the silence of the dead

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Anvisa was demoralized for several months by the agents of death from the Planalto and the Ministry of Health, who got everything wrong, delayed everything, denied everything and stayed with chloroquine, now expelled to Dante's inferno by Anvisa

Any reasonable scientific objections in Anvisa's presentation on January 17 could be answered by the boards that ended up approving the emergency use of Coronavac and ChadOx1. Wrapped in the well-known Brazilian pomp, the readings of the reports were distinguished by the discourse of rigor, regulation, precision and risk openings to be monitored. Everything was prepared, including written texts, as scripture confers all authority and the phenomenon has a national character. But in reality, the serious nature of the phenomenon is that of death, mourning, horror and disgust at the behavior of rulers and their troops.

The only impossible answer for Anvisa would come from breaking the silence of the dead. Or the relatives of the dead, who, along with millions of Brazilians, may be giving Thanks on this day for the saving news that we finally have a vaccine, without any importance to the fact that we do it after 60 countries. And despite being one of the ten largest economies in the world. What happens in education, health, sanitation happens here: the number ten of pomp must be projected onto the seventieth or eightieth of everyday reality in education, health, culture, sanitation, etc.

Nothing matters but the yearning for salvation. At least for today and tomorrow.

It may also have gone unnoticed that the directors of Anvisa transformed Bolsonaro and Pazuello, in the words of Estanislau Ponte Preta, into “sneezing powder subnitrate”, that is, they destroyed the agents of death and advertisers of the damned chloroquine, also called “early treatment”. And they did so by saying, in a very audible tone, that there is no alternative therapeutic treatment for SarsCov 2. There is vaccine. This is the end of chloroquine and its marketer, the fallen angel of death, from his own government. The only thing missing, then, is the impediment, as he tends to get in the way of everything he can.

The logic of the speeches at the Anvisa meeting, widely televised, was that of power, that Max Weber would work from the bureaucracy angle, which does not mean a bad thing. This is the regulatory framework that needs to be followed and that was organized in the history of the Brazilian medical-pharmaceutical bureaucracy based on international parameters. It happens that, many times, as Weber showed (Sociology Essays, 1983), this rationalization presents mistakes, discontinuities and tensions, especially because, in our case, the forms of bureaucracy are certainly added to the underdeveloped reading of the power of knowledge far above “popular ignorance”. And worse, that he is exercised despite the crying next door. This “ignorant people”, however, is the one that guarantees everything, maintains all the power in Brasilia and advances life.

These supposedly ignorant people, if they had been present in the form of advice at the base of the Ministry of Health, instead of the commanded and silent military, would have demanded that syringes and needles be purchased in July 2020 and would have demanded that vaccines be rushed in all the dimensions of the study, production and analysis process for social use. The people know death very closely. Let the most original Christmas work in Brazil say so, Severe Death and Life, by Joao Cabral.

Without the people in power in Brasilia, we were not even able to keep up with a nation that is always restless and even conflicted, but fierce, like Argentina, whose similar agency, Anmat, began analyzing the Oxford vaccine on October 5 and has already approved it. , or completes studies on Sputnik V and Pfizer's vaccine. Well, who can prove that Anmat was scientifically inferior to Anvisa? Or did he have a sense of urgency in the face of galloping death? By any chance, was Anmat negligent in approving the emergency use of vaccines just hours after the UK? Not at all. He did demonstrate superiority and courage, without losing his scientific capacity. In short, he did not suffer the murderous and governmental rage that covers our country and demands an immediate reaction from society as a whole.

There is always a bit of Machado de Assis's “humanitism” in each institution guaranteed by power, or in the transversality of the strata of centralizing and authoritarian power. These institutions, regardless of the virtues of their technical personnel, are always somewhat Darwinian, or, they live and survive well above the people who guarantee them and promote a sense of their existence.

Let it be said that Anvisa is right in saying that it needs a drug business submission in order to act. In this case, she was demoralized for several months by the agents of death from the Planalto and the Ministry of Health, who got everything wrong, delayed everything, denied everything and stayed with the chloroquine, now expelled to Dante's inferno by Anvisa. If this authoritarian country had set up popular councils to monitor the pandemic, including relatives of the dead, our health situation would be much different.

Well then. We will have a vaccine for a minimum of our people. An elderly person like me, 74 years old and undergoing treatment for cancer, will necessarily feel some remorse when taking the vaccine in February and March, as I know that more vulnerable people will take a long time to take the vaccine in this country without a government, which has not been able to buy, due to absolute incompetence, a single dose of vaccine, if not Coronavac, while Argentina already has many millions in stock. What we have is already corrupted by the fight between candidates for anything in the coming years, the fallen angel and the governor of São Paulo who has said a lot and said little in recent months. It can be seen that Doria, before any publication in an official body of Anvisa's decision, had already set up the São Paulo stage and started vaccinating. Expect the reaction of the candidate for re-election (God forbid!) in the next few hours… Dória wears the Brazilian flag. The entire Brazilian media seems to be spokespersons for the deities and we, who make some criticism, become pessimistic. E la nave va.

Anvisa's speeches had a scientific quality, but they avoided facts that require a lot of scientific work since yesterday. For example, the issue of new strains. As noted, after an English scientific committee, according to Reuters, earlier this month, raised the issue that the Oxford vaccine was probably not effective for the South African population, the matter went to the laboratories and is requiring a lot of work. . On the other hand, the South African government is under attack because, despite having supported the Oxford research, it now seeks as much of the WHO Covax system as possible. It turns out that we have a strain, called the Amazon, with similar mutations - and very dangerous ones - and, because we were very late, we cannot deny the Oxford vaccine, whose study and production path has already suffered several setbacks, known to everyone. It may be that the Indian laboratory SERUM is taking a responsible attitude at this time about whether or not to send the vaccine to the Brazilian reality.

Many questions remained in the air, despite the five hours of presentation, but they are understandable, not only for scientific reasons, but strongly cultural ones. Among them, ignorance about the Chinese pharmacopoeia, called “recent” despite the 5 years of civilization and medical culture in China. Next, great support is required from Brazilian scientists – and not just Anvisa – to carry out complete studies on the entire process of virus development and its mutations, as well as to improve vaccines to be distributed throughout the year and also in 2022. Special attention will be devoted to hazard ratio, the risk phenomena that need to be reduced by knowledge and the expansion of studies. It is also interesting to expand randomization studies, capable of guaranteeing this improvement and suppressing defects in the inclusion of social groups in studies. A lot of attention to studies on the elderly, not very present in the studies.

Just in case (because we don't have a government), we're on the side of the United Kingdom, Indonesia, Argentina, India, China and Turkey. This media praise that was seen on Sunday, including from colleagues at the university and research institutes, does not fit, because Anvisa did its duty in a late time and we must continue to criticize the exorbitant amount of mistakes made during the second half of 2020 and which lead us to more than 200 thousand families in mourning and thousands more to suffer humiliation in the vast territory, notably, as always, the poorest.

No pride in the face of Anvisa's role. Yes, the justice of seeing her banish Bolsonaro and Pazuello from our history. Yes, the recognition of the importance of Science.

What interests us is both to cut the death process (and remove those who go against this desideratum) and to analyze all the brutal errors and completely change the course of treatment, research, study and daily actions of a medical-pharmaceutical nature. No woohoo next to death. There is much to do and much compassion to share with the unselfish heart. And long live the SUS!!

*Luiz Roberto Alves is a senior professor at the School of Communications and Arts at USP.


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