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Cadernos de Saude Publica ; 36(11), 2020.
Article in Portuguese | CAB Abstracts | ID: covidwho-1496621


Nowadays, the concept of vulnerability occupies a central space in debates about the health of indigenous peoples on a global scale, and is also widely referred to in discussions about the dissemination of the COVID-19 pandemic. This concept is present in the National Health Care Policy for Indigenous Peoples in Brazil 2, in line with the perspective of the social determinants of health. In this interpretive scheme, which is so central to public policies in many countries around the world, and also in Brazil, any and all harm that affects human populations involves, to some extent, biological aspects, but the main determinants of illness and death of populations are seen as primarily linked to ethnic, political and socioeconomic inequalities. But in the case of the health of indigenous peoples, arguments are sometimes put forward that are anchored in what we could call the other "face of the coin" of the concept of vulnerability. That's when the notion is based, predominantly - or completely, on arguments linked to genetic determination. Here, we want to comment on a recently published article in PLoS One by Leal et al. which, it seems to us, is particularly illustrative of an emphasis that, mistakenly, gives second place to the perspective of social determinants in the field of health in indigenous peoples. It is a specific study on risk factors for tuberculosis, but it can be used as an example of a given way of doing (or not doing) science, with direct implications for care practices and health policies.