The Far-Right Takeover in Brazil: Effects on the Health Agenda

• Author: Maíra S. Fedatto
• DOI: http://doi.org/10.1177/0094582X221149026
• Published date: 01 January 2023
• Date: 01 January 2023
• Subject Matter: Articles

https://doi.org/10.1177/0094582X221149026

LATIN AMERICAN PERSPECTIVES, Issue 248, Vol. 50 No. 1, January 2023, 133–148

DOI: 10.1177/0094582X221149026

© 2023 Latin American Perspectives

133

The Far-Right Takeover in Brazil

Effects on the Health Agenda

by

Maíra S. Fedatto

On October 28, 2018, the far-right populist Jair Bolsonaro won Brazilian elections

against the Partido dos Trabalhadores (Workers’ Party—PT) candidate Fernando Haddad

after a vigorous social-media campaign reinforced by fake news. In a context of economic

crisis, escalating violence, and corruption scandals and a polarized population, Bolsonaro’s

authoritarian inclinations and reactionary rhetoric were concerns from several perspec-

tives, mainly regarding the environment, education, human rights, health, and even the

young Brazilian democracy. In particular, the Mais Médicos program, the national drug

policy, and the HIV/AIDS Department have all been negatively influenced by his anti-

communist rhetoric and the alarming escalation of evangelical conservatism. The milita-

rization of his supporters in terms of moral values challenges the future of the secular state

and therefore its substantial gains in international cooperation for health. With his

approval rate falling and an international health crisis under way, Bolsonaro may not have

an easy path ahead of him, and neither will the Brazilian population.

No dia 28 de outubro de 2018, o populista da extrema direita, Jair Bolsonaro, ganhou

as eleições contra o candidato do Partido dos Trabalhadores (PT), Fernando Haddad,

depois uma campanha enérgica baseada em redes sociais e reforçada por notícias falsas.

Num âmbito que inclui uma crise econômica, uma escalada de violência, escândalos de

corrupção e uma população polarizada, as tendências autoritárias e retórica reacionária de

Bolsonaro apresentam desafios com respeito a muitos temas como o meio ambiente, a edu-

cação, direitos humanos, a saúde, e mesmo a democracia jovem do Brasil. O programa

Mais Médicos, a política antidrogas e o Departamento de VIH/Sida, em particular, foram

negativamente influenciados pela retórica anticomunista e pela alarmante expansão do

conservadorismo evangélico. A militarização dos seguidores de Bolsonaro em termos de

valores morais ameaça o futuro do estado secular e, por conseguinte, seus ganhos signifi-

cativos na área de cooperação internacional com relação à saúde. Com sua índice de

aprovação em declínio e uma crise internacional de saúde que está atualmente em curso,

não podendo ser fácil para Bolsonaro e nem para a população brasileira nos anos a seguir.

Keywords: Brazil, Health, Bolsonaro, HIV/AIDS, Drug policy

Health and international relations have been predominantly distinct aca-

demic fields and policy arenas, but in recent years health has increasingly

become a subject studied by experts in international relations and political

Maíra S. Fedatto is a global health researcher and consultant. She holds a joint Ph.D. in international

relations from King’s College London and the Universidade de São Paulo and a Master’s from the

Universidade de Brasília. She has been a specialized consultant for UNESCO and a researcher for

the Núcleo de Estudos sobre Bioética e Diplomacia em Saúde (NETHIS/FIOCRUZ/PAHO).

1149026LAPXXX10.1177/0094582X221149026Latin American PerspectivesFedatto/THE FAR-RIGHT TAKEOVER AND THE HEALTH AGENDA

research-article2023

134 LATIN AMERICAN PERSPECTIVES

science. Throughout history, health studies adopted an epidemiological

approach while international relations were mainly dominated by concerns

about war and peace that reflected security-focused foreign agendas. The

undeniable importance of the social and economic determinants of health1

and awareness of the key role of collective action against disease and improve-

ments in health have developed research and practice accordingly. Health has

therefore begun to be seen as part of foreign policy. In 2007, for example, the

foreign ministers of Brazil, France, Indonesia, Norway, Senegal, South Africa,

and Thailand launched the Oslo Ministerial Declaration on global health.

Because of the perception that global health should have a strategic place on

the international agenda, 10 priority areas were chosen: preparedness and

foreign policy, control of emerging infectious diseases and foreign policy,

human resources for health and foreign policy, conflict, natural disasters and

other crises, response to HIV/AIDS, health and the environment, health and

development, trade policies and measures to implement and monitor agree-

ments, and governance for global health security (Amorim etal., 2007).

With regard to Brazil, in the past 20 years, health has turned into a central

and strategic topic for international relations and diplomacy, predominantly

under Luiz Inácio Lula da Silva’s governments (2003–2010). By promoting in

multilateral forums positions such as access to medicine as a human right and

social inclusion, Brazil has sought to strengthen in the international sphere

principles that underlie the constitutional right to health. Since 1988 the

Brazilian constitution has enshrined health as a citizens’ right and given rise to

a public, universal, and decentralized health system, the Sistema Único de

Saúde (SUS). Massuda etal. (2018) point out that the system was conceived by

civil society as part of the health reform movement and played a key role in the

redemocratization of Brazil and the reinstatement of citizens’ rights after 21

years of military dictatorship. Although underfunded from its creation and

challenged by a private health care sector that accumulates considerable fiscal

incentives, the system is widely acknowledged as having contributed to sig-

nificant enhancements of Brazilian health service coverage and access and of

health outcomes.

Under Lula, Brazil became a much-admired protagonist in South-South

cooperation driven by local ownership, nonconditionality, and noninterfer-

ence in partners’ internal policies, and the health sector was seen as key for the

country’s development ambitions. Along these lines Brazil developed numer-

ous cooperation initiatives in health such as establishing breast-milk banks,

training human resources, strengthening primary health care, tackling HIV/

AIDS and viral hepatitis, strengthening epidemiological surveillance, and pro-

moting food and nutritional security. In 2010 a survey conducted by the

Instituto de Pesquisa Econômica Aplicada (Institute of Applied Economic

Research—IPEA) estimated the value of Brazilian development cooperation

between 2005 and 2009 at US$1.43 billion, of which almost US$33 million were

allocated to health projects on the African continent. Lula’s foreign policy was

used as a soft-power tool combining national development and autonomy to

seek alliances and partnerships that would best serve both domestic and inter-

national objectives. Although without conditionality, Brazilian cooperation

was guided by self-interested perspectives in which costs and benefits were