IACHR and Its Special Rapporteurship on Economic, Social, Cultural and Environmental Rights Concerned about the Serious Public Health Situation Regarding COVID-19 in Brazil

March 16, 2021

Washington, D.C. – The Inter-American Commission on Human Rights (IACHR) and its Special Rapporteurship on Economic, Social, Cultural, and Environmental Rights (SRESCER) are concerned about the high numbers of deaths and infections involving COVID-19 in Brazil.

According to figures issued by the World Health Organization (WHO), there has been an alarming increase in incidence and mortality rates involving COVID-19 in Brazil in recent weeks. With more than 11 million confirmed infections and more than 260,000 deaths by March 7, 2021, the Brazilian State has the second-highest number of deaths of this virus in the Americas and in the world. According to reports issued by Brazilian authorities and by civil society, this increase in the number of infections and deaths is due to several factors, including the following: the new P1 variant of this coronavirus, believed to have a greater viral load and higher rates of transmission; the lack of public policies aimed at mitigating the ongoing pandemic, and the lack of well-coordinated federal strategies to address the challenges posed by COVID-19; healthcare system saturation in most of the country's states; and misinformation campaigns concerning measures to prevent infection.

Although COVID-19 has hit the whole of Brazil hard, the Inter-American Commission and its SRESCER have been informed of the serious situation faced by residents of the state of Amazonas and its capital, Manaus. Amazonas' specific problems are due to the saturation of the state's healthcare system and intensive care units (ICUs) caused by the increase in the number of infections, as well as to the shortage of medical supplies and oxygen caused by a rise in demand. This situation has reportedly caused further increases in the number of deaths in Amazonas, disproportionately affecting rural areas, indigenous peoples, women, children, and older persons.

The IACHR notes that healthcare system saturation and medical supply shortages have also affected other municipalities and states near Manaus, as patients were transferred and as the incidence of COVID-19 rose in these areas too. In this context, on March 3, 2021, the Pan American Health Organization (PAHO) warned of an emergency situation in the state of Acre, where residents are facing a combination of COVID-19 infections, a dengue fever epidemic, and flooding. This means that the state's ICUs had an occupancy rate of 94% and that its healthcare system risked collapsing even as the number of individuals in need of inpatient care kept rising. Further, on March 10, 21 of Brazil's 26 states (including the Federal District) had ICU occupancy rates of over 80%. Mato Grosso do Sul and Rondônia even reported that their ICUs were full.

The State of Brazil informed the Commission that, since a National Public Health Emergency (ESPIN, by its Portuguese acronym) was declared on February 3, 2020, the government has taken several healthcare measures to mitigate the pandemic. Concerning the importance of a well-coordinated federal response to address the challenges posed by healthcare system saturation, the Brazilian State noted the creation of a Crisis Committee to Address COVID-19 within the SUS (Single Healthcare System, by its Portuguese acronym), as a strategic discussion forum for the various levels of the State and as a platform to coordinate monitoring and mitigation decisions. The State further noted that, since the beginning of the pandemic, the Ministry of Health has had an open-access communication strategy in place on this matter. Concerning measures taken in the state of Amazonas, particularly those involving indigenous peoples, the State of Brazil noted that, by March 9, 2021, 56,885 residents of indigenous territories in the state of Amazonas had been given the first dose of the COVID-19 vaccine and 15,950 had been given the second dose. These figures amount to shares of 61% and 17% of the local population of 93,401 people, the State said.

Concerning the emergency situation in the state of Acre, the Ministry of Health was developing an action plan to solve the crisis caused by the combination of the COVID-19 pandemic, flooding, and other diseases.

The State stressed that the vaccination process, which started on January 18, 2021, has since been ongoing throughout the country. Nationally, 451,661 doses have been administered to indigenous individuals over the age of 18, a population estimated at 409,883 people. Of these, 273,957 indigenous individuals (67%) got the first dose and 177,704 (43%) got the second dose, according to data issued on March 12, 2021. Concerning measures taken to support public health, including the provision of medical supplies and materials, the Ministry of Health had supplied 45.24 million syringes and needles by March 8, 2021, according to the LocalizaSUS platform.

The Inter-American Commission warns that the Americas continue to be the continent worst affected by COVID-19. According to the WHO, one year after the pandemic was first declared, the Americas remained the continent with the highest number of deaths of COVID-19 in the world. By March 7, 2021, the number of confirmed infections in the region topped 51,531,438, while the number of deaths stood at 1,237,781.

In this context, the IACHR and its SRESCER urge States in the region to immediately and intersectionally strengthen the human rights, public health aspects of all strategies, policies, and measures aimed at addressing the pandemic and its consequences. The Commission and its Special Rapporteurship call on States to ensure and speed up access to extensive vaccination and immunization against COVID-19.

Finally, the Inter-American Commission and its Special Rapporteurship urge the State of Brazil to brace the measures it has implemented to protect the rights to life, physical integrity, and health of affected individuals. In particular, the State should adopt broader public health measures, provide adequate medical supplies, materials, and services to ensure appropriate care for anyone requiring treatment for COVID-19, and protect the labor rights and the biosecurity of healthcare workers.

The Commission and its Special Rapporteurship further call for the adoption of urgent, decisive measures to prevent the spread of the virus and contain the pandemic, based on the best available scientific evidence and in keeping with the recommendations of specialist international institutions. They also call for campaigns to guide people to scientifically proven risk-mitigation measures, efforts to improve transparency, and full access to public information and to measures to contain the pandemic.

In the current circumstances, State authorities have an absolute duty to broadly inform the population, taking into consideration its diversity, and to address the issue, act with due diligence, and reasonably consider the available scientific evidence. These measures should ensure an approach that is focused on the comprehensive protection of human rights, in accordance with , and Resolution 4/2020, Human Rights of Persons with COVID-19.

The SRESCER is an autonomous office of the IACHR and was especially created to brace the Commission's compliance with its mandate to promote and protect economic, social, cultural, and environmental rights in the Americas.

The IACHR is a principal and autonomous body of the Organization of American States (OAS), whose mandate derives from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission has a mandate to promote the observance and defense of human rights in the region and acts as a consultative body to the OAS in this area. The IACHR is composed of seven independent members who are elected by the OAS General Assembly in their personal capacity, and do not represent their countries of origin or residence.

No. 061/21