• Francisco Ortega and Michael Orsini.
• Institute for Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
• Glob Public Health. 2020 Sep 1; 15 (9): 1257-1277.

AbstractBrazil's governance of the COVID-19 pandemic has been described as nothing short of tragic by several commentators. President Jair Bolsonaro's dangerous brew of neoliberal authoritarianism, science denialism and ableism has plunged this country into catastrophe. In this article we argue that this form (or lack) of public health governance can best be described as governance without (central) government. We begin with an overview of public health governance in the country before introducing the main theoretical concepts that guide our analysis, namely the notions of 'government by exception' and 'strategic ignorance'. Finally, we sketch the main features of this emerging form of (non)governance of COVID-19. We highlight the new forms of solidarity and mutual aid that have emerged in favelas and Indigenous communities, which have stepped in to fill the void left by a limited federal presence. The article concludes by reflecting on what this collapse of public health reveals about the limitations of democratic governance in the age of Bolsonaro.

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