Actions during the COVID-19 pandemic to protect the most vulnerable population: what is the potency amid chaos?

ABSTRACT

By 30 May 2021, Brazil had 16 471 600 COVID-19 cases and 461 142 deaths, ranking second in the world in number of deaths and third in number of cases. Preliminary research results in Brazil and around the world show the impact of COVID-19 on more vulnerable communities. However, despite the adverse circumstances of their territories, leaders have mobilized to face the challenges. Between April and June 2020, the authors of this article interviewed informants in eight Brazilian state capitals, addressing the five points of discussion (intersectoriality, sustainability, empowerment and public participation, equity and the life cycle perspective) recently presented by EUPHA-HP, IUHPE and UNESCO Chair Global Health & Education. Official actions and documents from the Ministry of Health and Municipal Health Departments (SMS) of each capital were also analyzed. No records were found of official actions aimed at COVID-19 that addressed the territories' specificities. In total, 15 promotional actions by the communities were identified. The selection of local actors to take on specific responsibilities during the pandemic is highlighted as a relevant action. This action alone weaves together at least three of the five HP principles (equity, life cycles and empowerment). We consider that previous forms of political empowerment, such as the recognition of territories and educational initiatives, have contributed to the subjects who are leading these inventive initiatives. However, although there is scope for promotional actions, there are infrastructural limitations that only public policies could mitigate. Such actions would demand deliberate coordination between the government and social movements, which is absent in the current context of national governance.