 We are joined today by Mateus Falcone from the Brazilian Center for Health Studies and the People's Health Movement in Brazil. He's going to discuss with us the current situation in Brazil, what policies has the government taken that has brought it to this current moment in the pandemic where it continues to be the hotspot after months of tragic news of continual deaths and a growing infection right there. So thank you so much for joining us, Mateus. Thank you Zoe, it's nice to be here. Great, and so first question is that, you know, in the past couple of days, Brazil has overcome the very worrisome milestone of over 100,000 deaths from COVID and over 3 million confirmed cases. So what is the current situation looking like? Has Brazil reached the peak yet? What are infection rates looking like? If you can give us a general kind of scope of what's happening across the country. Yeah, so indeed it's a very hard situation. Brazil is a big country with more than 200 million people. So it would look like a country that would have a lot of cases. But actually it's one of the countries that has more cases per person as well. And it's basically do bad pandemic handling by the central government. There's no evidence for now that we have reached the peak or that we are close to flatten the curve. It's very important to keep in mind that Brazil is a very big country and it has a lot of difference between regions which include healthcare infrastructure, social inequalities, a bunch of inequities. So now we will see some regions in Brazil, especially the big cities where the pandemic has started here, like Sao Paulo for instance, the city where the pandemic indeed start that are close to reach like perhaps the peak or even to flatten the curve. But what we see now is that the pandemic in Brazil is moving towards the countryside part. So we see increasing of case in medium cities and small cities, which is dangerous as well because sometimes the city doesn't have a good healthcare infrastructure like the capital of the big cities. And this would be the movement now. It's important to notice as well that each state or municipality in Brazil has such an autonomy. We'll talk about this later I guess but an autonomy to create its own policies in terms of pandemic handling. So we see this difference as well across the territory. Yeah, and so you mentioned that a lot of these kind of alarming numbers and the higher cases per resident also has to do with the failed policies of the central government. And a lot of cases, you know, not only failed policies but actually resistance to taking any policies. So can you discuss some of the public health mishap that has been undertaken by the central government? And then maybe also on a state level what has been done, what hasn't been done? Yeah, sure. So first of all, it's important to understand how the Brazilian health system works. We do have a big healthcare and public health system. Public, yeah, I mean for public health measures and for healthcare that is called the unified health system, Sistema Unico de Saúde in Portuguese. It's similar in some ways of the NHS in the United Kingdom. So it's a public healthcare system and it's also, it should also take the public health measures. It's organized in three levels. So municipalities that is the local level, the cities, state level and federal level, right? So each of them should work coordinatedly, even in financial measures but also in health actions including public health actions. It's important to understand. So the federal government within this system should take a role of coordination, of information, of proposing the framework for adopting the measures at state and local level. This would be the expected role besides financing healthcare and public health measures. This would be the basically two roles expected by the federal government. What we have seen since the beginning of the pandemic in Brazil is a position, a point taken by the federal government, especially by our president of complete denial of the pandemic. So we are dealing with a very hard and dangerous situation and the central government is basically denying how dangerous it is. So we had one minister that was developing the one health ministry at federal level that was developing the first public policy, public health measures and it was fired by the president. Then we had a second minister that was in charge for, I guess, one month and it was fired again. And now we have, how can I say this? It's not exactly an official minister, it's like a minister that is waiting for the nomination of the next one, but it has taken more than 30 days, more than one month, basically two months. So we are just expecting the nomination of the next health minister that have happens. So here we can see by this position of denial a very bad pandemic handling at central government. The central government has also replied, has also answering the pandemic by offering to people one solution. The solution would be some medicines with unproven effect to handling pandemic. I'm talking especially about chloroquine and hydroxychloroquine that was also a medicine supported by the US, United States central government, right? So the central government were basically supporting that this medicine would be the cure for COVID-19, which we know it's not. So basically this was the only main action, the only main plan taken by the central government which has revealed itself inefficient for having any better results in pandemic handling. There are some phrases, very iconic phrases from our president that express this point of denial of the pandemic. Like when we reach a certain levels of death, he just stated, so why? I don't work in centuries, very weird sentence, very weird statements that he just, that just proves this position of denial of this hard situation. So this would be a general framework. On the other hand, we have some public health measures that were adopted by state level governments. So the main discussion