In about a month, in the middle of a pandemic with tens of thousands of deaths, Brazil lost its second minister of health, the highest public health authority in the country. On April 16th, 2020 Luiz Henrique Mandetta, physician and politician, was fired by Brazilian President Jair Bolsonaro. The reason for that was that Dr. Mandetta wanted to keep measures of social distancing and to follow public health experts-recommendations in the measures to combat coronavirus spread and the COVID-19, while Mr. Bolsonaro was denying the severity of this disease and wanted the country fully opened for business. For the position of minister, Mr. Bolsonaro appointed Nelson Teich, another physician, considered a technical person for the function and with no political career.
Dr. Teich resisted three weeks as minister, resigning on May 15. In his announcement, Dr. Teich did not say why he was leaving a position that he himself said was a dream to have in order to serve the public system, in which he learned how to be a physician. But it is clear that the reason was the disagreement between Dr. Teich’s plan to address the pandemic – based on strategies following health experts and collaboration among the three levels of power: Municipal, State and Federal – and Mr. Bolsonaro’s fight for a fully opened economy, denying the need of any kind of stay-at-home orders. Behind the scenes, there are rumors that the limit for Dr. Teich’s tolerance of Mr. Bolsonaro’s interference in the Ministry of Health was when the President requested the minister to include hydroxychloroquine as a COVID-19 drug to be mandatory used in all patients. As a physician who exercises his profession based on evidence-based science, Dr. Teich couldn’t agree with the President because there is no evidence that hydroxychloroquine helps to treat COVID-19 patients. Actually, the first studies show that this drug creates more damage than benefit, not only being ineffective but increasing the risk of death for some.
The context above reveals that the lack of harmony among science, economy, and politic creates a huge damage for the public good. In this case in Brazil, this means more than 330,000 infected with the coronavirus and 21,000 deaths,[i] in the midst of an economic crisis and political chaos. Harmony among science, economy and politic is essential for the administration and the care of the public concern or thing, that is, the republic, a word originated from the Latin respublica (res - concern/thing, and publicus - public, of the people).
Responsibility for the respublica should be the bottom line of any public administration. The respublica covers many areas and dimensions of human individuals organized in societies. The administration of the respublica is complex, tense, and imperfect. It is never a completed work, but an ongoing effort. In addition, when the respublica is managed by a democratic system – in which people’s participation become part of the being a republic – the care for the respublica is always managed through negotiation and public debate that include independent branches of government (Executive, Legislative, and Judiciary) and critical, analytical public voices to show and question facts, actions, proposals, and decisions. For this, a free and independent press is crucial for the functioning of a democratic republic. Public leaders, exclusively in charge of the administration of a respublica, must understand that their function is not to care for the res – individuus, that is, the thing (res) that is not (in) divided (dividuus). Individual interests are not part of the respublica, therefore, they should not be the perspective from which public leaders look at their role in a republic. Unfortunately, this basic understanding of public administration seems to be strange to whom was elected to lead the Republic of Brazil.
Science, economy, and politic are essential tools to be used as resources and practice by a public authority caring for the respublica, for the good of its populus, that is, the people. Briefly, let us remember what these tools mean. Science, from the Latin scientia, means knowledge or knowing something. In modern times, science refers to a specific kind of knowledge that is achieved through systematic studies. This knowledge tends to be objective and, in itself, does not have a political ideological side, although it can be used ideologically to achieve a determined end that is not a part of scientific knowledge. Most of the times, manipulation of the scientific knowledge is not made by those who achieve this knowledge.
Economy has a Greek etymology, eikonomia, the fusion of two words: eikos (house) and nemein (manage). Therefore, economy could be defined as household management. It exists a domestic economy: every family manages its financial life for the good of its members. There is also a social economy, in which economic decisions and policies are made by those responsible for the management of the republica. This social economy, that also includes international and global relations, is essential for a healthy domestic economy. On the one hand, the domestic economy works for an individual family or person, which private interests take priority. On the other hand, social economy does not include a space for individual private interests because it is an economy for the good of the respublica and the growth of the common good.
Finally, politic is also from Greek: politikos, an extension of the words polis (city) and polites (citizen). A simply suggested definition for politics is the citizen who takes care of the city, a public space where all live in society, that is, a respublica. Aristotle said that humans are not only rational animals (zoe logikos), but also political animals (zoe politikos). We are social beings who live in relationship to one another sharing the same public space, that is, a city, a state, a country. Everyone has his/her responsibility for the respublica. However, in the representative democracy we live in, there are those who are elected by the citizens to make caring for the respublica their fulltime job. Those are the politicians who are elected officials to form a government.
These three concepts are core for an appropriate management of a respublica. They need to be in a harmonic relationship for the promotion of the common good. But, each one has its own ways of operation and times to achieve results. For all of them, the public administration needs more – and not less – politic, but a good politic that really cares for the respublica to promote its people. More politic means more dialogue, more social negotiation, more confront of ideas, more people’s participation, more honesty, and even more frustration; all in order to make decisions for the public interest. For these decisions, science is a crucial tool because it will provide evidence-based knowledge pointing out ways to address problems. For instance, it is not role of the President to determine whether or not physicians should prescribe hydroxychloroquine or chloroquine to COVID-19 patients. This is the role of science that will determine if this drug works and is safe to treat this disease. To achieve this response, science has its own methods and time that often enough do not match with political time. But politicians have nothing to do with determining the effectiveness of a drug. They must wait until a medication is safely developed. Meanwhile, the President discusses other measures to mitigate the pandemic for the good of its citizens. Whether or not a drug is efficacious to cure COVID-19 is not a political role. Politicians won’t develop medicines. When scientists develop this medication, it becomes the role of political leaders to create measures to make these goods accessible for the people. This is a republican thing to do.
Where is economy in all of this? All over! However, it is worth to stress the rhetoric of many people affirming that a country’s economy cannot stop because of a public health crisis. This rhetoric inverts the meaning of economy which the household management passes from a means to serve those who live in this house to be an abstract master who is served by the people. Obviously, this pandemic creates an economic problem for the respublica and its citizens. But the way to address it, is not through an economic terrorism serving the private interests of a few powerful people on the cost of thousands of lives lost for the pandemic. Again, the public leader of a respublica needs to be more political and use more science to find ways and alternatives to help the people who are having their domestic economy heavily impacted by some measures to stop the coronavirus.
All concepts described above are essential for a republic. Any political leader of a democratic country as Brazil must understand them in order to exercise the position he/she took after been elected by citizens of the republic. It does not seem that Mr. Bolsonaro understands these concepts. Certainly, he didn’t study the job description of the position he applied in Brazil 2018 election. His attitudes and decisions clearly show that his private interest comes first that the interest of the respublica. The reasons presented for the resignation of the former ministry of justice revealed that President’s private interests are over the public ones. Now Mr. Bolsonaro dismisses science and wants to be the “medical scientist” who determines what is better for COVID-19 patients, overruling the authority of his own ministers of health, losing two of them in about a month because they refused to obey the authoritarianism, right-wing populism and anti-science of a President who governs for himself and his clan. Mr. Bolsonaro makes his domestic economy the raison d’êtreof President’s role in the Brazilian Republic.
*Alexandre A. Martins is an assistant professor at Marquette University em Wisconsin, EUA. Author of several articles and books in social ethics and bioethics, such as “Bioética, Saúde e Vulnerabilidade: em defesa da vida dos mais vulneráveis” (Paulus, 2011); “The Cry of the Poor: liberation ethics and justice in health care” (Lexington Books, 2020)