Management of the health workforce in facing COVID-19: disinformation and absences in Brazil's Public Policies.

The objective of this research was to analyse federal government interventions in crisis management and the consequences for health professionals. This is a documentary-type qualitative research. Brazilian Federal regulations referring to work and health education produced during the pandemic emergency of COVID-19, published from January 28 to June 2, 2020, were identified. Of the total of 845 documents, 62 were selected in accordance with the inclusion criteria and were then submitted to Thematic Content Analysis. The results and discussions were grouped into four categories:workforce management, workforce protection, workforce training and academic-workforce relationship. Absence of a federal coordinating actions and policies for desinformation were identified. This lacking mechanisms for coordination contributed decisively to the tragic epidemiological situation still underway, especially in terms of the exposure of health workers to the risk of contamination, revealed in the extremely high rates of professionals infected or killed by COVID-19 in Brazil and the failure to control the pandemic in the population.

Inequity in access to vaccines: the failure of the global response to the COVID-19 pandemic.

This article summarizes the strategies used to rapidly develop COVID-19 vaccines and distribute them globally, with an emphasis on vaccines developed in western nations. It is based on interviews and information gathered regarding the response to the pandemic, both from international organizations and official documents from Brazil, Argentina, Colombia, Peru, and Mexico. While vaccine development has been hailed as successful, their global distribution has been highly unequal. We look at how the pandemic succeeded in mobilizing large quantities of government resources, and how citizens volunteered their bodies so that clinical trials could be completed quickly. However, patents prevented the expansion of manufacturing capacity, and the governments of a few wealthy countries prioritized the protection - and in some cases overprotection - of their citizens at the expense of protecting the rest of world's population. Among the major beneficiaries of the global response to the pandemic are the leading vaccine companies, their executives, and investors. The article concludes with some of the lessons learned in this process.

Este artículo resume las estrategias que se han utilizado para desarrollar rápidamente las vacunas COVID-19 y distribuirlas a nivel mundial. Se centra en las vacunas desarrolladas en los países occidentales. Con base en entrevistas y recopilación de información existente sobre la respuesta a la pandemia, tanto de agencias internacionales como de documentos oficiales de Brasil, Argentina, Colombia, Perú y México se reconoce que, si bien el desarrollo de las vacunas ha sido un éxito, su distribución a nivel mundial ha sido muy desigual. Como veremos, la pandemia consiguió movilizar una gran cantidad de recursos gubernamentales y los ciudadanos prestaron sus cuerpos para que los ensayos clínicos se pudieran concluir rápidamente. Sin embargo, las patentes impidieron la expansión de la capacidad de fabricación y los gobiernos de unos pocos países ricos priorizaron la protección y, en algunos casos, la sobreprotección de sus ciudadanos a expensas de la protección del resto de la población mundial. Entre los principales beneficiarios de la respuesta mundial a la pandemia se encuentran las principales empresas de vacunas, sus ejecutivos e inversores. El artículo concluye con algunas de las lecciones aprendidas en este proceso.

Un ensayo clínico no ético y la politización de la pandemia de COVID-19 en Brasil: El caso de Prevent Senior.

El Senado Federal de Brasil creó una Comisión Parlamentaria de Investigación (CPI) para investigar las irregularidades del gobierno de Bolsonaro en la gestión de la pandemia de COVID-19. Uno de los casos que llamó la atención fue la investigación llevada a cabo por Prevent Senior, una empresa privada de seguros de salud, sobre el tratamiento temprano de COVID-19. Este artículo analiza la validez científica de la investigación y los problemas éticos relacionados con su implementación. Se basa en un análisis del informe del estudio clínico de Prevent Senior, de los registros de ensayos clínicos de Brasil y Estados Unidos, del informe de la CPI del Senado y de información difundida por los medios de comunicación. Este caso de fraude científico y sesgo político-ideológico ejemplifica cómo Prevent Senior, utilizando un protocolo cuestionable para mejorar su reputación y obtener el apoyo del gobierno, contribuyó a la construcción de la narrativa de "tratamiento temprano" para COVID-19, y muestra cómo sirvió de base para una política pública del gobierno que promovió el uso de medicamentos ineficaces.

Uma pesquisa clínica não ética e a politização da pandemia da COVID-19 no Brasil: o caso da Prevent Senior.

O Senado Federal brasileiro criou uma Comissão Parlamentar de Inquérito (CPI) para investigar as irregularidades do governo Bolsonaro na gestão da pandemia da COVID-19. Um dos casos que chamou a atenção foi a pesquisa realizada pela Prevent Senior, uma seguradora privada de saúde, sobre o tratamento precoce da COVID-19. O artigo analisa a validade científica da pesquisa e os problemas éticos relacionados à sua implementação. Baseia-se na análise do relatório do ensaio clínico da Prevent Senior, dos registros do ensaio clínico em plataformas do Brasil e dos EUA, do relatório da CPI do Senado e nas informações divulgadas pela mídia. Esse caso de fraude científica e viés político-ideológico exemplifica como a Prevent Senior, usando um protocolo questionável para melhorar sua reputação e ganhar o apoio do governo, foi fundamental na construção da narrativa do "tratamento precoce" para a COVID-19, e mostra como serviu de base para uma política pública governamental que promoveu o uso de drogas ineficazes.

An unethical trial and the politicization of the COVID-19 pandemic in Brazil: The case of Prevent Senior.

The Brazilian Federal Senate created a Parliamentary Inquiry Commission (CPI) to investigate the Bolsonaro government's irregularities in the management of the COVID-19 pandemic. One of the cases that drew attention was the research conducted by Prevent Senior, a private health insurance company, on the early treatment of COVID-19. The article analyzes the scientific validity of the research and the ethical problems related to its implementation. It is based on analysis of Prevent Senior's report of the clinical study, the Brazilian and USA clinical trial registries, the Senate's CPI report, and on the information reported by the media. This case of scientific fraud and political-ideological bias exemplifies how Prevent Senior, using a questionable protocol to enhance its reputation and gain government support, was instrumental in building the "early treatment" narrative for COVID-19, and shows how it served as a basis for a government public policy that promoted the use of ineffective drugs.

COVID-19 and Moral Imperialism in Multinational Clinical Research.

A TV debate in April 2020 between two French doctors regarding the benefits of testing a coronavirus vaccine in Africa where there are no masks or treatments available has led to international criticism. This case highlights a problematic ethical double standard in multinational clinical research: trials that would be considered unethical in high income countries (e.g., placebo-controlled where there is an existing treatment) are nonetheless justified in low-and-middle-income countries because the existing standards of care are less (i.e., no access to a treatment). Underlying this ethical double standard in some multinational clinical trials is a moral imperialism and persistent colonialist thinking that must be rejected.