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© Reuters. Helio Angotti Neto, chief of the Well being Ministry’s Science, Know-how, Innovation and Strategic Inputs division attends a information convention in Brasilia, Brazil June 27, 2020. Carolina Antunes/Brazilian Presidency by way of REUTERS
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By Gabriel Stargardter
RIO DE JANEIRO (Reuters) – Brazilian President Jair Bolsonaro, addressing the nation final month in a social media video, touted the newest in a string of unconventional medicine he says can ease the nation’s COVID-19 disaster.
Bolsonaro – a vaccine skeptic and promoter of discredited remedies equivalent to hydroxychloroquine – mentioned this new drug, Proxalutamide, would “quickly be out there to all Brazil.” He invited a little-known Well being Ministry official, Helio Angotti, to broaden on its promise.
Angotti, an eye fixed physician with no epidemiological expertise, cited a home Proxalutamide examine displaying a 92% lower in mortality threat amongst hospitalized COVID-19 sufferers. It was a dramatic declare amid a world battle to search out efficient remedies. He mentioned he aimed to “get it to the Brazilian inhabitants as quickly as doable.”
However the examine – co-authored by a advisor Angotti employed – hasn’t been peer-reviewed or revealed, past a cursory outcomes presentation the authors launched in a March information convention. The drug doesn’t have regulatory approval and is not out there on the market.
Alexandre Cavalcanti, director of Sao Paulo’s HCor Analysis Institute, mentioned the claimed effectiveness within the examine Angotti cited far exceeds any vetted COVID-19 remedy.
“I do not consider it,” mentioned Cavalcanti, who co-authored a significant examine, revealed final 12 months within the New England Journal of Drugs, that discovered hydroxychloroquine basically ineffective for COVID-19.
As a comparability, Cavalcanti cited the generally used steroid, Dexamethasone, has been proven to cut back deaths by as much as one-third in sufferers with extreme COVID-19.
The looks with Bolsonaro was the newest signal of Angotti’s rising affect amid a pandemic that has killed about 430,000 Brazilians. Present and former Well being Ministry workers say the mid-level official has quietly amassed energy by elevating what they are saying is questionable science to help Bolsonaro’s convictions: that masks are ineffective, lockdowns are harmful, vaccines aren’t any silver bullet, and different miracle cures can be found or quickly will probably be.
Angotti declined to remark for this story. Bolsonaro’s workplace and the Well being Ministry didn’t reply to requests for remark.
Carlos Wambier, one of many co-authors of the Brazilian Proxalutamide examine, acknowledged it lacked peer-review however mentioned its findings have been “actually very encouraging.” He dismissed its critics as “extra involved with politics than with scientific outcomes.”
“If the article is revealed, I consider any authorities on this planet can pay consideration,” mentioned Wambier, a dermatology professor at Brown College who focuses on beauty procedures equivalent to Botox injections and tattoo elimination.
Reuters reviewed inner ministry paperwork and interviewed over two dozen present and former officers, scientists and politicians to chart Angotti’s rise in Bolsonaro’s administration. Angotti final 12 months grew to become chief of the Well being Ministry’s Science, Know-how, Innovation and Strategic Inputs (SCTIE) division. Amongst different duties, the SCTIE decides which medicine – not together with vaccines – Brazil’s huge public well being system purchases.
The sources mentioned his division’s give attention to unproven coronavirus treatments equivalent to hydroxychloroquine, together with its opposition to masks and lockdowns, contributed to the explosive unfold of the infectious P1 variant, which originated final 12 months in Manaus, the capital of Amazonas state, and made Brazil one of many world’s worst hotspots.
Federal prosecutors in Amazonas have accused Angotti of administrative misconduct, in a civil continuing that can lead to fines or job loss, for pushing well being staff there to prescribe hydroxychloroquine. Angotti declined to touch upon that accusation.
Angotti can be beneath scrutiny in a high-profile congressional probe into Bolsonaro’s pandemic response. The Senate has been grilling administration officers in public hearings for about two weeks, and three senators have formally referred to as for Angotti to testify earlier than the investigative committee, which has not but thought-about their requests. The committee will produce written findings however has no energy to punish administration officers.
Angotti’s ascent reveals the central function that unproven remedies proceed to play in Brazil. It additionally exemplifies the unconventional make-up of Bolsonaro’s authorities, a coalition of troopers, free marketeers and social conservatives.
“Helio is the face of that anti-science group that seized management of the ministry,” mentioned Adriano Massuda, who led the SCTIE division in 2015. “It is the ideological wing of the Bolsonaro authorities that now offers orders on the Well being Ministry.”
Angotti’s efforts to help Bolsonaro’s pandemic technique got here because the administration – now on its fourth well being minister of the pandemic – was broadly criticized for Brazil’s delayed vaccine rollout. https://www.reuters.com/article/health-coronavirus-brazil-vaccines-idCNL1N2JW1R3 As different nations scrambled to chop offers with pharmaceutical companies, Bolsonaro’s administration was sluggish to safe vaccines for Brazil’s 210 million individuals. About 15% of Brazilians have now acquired a minimum of one dose, in contrast with 36% in neighboring Uruguay, 46% in america and between 20% and 35% in lots of European nations, in line with Our World in Knowledge, a nonprofit public-service analysis group.
