Brazilian President Luiz Inácio Lula da Silva (Workers Party - PT) fired Health Minister Nísia Trindade on February 25. In the two years that she led the ministry, her tenure was marked by the largest dengue outbreak in the country’s history and the deepening of the “herd immunity” policy in response to the COVID-19 pandemic.

She will be replaced by the former Minister of Institutional Relations, Alexandre Padilha, who previously headed the Ministry of Health between 2011 and 2014 in the government of Dilma Rousseff (PT).

Former president of Brazil’s largest epidemiological institute, Fiocruz, ex-minister Trindade was considered a “technical cadre” who had been chosen by Lula for his supposed “reconstruction of Brazil” after four years of destruction by the government of fascist ex-president Jair Bolsonaro (2019-2022). With the replacement of Trindade, Lula hopes that the health ministry under Padilha will help him increase his government’s increasingly low approval rating and put him in a better position in the 2026 presidential election.

Absent from the bourgeois media has been an objective assessment of Trindade’s tenure at the head of the health ministry, first and foremost in the response to the COVID-19 pandemic. The many allegations in the media that her resignation represented an act of “misogyny” by the Lula government have been amplified by the pseudo-left, which throughout the pandemic has functioned as a left-wing cover for the “COVID forever” policy of the world’s ruling elite.

Any serious assessment of Lula’s health ministry has to take stock of the COVID-19 pandemic in just over two years of his government. Significantly, the day after Trindade’s resignation, Brazil marked five years since the first case of COVID-19 in the country, a subject little reported in the Brazilian media.

In mid-February 2023, shortly after Lula’s inauguration, his government’s health ministry decided to end the release of daily COVID-19 data in Brazil without any scientific basis. Days later, Trindade made her first nationwide pronouncement, saying, “finally, the time has come to celebrate our country's biggest popular festival [Carnival].”

As the WSWS wrote at the time, “this statement on the eve of Carnival, when the service and tourism sectors in Brazil make billions in profits, also expressed the Lula government’s intention not to place any restrictions on the economy even as the pandemic worsens.”

Today, this situation has only worsened in Brazil, which saw an increase in the number of cases and deaths at the beginning of the year after the Christmas and end-of-year celebrations. Carnival, an event that brings together millions of people across Brazil, has served as a super-spreader event for the novel coronavirus in the country.

Even with this well-established pattern, the Lula government has preferred to ignore science in favor of private profits. The country is going through a new wave of the COVID-19 pandemic, which will certainly worsen in the coming days and weeks due to Carnival.

Data released on February 25 by the “Todos pela Saúde Institute” showed that the positivity rate for SARS-CoV-2, the virus that causes COVID-19 , grew by 7 percentage points in one month, reaching 24 percent. In recent weeks, the increase in the positivity rate has coincided with the reopening of schools across Brazil for the start of the school year.

These figures are supported by the National Council of Health Secretaries (CONASS). According to its COVID-19 panel, between the second (9-16) and third (16-22) weeks of February, the number of cases rose from 13,709 to 22,097. In the same period, the number of deaths rose from 82 to 153. Brazil has a total of 39 million cases and 715,000 deaths from COVID-19.

COVID-19 data in Brazil, however, hugely underestimates the real rate of infections and deaths. A study entitled “Epicovid 2.0” published in December showed that 28.4 percent of the Brazilian population (around 60 million people) have already had at least one COVID-19 infection, a figure 1.5 times higher than the official count.

When Trindade gave her speech at the end of February 2023, it was clear that the Lula government intended to ignore the need for nationally coordinated monitoring of the pandemic— exactly what had marked the open policy of “herd immunity” adopted by the Bolsonaro government. Analyzed today, the speech made two years ago by former minister Trindade becomes even more repulsive in the face of what was promised.

Repeating the claim of the world’s ruling elite that “our great ally is vaccination,” she continued: “The more people with a complete vaccination schedule, the more we will be protected from the severe forms of the disease.”

This was an explicit acknowledgement that the novel coronavirus would be free to spread in Brazil, ignoring the fact that even mild infections can cause numerous effects associated with Long COVID that can also be minimized with the vaccine. In May 2023, she welcomed the World Health Organization’s (WHO) unscientific decision to end the COVID-19 Public Health Emergency of International Concern, saying, “We’re still going to live with COVID-19.”

At the end of 2023, the Lula government abandoned universal vaccination against COVID-19 and limited it to a few specific groups, deepening the “herd immunity” policy initiated by Bolsonaro. Throughout 2024, the lack of vaccines for COVID-19 and countless other diseases was widely reported in the Brazilian media.

