Pandemic Political Conflicts Lead to Harmful Changes in Health Management
A study analyzes the influence of political differences and corruption on the turnover of health leaders during the COVID-19 pandemic in Brazil. During the first two years of the outbreak alone, in 2020 and 2021, the country had four different names at the head of the Ministry of Health. Professor Lorena Barberia, from the Department of Political Science at the School of Philosophy, Letters, and Human Sciences (FFLCH) at the University of São Paulo and one of the authors of the study, discusses the data presented and comments on the factors that influenced the constant turnover of ministers.
According to the expert, the objective of the study was to analyze turnover in both the Ministry of Health and in state and municipal departments to find out how many changes occurred in the leadership of these departments. In addition, she says that the way in which this change was caused was also analyzed, which may have been due to relational or reputational conflicts, that is, due to corruption and fraud crises or conflicts of ideas between government officials regarding the implementation of certain public policies.
“In Brazil, these issues were very important and caused concern among people. It is important to remember that changing leadership in the most important department during a health crisis is very threatening and worrying. It generates institutional paralysis and several conflicts, because the new secretary may have completely different agendas and ideas from his predecessor,” he says.
Deviation of focus
According to the professor, these constant changes were reflected in the forms of treatment offered to people, since the focus on research, testing and immunization was often left aside and discussions about alternative treatments that did not have scientifically proven efficacy, such as ivermectin and chloroquine, came into play.
“Now that we have more time to reflect on this period, it is important to start thinking about these issues of leadership fragility for possible pandemics in the future. We need to closely monitor who is appointed to these positions, because this person needs to have some prior experience in management and public health. What we also observed in the research is that a person who took over the position and already had prior experience was less likely to leave the position,” he says.
Transfer of positions
According to Lorena Barberia, the Brazilian political system has many parties and, as a result, party coalitions are formed, which often result in the transfer of positions so that the parties can obtain the majority necessary to govern. She says that this can cause problems if the appointment is made to politicians who do not have the necessary experience to lead certain departments, as in the case of Eduardo Pazuello, who is a military man and was head of Health for nine months, between 2020 and 2021.
“The issue of corruption was also important, as we found evidence of some departments where there were changes in positions due to illicit purchases involving high amounts of money, leading to the secretary being dismissed or resigning. But this was in smaller numbers, as the main reason for this high turnover at the head of the health departments was political conflicts and not corruption,” he concluded.