 70 million doses from Pfizer and 100 million doses from AstraZeneca. In total, it says it has lined up 300 million doses via agreements with several manufacturers. Despite this progress, there is conflict over the source of these vaccines and so both private companies and governments are looking to capitalize on the needs of the over 200 million Brazilians [5].

Jair Bolsonaro has said he refuses to buy the Chinese vaccine for a national immunization program. The federal government, taking its lead on the issue, leans heavily towards using American made vaccines. On the other hand, the governor of São Paulo, João Doria, reports that said 11 Brazilian states have contacted Butantan seeking doses of CoronaVac. As a result, there is a political conflict between the federal and many state governments about the necessity of and the source of vaccines. This conflict is ongoing and has only escalated as Doria prepares to run for president in 2022 [5].

In an interview on the popular Brazilian show Roda Viva, three PhDs were interviewed about their thoughts on vaccine production. The first 45 minutes of the program revolved around the use of CoronaVac. When asked about concerns regarding the origins of the vaccine and if it could be trusted, all three replied that the notion of CoronaVac being Chinese is inaccurate. Firstly, the vaccine itself is produced at the Butantan institute and done with raw materials from China, and secondly, that is the case for the vast majority of SARS-CoV-2 vaccines. As such, the concern when someone is talking about a Chinese vaccine is not over the quality of ingredients but ultimately, what company or country one wants to support. Although designed by a Chinese company, CoronaVac is licensed to Butantan and is being produced in Brazil rather than being sold premade [7]

 

“Built in Brazil” – Native Vaccine Production

Amongst the competition, FioCruz (Oswaldo Cruz Foundation) is expecting to produce vaccines for an estimated 130 million people by 2021 by making use of Biomanguinhos (FioCruz’s vaccine production laboratory).  FioCruz is an advanced biotechnological research and production facility run by the government of Brazil. The organization is responsible for the research and production of many of the vaccines used by the federal health system and intends to produce the AstraZeneca vaccine in January [8].

Not only this, but the organization has put 3.4 billion reais (~$700 million) towards the construction of a new biofactory in Rio de Janeiro to accommodate the increased production demands of the pandemic [9] 

Despite the agreement with AstraZeneca and the enthusiasm of the Federal government for that, FioCruz has two proposals for creating its own vaccine. 

One of the proposals under development is a protein subunit vaccine made from the S (spike) and N (one of the core) proteins from SARS-CoV-2. The second proposal developed at FioCruz is a synthetic vaccine identified through computer modeling, which makes use of protein S and N peptides produced through chemical syntheses and attached to synthetic virus-like nanoparticles. Both proposals do not make use of the same production line that will be used for the joint project with AstraZeneca and so the two vaccines could be produced concurrently [10].

Brazil has the knowledge base to develop its own treatments and secure supply deals. State and Federal institutions that existed long before this crisis and its current management are weathering the storm and working to protect the nation and display the scientific chops of Brazil.

By Eduardo Longoria

Related Article: Putting the Bio in Canadian Biomanufacturing

References
  1. Brazil passes 200,000 COVID-19 deaths as cases hit daily record | Reuters
  2. Chinese vaccine made in Brazil draws demand across Latin America, World News & Top Stories – The Straits Times
  3. Bolsonaro diz que covid-19 é uma ‘gripezinha’ e pede volta à normalidade (blastingnews.com)
  4. Bolsonaro turns to military allies to set Brazil’s coronavirus vaccine policy | Reuters
  5. Ministério da Saúde comprará 46 milhões de doses da CoronaVac, diz governador do Piauí (globo.com)
  6. Sinovac coronavirus vaccine effective in Brazil trial, source says – Business Insider
  7. Chinese vaccine draws demand across Latin America, say Brazilian officials | Reuters
  8. (2) Roda Viva | A Corrida da Vacina | 14/12/2020 – YouTube
  9. Fiocruz Expects to Manufacture Vaccine for 130 Million Brazilians in 2021 | The Rio Times (riotimesonline.com)
  10. COVID-19: Fiocruz’s own vaccine may start clinical trials in 2021 | Agência Brazil (ebc.com.br)

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