Community health workers reveal COVID-19 disaster in Brazil

Brazil has become one of the epicentres of the COVID-19 pandemic. The failure of President Jair Bolsonaro and his administration to recognise the severity of the pandemic
is being compounded by the neglect of Brazil’s community health workers (CHWs). In Brazil, there have been no nationwide guidelines for primary health care services in the COVID-19 response. Since CHWs in Brazil are not considered to be health professionals, only an estimated 9% have received infection control training and personal protective equipment (PPE).
Unions estimate that at least 50 CHWs have died as a result of COVID-19.
The number is likely to be vastly underestimated, since deaths of CHWs are not registered in Brazil’s official statistics of health-care worker mortality.
Moreover, CHWs have faced threats and aggression in some territories where they work.
We call on the Brazilian Government and the global health community to recognise and support the role of CHWs in the COVID-19 response and to ensure their health and safety.

There are more than 286 000 CHWs in Brazil.
They are the bedrock of Brazil’s Sistema Único de Saúde (SUS): they provide primary health care within their territory, make house visits, and establish a relation of trust between communities and the health system. The value of CHWs stems from their local knowledge and daily contact with families.
This proximity to communities is also vital for ground-level outbreak surveillance
and risk communication, as seen with the outbreak of Zika virus disease.