THREE CONSULTANTS AND A RESEARCH MEMO
Angotti taught at a college in southeastern Brazil earlier than he joined the Well being Ministry in 2019, when Bolsonaro took workplace. He served as a well being training supervisor earlier than being promoted final June. Like Bolsonaro, Angotti is an avowed follower of the esoteric Brazilian thinker Olavo de Carvalho, who promotes false conspiracy theories together with a declare that Pepsi used the cells of aborted fetuses as sweetener.
Bolsonaro, who took hydroxychloroquine when he contracted the virus final July, has questioned the protection and effectiveness of vaccines and declined to take a shot himself. Angotti declined to remark to Reuters on whether or not he considers vaccines efficient.
By November of final 12 months, Angotti had employed and assigned three consultants to search out proof to help Bolsonaro’s medical claims, in line with a Nov. 19 memo Angotti wrote. The memo, reviewed by Reuters, hasn’t been beforehand reported.
Among the many consultants have been Ricardo Zimerman, an infectologist with some 60,000 followers on Instagram, the place he repeatedly posts information about experimental COVID-19 remedies and pictures of himself pumping iron. The 2 others have been Bruno De Souza, a administration professor on the Federal College of Pernambuco who additionally has a doctorate in psychology; and Rute Costa, a medical researcher.
The consultants didn’t reply to requests for remark.
Angotti’s Nov. 19 memo instructed the consultants to “checklist and criticize the protocols and articles associated to the totally different immunization proposals.” The consultants have been additionally to replace the ministry protocol for treating COVID-19 with a cocktail of anti-malarials, equivalent to hydroxychloroquine, together with different medicine. Angotti informed them so as to add “the most recent proposed therapies,” displaying how they’ll “save many lives.”
The memo additionally directed the consultants to supply a “complete evaluation” of lockdowns, specializing in the “social and financial impacts of social isolation.” In March, the consultants co-authored a examine that went past inspecting social-isolation impacts and concluded that lockdowns have been “related” with the emergence of the P1 variant in Manaus, asserting that the virus had mutated in cooped-up households.
In early December, the consultants shocked some staffers on the ministry’s coronavirus operations desk with a presentation on why masks do not work to manage virus unfold, in line with two individuals current. Others have been much less shocked: When Bolsonaro visited the desk in October, officers have been informed to not put on masks, in line with an individual in attendance.
HYDROXYCHLOROQUINE TO THE RESCUE
As Angotti’s workforce chased proof for unproven remedies, the P1 variant exploded in Manaus, accounting for three-quarters of the town’s circumstances by the top of January, in line with a examine by Fiocruz, a federally funded biomedical institute. Town’s hospitals rapidly ran out of oxygen; the variant quickly unfold throughout Brazil.
The Well being Ministry despatched a minimum of 120,000 hydroxychloroquine capsules to Amazonas state and flew 12 medical professionals to the town of Manaus to push healthcare staff to make use of anti-malarials. Zimerman, De Souza and Costa have been within the group, in line with a Feb. 23 assertion despatched by one in every of Angotti’s colleagues to federal prosecutors in Amazonas, responding to their inquiries concerning the ministry’s dealing with of the Manaus disaster. Angotti’s SCTIE financed their journeys, the assertion says.
The ministry additionally deployed a short-lived telephone app that purported to assist medical professionals diagnose COVID-19 with a signs questionnaire – then instructed them to prescribe anti-malarials like hydroxychloroquine. The app was based mostly on a diagnostic device that Angotti’s consultants helped to develop.
Lower than two weeks after its January launch, Brazil’s Federal Council of Drugs (CFM), which licenses and regulates medical professionals, requested the Well being Ministry to deactivate the app as a result of it claimed “scientific validation for medicine with out worldwide recognition.” The council mentioned the app had been out there to individuals who weren’t docs and that it inspired them to self-medicate. The ministry shut the app down.
The give attention to hydroxychloroquine within the Manaus disaster was emblematic of the Bolsonaro administration’s failed pandemic response, mentioned Felipe Naveca, one of many first scientists to check the P1 variant and the deputy analysis director on the Fiocruz Amazônia biomedical institute, the group’s outpost in Manaus.
“The size of the issue was by no means taken critically,” he mentioned. “So that they targeted on a miraculous resolution that does not exist.”
Amid the chaos in Manaus, one in every of Angotti’s consultants, Zimerman, joined with different researchers to launch the examine of Proxalutamide, the drug Bolsonaro and Angotti would later tout on the social media video. On March 10, simply weeks after beginning the examine, the authors referred to as a information convention in Manaus to announce their outcomes.
“As a researcher, I can verify that I’ve by no means seen something like this – and I conduct plenty of trials,” mentioned Cadegiani, one of many examine’s co-authors. “We’re not kidding round.”
Cadegiani declined to touch upon the criticisms of the examine.
Cavalcanti, the Sao Paulo scientist, mentioned the presentation of findings for the still-unpublished examine did not meet the requirements for such analysis.
“That examine is beginner,” he mentioned. “The way in which it was introduced, how the info have been offered, these guys are amateurs.”
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