Since February 25, when the first case of Covid-19 was confirmed in Brazil, we have sadly accumulated 175 thousand deaths and over 6.5 million infected people until the first week of December 2020. Declared by the World Health Organization as a pandemic on March 11, the disease moves from the wealthiest neighborhoods to the peripheries; and from large urban centers to cities in the countryside, spreading throughout the country during these months, drawing a wide curve in which the highest levels of incidence, transmission rate and deaths stand out in the months of June, July and August. Without the control of the disease and still with a significant transmission rate, Covid-19 is growing again in the country, this time having the entire national territory as its epicenter. Brazil currently ranks seventh and ninth among the countries with the highest mortality and lethality rates, but this situation may change in view of the increase in the number of cases of the disease, the extinction of the emergency income and the resumption of the expenditure ceiling law with the risk of a loss of around R$ 40 billion for the Health budget as of 2021. In accentuating the unjust social inequalities that persist in the country, Covid-19 reveals its discriminatory nature in affecting the poorest and most vulnerable, sacrificing invisible subalternized populations - indigenous, black, gypsy, quilombolas, homeless, refugees.

What has been happening in facing the pandemic in Brazil is the focus of the analysis of several scholars, who emphasize the neglect and ineffectiveness in adopting measures and initiatives recognized as adequate and efficient to contain the disease. Many attribute the chaotic and silent conduct of the Federal Government to unpreparedness and incompetence, but the evidence suggests a disconcerting deliberate action of necropolitical economics associated with social Darwinism¹1 Silva EA, Silva MM. O Brasil Frente à Pandemia de COVID-19: da bio à necropolítica. Confluências. 2020; 22(2):361-383.. However, it is no longer a question of the necro-state or the necropolitics in which the State is the manager of death. Here, the government has been taking pains to implement the suicidal State, that is, a new and perverse stage of management models immanent to neoliberalism in which the State becomes a continuous actor in its own catastrophe. It is a condition mirrored in Hitler’s fascism in which the State takes care directly of the death management of sectors of its own population, which is dangerously close to its own destruction²2 Safatle V. Bem Vindo ao Estado Suicidário [internet]. [acesso em 2020 jun 15]. Disponível em: https://www.n-1edicoes.org/textos/23.
https://www.n-1edicoes.org/textos/23... .

The substitutions and disallowances of Ministers of Health and the failure of the Federal Government to exercise its role has mobilized municipal and state managers to take over the process of controlling the pandemic. Without support in the acquisition of inputs and receipt of resources and without federal coordination, managers of the Unified Health System (SUS) have been not only destitute, but boycotted by the Federal Government. Social distancing and the use of masks, effective measures to contain the spread of the pandemic, are discouraged and ridiculed by members of the Federal Government. Despite warnings from researchers and academic institutions around the world about the importance of population testing, the Brazilian government has not established a testing strategy for identifying infected individuals that would allow isolation and control of disease outbreaks to reduce transmission of the new coronavirus. In the same direction, even though the National Congress has approved and allocated extra resources to face Covid-19 with the SUS, the government has not used existing resources to protect the population and control the progress of the disease.

The leading role of the SUS, even though its performance takes place under precarious conditions that put hundreds of its professionals at risk of illness and death, has positively impacted thousands of lives. This paradoxical condition makes it clear that there is no possibility to build strategies to comply with the constitutional mandate of Health with the Right of All and State Duty without a thorough assessment of the challenges and impacts caused by the Covid-19 pandemic.

The Unified Health System proved to be fundamental for saving lives, for the health and well-being of the Brazilian population. The universal access provided by the SUS among us contrasts with what we see in the experience of other countries, particularly in the United States, where, without a public system, many citizens with symptoms of Covid-19 escape treatment, die at home and on the streets for fear of exorbitant expenses to pay for their health care from their own pockets. It is the SUS that sustains health as a right for all.

A population’s health is the product of its political accumulation and results from social, economic and cultural determination; and, from that perspective, the realization of the universal right to health, as achieved in the Federal Constitution, depends, centrally, on social democracy aimed at reducing those inequalities. The SUS, as a public and universal system, is part of this complex condition required for the right to health. However, it is worth noting that the universal and quality health objectives that are essential for the consolidation of the SUS face barriers, interests and contradictions within the very model of the State, in society, in democracy and in the country’s development project. Health is under the eyes of the private sector, which intends to transform health care, attention and assistance into merchandise - and, once again, a health emergency situation has shown us that health cannot be a commodity, in which only those who are wealthy can have access. Otherwise, the result is barbarism.

The measures to weaken and even make the SUS unviable are varied, but the blows on its funding, which compromise the SUS’s ability to provide adequate and timely care to health needs, are the death sentence for hundreds of thousands of Brazilians over the next years, with or without a pandemic.

And what will become of tomorrow?