Today, Brazil is applying the COVID-19 vaccine against variants of Omicron XBB. However, the variants that have been dominant in Brazil since the middle of last year are descended from JN.1, which is why the WHO has been recommending the use of updated vaccines for this variant since last April. According to an early February report in O Globo, the health ministry “could have asked [health agency] Anvisa for exceptional authorization to import ... or made an exceptional purchase of doses ... adapted for JN.1” but chose not to.

Without any warning to the population about COVID-19 and the effects associated with Long COVID, the vaccination campaign has been a failure. Only 21.6 percent of the population eligible to be immunized has taken the booster dose recommended by the Ministry of Health. Among most of the Brazilian population who have not updated their doses is former minister Trindade, who was recently exposed by the Brazilian media for not having taken the booster dose last year.

The Lula government’s negligence in response to the pandemic is also expressed in relation to Long COVID. According to the “Epicovid 2.0” study, 65.2 percent of people infected with the new coronavirus have or have had Long COVID, which corresponds to around 40 million people (18.9 percent of the Brazilian population).

A report by Agência Brasil in early February about a Fiocruz study showed that Long COVID “remains unnoticed in health services, indicating that patients are unable to obtain the necessary care and health services are not prepared to care for them.” According to the report, “The research also points out that, despite the high cost of Long COVID to individuals, families and society, awareness and understanding of this condition are very low.”

This widespread neglect of public health in Brazil by the Lula government has not gone unnoticed even among the unions that supported his election. The Union of Workers in Health, Labor, Welfare and Social Assistance in the State of Rio de Janeiro (SINSPREV/RJ)—affiliated to the CTB union center controlled by the Maoist Communist Party of Brazil (PCdoB) which is part of the PT party federation—wrote after Trindade’s dismissal that her tenure was marked “by authoritarianism, arrogance, disrespect for health workers, ... the instances of social control in the SUS ... [and] the problems in vaccine management.”

It denounced the “slicing up of the federal network [of hospitals], handing over hospitals to the municipality of Rio [de Janeiro] and to social organizations which in practice are disguised forms of privatization.” SINSPREV/RJ also wrote that this is a policy that “not even the extreme right has dared to practice in Brazil.” For this reason, workers at Rio de Janeiro’s federal hospitals have been on strike since May 2024.

SINSPREV/RJ also criticized the “narrative of misogyny about Nísia Trindade’s dismissal,” the “end of public tenders” in federal public health and the fact that “Nísia Trindade’s management has never [complied] with the provisions of the 2023 strike agreement in federal health”.

This is just one example of the countless sectors of the federal workforce that have gone on strike for months against the Lula government over the past year, such as teachers and federal education workers and environmental workers.

In a revealing article, Folha de S. Paulo reported at the end of January that “Lula’s base sees lack of social mobilization as a risk for the government and the election in 2026.” It mentioned the criticism from social movements and trade unions that Lula’s government has lost “connection with the popular layers,” which was expressed particularly in the fiasco of last year’s May Day rally organized by the PT-controlled trade union federations and their satellites.

Since then, Lula has shown himself to be incapable of seeing the widespread social misery in Brazil that has undoubtedly been driven in part by the COVID-19 crisis. According to a report in Folha on February 27 based upon comments by Lula’s allies, the current president has an “excess of optimism that, at the current juncture, according to them, borders on alienation.”

The report also wrote that “Lula still hasn’t realized the true dimension of the problems his government is facing,” particularly “the sharp drop in his approval rating, which is even occurring in states in the Northeast, where the PT has always reaped an avalanche of votes” in the 2022 election.

Lula’s alleged “alienation” has objective class roots. This is a government that was elected to satisfy a section of the Brazilian ruling class that was unhappy with Bolsonaro and received the support of Joe Biden’s government in the US and the European imperialist powers. In turn, this process is accelerating the defection of workers from the PT and the unions it controls, of which SINSPREV/RJ is just one example.

The fundamental task for Brazilian workers is to break with the illusions promoted by the pseudo-left and the unions that the Lula government can be pushed to the left. At a time when workers in the US and around the world are fighting back against attacks on their fundamental social and democratic rights, a process that will accelerate as the impact of Trump’s trade war intensifies, Brazilian workers must see their struggle in defense of social rights in Brazil as part of an international struggle against the source of these attacks, the capitalist system.