in Brazil is, should we take social isolation measures like quarantine or not, central government basically? No, we shouldn't have, we shouldn't adopt this measures because this will harm economy. But what scientists and specialists and some politicians, the opposition says is, yeah, we should take these measures and we should provide economic relief, economic help for people in general in order to avoid this economic harm. So some state level governments and some municipalities as well, they have adopted social isolation measures in order to tackle the pandemic developing in Brazil. Our Supreme Court has decided, and this was very important, that this public health measures should be taken by state level, which does not mean that the central government shouldn't also take these public health measures. They also have a very important duty and a very important role in financing health care, public health care, and in taking the coordination within this framework of public health measures. One last point, the central government should provide more financial resources for health care. We have recent studies showing that not even half of the resources reserved for transferring in order to tackle COVID-19 pandemic were indeed transferred to state level and to municipalities. So this is also a very important problems that could also result in the future, we hope in even juridical court responsibility of the central government. Yeah, I think that's a really challenging and complicated situation, especially given as you comrades have written about before, is that the neoliberal policies of this government and the entering government of Michel Temer have really worked to dismantle this very important unified health system in Brazil, which is the safety net for the majority of Brazil's population, as many people do not have access to private health insurance. So can you talk about how years of neoliberalism has set up Brazil, not only to do poorly with the introduction of a fascist government, which outrightly doesn't take the necessary policies, but also it's already in a bad situation to be able to respond. Yeah, yeah, sure. So we have this unified health system that was a system adopted in our constitution in 1988, sorry, after a big social movement struggling for right to health. So Brazil has acknowledged, recognized right to health in our constitution in 1988. And since then we are trying to develop this great and beautiful public healthcare and public health system in order to realize, to fulfill this idea of right to health. But on the other hand, we also have this public insurance system that works similarly to what we would find in the United States of America, for instance. And what we see by comparing this two system is that the public system is much more cheap and much more effective. So 75% of the Brazilian population can only rely on healthcare on the public system and not on the private because they don't have private health insurance, right? Besides that, the private health insurance companies do not provide all the medicines, the essential medicines, and some very complex procedures, just like transplants are mostly, deed are mostly done here in Brazil by the public system. I'm talking about 90, 80% of the transplants in Brazil being doing within the public healthcare system and not in private healthcare system. So we see that, and besides that, the public system, unified health system suits also works on production of medicines. We have public production of medicine in Brazil and even in the developing of the COVID-19 vaccine. So, and also in formation of health professions. So it's a very wide public health system and about 75% of our population relies only on this public healthcare. But on the other hand, the private healthcare system, not system, I mean, private healthcare in general in Brazil costs about half of our public spending in health. And the other half goes to our public system. So what we see, what you can conclude by looking into this numbers is that the public system is more cheap and more efficient, more effective while the public healthcare and the unregulated private healthcare are much more expensive. So this would be a good comparison. And what we had recently is that the central government, and this is not from this current government, it has happened in the last decades, are not complying as we think it should comply with financing duties with the public system. It has worsened in Michel Temer government with the adoption of constitutional amendments, the constitutional amendment number 95 that established a cap for public spending. And this has worsened public spending on public system, public health system. So this would be something that we are struggling now for a review. And we do think that within this pandemic context, the public system has been strengthened within the public scores, the public speech, as we have noticed that only a public system can handle the pandemic well. Yeah, no, I think that's a really important reflection that we're seeing across the world that the privatized healthcare system is incapable of responding to the masses and that its incapacity also has propagated the further spread of the virus. Of course, we see the case of the United States as a very extreme example of this. But I think that's all we have time for at this moment. It's a very important case to continue watching and concerning that the virus continues to spread and we're hoping that the people's maintaining disciplines and being able to take the measures that they can, hopefully, in some way counteract the mismanagement on a national level. But yeah, thank you so much for joining us. And yeah, I thank you for the opportunity and I also hope that we can overcome this very hard situation and strengthening this sense of solidarity that shapes our public health system and the struggling for right to health. Thank you very much. Thank you so much. Now we have time for thank you for our team people's dispatch.