Currently, with almost exclusive dependence on coronavac, distributed by the Butantan Institute, the City Hall is unable to exceed 120 thousand vaccinated people daily, despite having the structure and personnel to obtain a number four times higher. More privileged from a fiscal point of view than other municipalities, São Paulo still has cash resources to pay doses in advancein order to guarantee priority in the negotiations.
But, even if it manages to close a contract with vaccine manufacturers – the City Hall has already formalized with Janssen the intention to purchase 5 million doses -, the Attorney General of the Municipality believes that Covas will need to close a “deal” with the Ministry of Health to be able to use all units in São Paulo. This is because part of the attorneys understands that the municipal purchase would have to be transferred in full to the National Immunization Plan (PNI).
Thus, the alternative discussed internally is to negotiate with the federal portfolio the temporary suspension of the quota to which the city is entitled, postponing this transfer until the end of the program.
The municipal health secretary, Edson Appeared, confirms the plan, but recognizes that laboratories prefer to negotiate with central governments rather than regional authorities – Jansen has already reported this to the City by email. But Aparecido says that the management continues to insist and has conversations with Pfizer, AstraZeneca, Moderna and also with the Indian laboratory Biotech, responsible for the covaxin vaccine, in addition to Janssen itself.
“Our conversation with the Indians was going well, but Anvisa has now denied the registration of the vaccine”, laments the secretary, referring to the decision taken last week on the rejection, on the part of National Health Surveillance Agency, of the application for certification of good manufacturing practices by Biotech. According to Anvisa, the action plan sent by the company “is not enough” to mitigate all the risks involved in the short term.
To ensure the necessary resources for the purchase of vaccines, Covas signed a law that allows the opening of special additional credit, by means of a decree. The toucan also undertook, in other specific legislation, to “provide guarantees to cover risks related to civil liability, under the terms of the instrument for the acquisition or supply of vaccines entered into.
Pfizer, for example, only realizes sales agreements under this guarantee – a fact that has been criticized extensively by the president Jair Bolsonaro. Last year, he went so far as to say that anyone who took the company’s vaccine could become an “alligator”. In São Paulo, in addition to being authorized by law, this accountability is anchored by a portion of the money allocated to some municipal funds, such as the Environment, the Preservation of Historical and Cultural Heritage, Parks and Consumer Protection. The same law allows the City to allocate up to 25% of the revenue collected from eight funds in the years from 2021 to 2024.
The frictions between Covas and Doria are considered, by interlocutors of the City Hall, as a result of the current moment of the pandemic, extremely critical. But they also reflect a history of disagreements accumulated during the pandemic, whether in the return to face-to-face classes, in the division of vaccines delivered by Butantan or in the closure, by the State, of emergency hospitals in the capital.
The determination to make “closed doors” four state hospitals that operate in the city even led to an extra request for funds from Covas to compensate for the high number of services in the municipal network. The mayor even sent a letter to Doria reporting the effects of the state decision on City Hall units. The expectation is that the ‘payment’ will reach R $ 230 million.
The vaccination plan itself would be a way to act independently of the Doria government, being able to choose more priority groups for immunization and, even, accelerate vaccination within the city – since São Paulo, in practice, is the executor of the plan national. In parallel, it would still meet the pressure put on by councilors for the purchase of immunizers.
The City Council should vote this week on a bill that defines the groups to be prioritized in an eventual municipal vaccination plan. According to the government leader in the House, Fábio Riva (PSDB), public servants, taxi and application drivers, as well as disabled people, will be on the list of priorities.
While the relationship with Doria adds points of conflict, as the criticisms that the governor made two weeks ago about the decree of holidays in the capital, the relationship between the São Paulo administration and the Ministry of Health showed signs of improvement after the arrival of Marcelo Queiroga.
The new minister has already called Edson Aparecido to ask what help was most urgent and to make himself available. And the ministry has already regularized the homologation of ICU beds in the city (administrative measure that, in practice, allows the federal government to finance the operation of the beds).
According to Covas reported on Tuesday, 30, during the first meeting of the National Vaccine Consortium of Brazilian Cities (Conectar) – which brings together 1,890 Brazilian cities with more than 80 thousand inhabitants -, the City Hall has made efforts in the international area to leverage the purchase of vaccines on all possible fronts, trying to help even the American vice president, Kamala Harris.
“On the bilateral front, we have held meetings at the American embassy, at the British embassy, in addition to exchanging messages with the American vice president, Kamala Harris, and with the presidents of the Senate Foreign Relations Committee (Robert Menendez) and the Chamber (Gregory Meeks) of the USA ”, said the toucan on video that the Estadão had access.
Covas also told colleagues that his management maintains multilateral relations with representatives of the UN, WHO and WTO in order to emphasize the importance of prioritizing vaccination in countries that are experiencing escalating cases and deaths, such as Brazil. “This is in addition to maintaining business relationships directly with companies.”
The actions mentioned by the mayor have been developed by the Municipal Secretariat for International Relations, led by the former mayor Marta Suplicy. It was she who brokered, for example, government talks with the Indian consul to discuss the possibility of buying the covaxin vaccine.
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