Capitalism of overconsumption of the wealthy classes has serious consequences for the survival of humanity itself, by transforming the State into a company serving the interests of the market and capital owners. The unrestrained and State-protected environmental degradation is the product of the inconsequence of the race for profit and, affecting people’s mentalities, dismantles the civilizing values of solidarity and collectivism that are at the origin of the production of this health crisis that entails all the characteristics of a pandemic of class, of gender and of race³3 Harvey D. Política Anticapitalista em tempos de coronavírus [internet]. [acesso em 2020 jun 15]. Disponível em: https://blogdaboitempo.com.br/2020/03/24/david-harvey-politica-anticapitalista-em-tempos-de-coronavirus/.
https://blogdaboitempo.com.br/2020/03/24... .

The conjunction of this storm of crises - sanitary, environmental, economic and social - accentuates the effects of a country that had been devastated by neoliberalism in the last decades and is now, under a far-right government, led to an authoritarian suicidal state moving around nothing. It is a disturbing reality that often immobilizes resistance itself. In a way, there is an accommodation of society - particularly of the poor populations -, which has always lived an undeclared civil war with the naturalization of genocides and massacres and in which capital accumulation is guaranteed by bullets and by fear²2 Safatle V. Bem Vindo ao Estado Suicidário [internet]. [acesso em 2020 jun 15]. Disponível em: https://www.n-1edicoes.org/textos/23.
https://www.n-1edicoes.org/textos/23... .

It is then necessary to inquire about the future, through the bafflement of a government ruled by a delusion of surrender to sacrifice, which incites the applause of the people to their executioners and which does not care about the death of others. In this reality, however, it is possible to identify emotions or affections capable of mobilizing changes to strengthen solidarity in the peripheries and slums.

The Social State that has given power to human rights, particularly social rights, as a strategy to combat social inequalities, no longer finds resonance in this disturbed reality. Any resumption of the centrality of human rights in the struggle of the excluded, exploited and discriminated against requires reframing them, starting by reaffirming that rights are the result of the historical conquest of the oppressed. The capture of those rights by hegemony, which, once again, applied an institutionalized makeup to them, naturalized and trivialized human suffering, resulting in the fraying of the fabric of social solidarity. This hegemony is definitely of no interest and does not serve the fight against social and economic inequalities rooted both in Brazil and in Latin American countries⁴4 Santos BS, Chaui M. Direitos Humanos, democracia e desenvolvimento. São Paulo: Cortez; 2013..

The current scenario is that the majority of the population, inspiration and object of the discourse and the fight for justice and human rights, has not managed to be their subject. In Brazil, the insurgents who occupied the streets were young people from the periphery, informal workers of essential services, including transportation by apps. Living daily with risk, illness and death, prevented from social distancing, they protested and entered the practice of politics. They are young people who face police violence, drug trafficking, unemployment and exclusion for a long time and on a daily basis; who bring a life experience of exclusion and institutional violence from the day they were born. The real Brazil owned up to its voice and, in scarcity, shows the new solidarity among those who share what they little have.

Learning is presented to those who want or will manage to learn. The fact is that new realities and narratives challenge humanity, and these challenges will continue to impose new political, economic and social responses on the future. Listening to and reading the complexity and rawness of reality challenges democratic political parties, not just those in the field of the left, to a new commitment to democracy combined with the fight against inequality and discrimination.

These new political actors, now present and active, who redefine and resignify human rights and social policies, will be the basis of the State founded on social solidarity. However, more profound changes will be essential. The richest will have to lose privileges, accumulate less and share more. Taxing large fortunes can no longer be taboo. It is addressed in our Constitution, and the matter continues under the carpet.

Science was also surprised by the intensity and magnitude of the pandemic if we compare it to previous experiences in the past two decades. The degree of ignorance about the new virus, coupled with the disbelief, on the part of some segments of society, of the role of science in solving health problems, created the perfect storm for the spread of fake news and its use to strengthen far-right political groups. Despite the accumulated and rapidly disseminated knowledge since the beginning of the pandemic and the speed in the development of new vaccines to contain the transmission of Covid-19, there remains the challenge posed to pharmaceutical companies to convince the population about the efficacy and safety of these products. To this end, it is not enough to claim that the studies were carried out within the best scientific standards required by regulatory agencies. Transparency is needed, ensuring public access to the anonymous data of study participants that provide scientific support for claims that vaccines are safe and effective.

Even before its approval, there are already rumors are about alleged health risks due to the use of these vaccines. The challenge for society will be to deal with blatant situations, material often used by anti-vaccine groups to disseminate their conspiracy theories and discredit scientific arguments. In societies where governments and population segments support such theories, the negative repercussions of this disinformation pandemic may undermine efforts to achieve the levels of vaccine coverage necessary to reverse Covid-19’s current epidemiological picture.

In this scenario of devastation, death and disinformation, it is no longer tolerable to accept the maintenance of models of doing science and of health systems attached to the interests of corporations whose main objective is the good financial health of their shareholders. Nor should the academy and its researchers continue to base their actions on neoliberal performance models that favor large publishing groups at the expense of a citizen science.

Likewise, the political scenario has to ensure that these new actors from real Brazil can voice their aspirations for democracy, rights, equality, equity, non-discrim ination of race, sexual orientation and gender, justice and social inclusion. There are persistent but renewed demands that, from now on, will guide our challenges, as well as our politics.

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