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Covid-19 in Brazil: innovative initiatives by civil society and public policies

August 28, 2020

by Patrícia Laczynski, Professor in public policies at the Instituto das Cidades, Campus Zona Leste da Universidade Federal de São Paulo (Unifesp).


by Eduardo de Lima Caldas , Professor in public policies at the Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (USP).


by Livia Kalil currently coordinates the Institut des Amériques' office in Brazil (hosted by USP) and is a doctoral student in Political Science at the University Sorbonne Nouvelle and at the University of São Paulo.

The health crisis that Brazil is going through because of the Covid-19 pandemic has led to many actions at the local level, but also a multitude of initiatives from civil society. Their impact on the most socially vulnerable regions and the potential consequences on the redefinition of public policies needs to be analyzed.


São Paulo is a good example of the rise of initiatives due to the lack of response by the public authorities in some neighborhoods. It is, as we know, a city characterized by abysmal disparity in salaries, which is reflected in a geography marked by barriers of race and gender. The segregation is visible there and geographically revealing, with a whiter and richer downtown and outskirts, poorer and blacker, in which access to public services and equipment is difficult or non existant.


According to a study by Rede Nossa São Paulo[1], the Jardim Ângela district on the southern end where 60% of the residents say they are black or of mixed-race has had five times more Covid-19 deaths than the Alto de Pinheiros district on the west side where close to 90% of the people say they are white. In the same vein, the mortality rate is four times higher in the Grajaú district, southern end, where 57% of the population say they are black or of mixed-race, than in the Moema district, also on the southern end, where close to 94% of the population say they are white[2]. The differences between these districts can also be seen in the average monthly salary of people having a formal job. It is R$ 1,889.36 at Jardim Ângela, against R$ 4,285.11 at Alto de Pinheiros. At Grajaú, the amount is R$ 1,852.28, while at Moema the average is R$ 3,277.85. If you compare the first and the last on the list, we go from R$ 10 079.98 at Campo Belo, district in the south of the city, and from 1 287.32 R$ – almost 8 times less – at Engenheiro Marsilac, a district located in the most southern section[3].

Disparities in salary and deaths in São Paulo because of Covid-19
Disparities in salary and deaths in São Paulo because of Covid-19

The population living in the outer districts has no basic medical infrastructures and lives piled up in small houses, often in single rooms, and has little access to medical equipment. And it is mainly in those peripheral areas that the housekeepers, building caretakers, app drivers, delivery people and informal workers live, who cannot stop working and who must use public transportation, either to get somewhere, or to sell their merchandise.


And yet, the decision makers and public administrators do not seem to consider these disparities since, so far, there have been no proposals based on reality and the needs of the outer sectors.


For example, in terms of health, the town hall of São Paulo has created two rural hospitals to handle the patients who have the coronavirus in situations of weak or average complexity. Both are located in central regions of the city (one is in the Pacaembu stadium, the other at Anhembi). The third rural hospital is managed by the federal government and is operating in the Ibirapuera stadium. None of this equipment was installed on the outskirsts even though they are the ones the most impacted by the virus.


Though the public authorities continue to spin, the affected populations have demonstrated different types of solidarity that could help rethink territorial public policies in order to confront adverse realities, and not just during crisis periods. Numerous initiatives have come to light around which residents have organized themselves. On top of devising a fundraiser, they also collected food and essential supplies (personal hygiene products, disinfectants, soap, non-perishable goods) in order to put together baskets and distribute them to the most vulnerable individuals impacted by the lockdown. 

On the East side of the city, a strong rallying was done to demand from the government leaders the construction of a rural hospital. The initiative was born in April from a virtual meeting promoted by the East Side Cultural Forum, with the participation of nine cultural organizations and educators from the Centro de Estudos Periféricos, the Campus São Paulo - Unifesp East side. The organizations located in districts such as São Mateus, Itaquera, Cidade Tiradentes, Ermelino Matarazzo, São Miguel, exchanged information on the different initiatives they were doing in their area. At the end of the meeting, a pact was signed among the participants that a request needed to made for the creation of a rural hospital. Thanks to brochures, videos and several other types of communication, the campaign grew and received the support of several social movements, and even of some parlement members. And yet, as of yet, the authorities have not put a plan in place.


In the southern section of São Paulo, at Paraisópolis, a district of more than 100 000 residents, the G10 Favelas organization[4] started a real war strategy to manage the pandemic and the lockdown in a situation of extreme poverty. Neighborhood committees were organized to set up a map of the community and identify volunteer leaders. Each leader, also called "street president", was responsable for managing 50 houses. Their job included sensitizing the residents to the need to isolate, the distribution of the donations and collecting information on all Covid-19 cases.

Furthermore, since emergency services do not go into the favela, three ambulances were rented and provided to the residents 24x7. The team of this service is made up of two doctors, four nurses and two rescue workers, hired and paid by the neighborhood association. Another service provided is first aid training for the residents of the community. They initiate the first steps in an emergency when the ambulance is late. For the covid cases that are not serious, two public schools, totally renovated, were altered to serve as a welcome center. Currently, over 500 people are staying there.


Prevention is also primary. Through the Costurando Sonhos Brasil program, seamstresses from the favelas are making masks that are distributed to the community residents.

In addition, the G10 Favelas have stimulated local businesses by encouraging people to buy in neighborhood grocery stores and shops. Furthermore, marmitas[5] and basic food baskets have been made and purchased locally (55 000 marmitas and 19 000 baskets were made up through June). The first ones are part of the Mãos de Maria (Hands of Mary) program, which enabled the daily production of close to 10 000 marmitas purchased in local restaurants and distributed for free.


Though Brazil seems disoriented by a government overwhelmed by a pandemic that it refuted for too long, the civil society seems however able to organize itself to mitigate the failures of public authorities. These initiatives can be a source of inspiration to help redefine public policies when the situation returns to normal.

[1] "The Nossa São Paulo network (RNSP) is a civil society organization whose mission is to rally different segments of society in order to build and participate in a program and a set of goals, in partnership with public and private institutions, to articulate and promote actions, leading to a São Paulo city that is just, democratic and sustainable. It is non-partisan and its actions are guided by the fight against inequalities, the promotion of human rights, social participation and control, as well as tranparency and respect for the environment". For more information, see their website.

[2] Edição extraordinária do mapa da Desigualdade indica CEP como fator de risco na pandemia, Rede Nossa São Paulo, June 2020. 

[3] Data taken from the Mapa da Desigualdade study, done by the Nossa São Paulo network, published in 2017 using 2015 data taken from the RAIS of the ministry of labor and elaborated by the DIEESE, and that are available here and here.

[4] The G10 of the Favelas is "a group of favela leaders and business owners who, as in the rich countries of the G7 (Germany, Canada, United States, France, Italy, Japan and United Kingdom), have gathered together for the economic development and the protagonism of communities, for the economic and social development of those urban areas". The initiative was led by Gilson Rodrigues, president of the Paraisópolis Resident Union, a community of the city of São Paulo.

[5] Packaged meal to be eaten immediately. It is usually made of rice, red beans in a sauce, an animal protein and sometimes, vegetables.

Patrícia Laczynski is a Professor in public policies at the Instituto das Cidades, Campus Zona Leste da Universidade Federal de São Paulo (Unifesp).


Eduardo de Lima Caldas is a Professor in public policies at the Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (USP).


Livia Kalil currently coordinates the Institut des Amériques' office in Brazil and is a doctoral student in Political Science at the University Sorbonne Nouvelle-Paris 3 (IHEAL, CREDA UMR 7227) and at the University of São Paulo (USP) in the Environmental Sciences program (PROCAM).