Just ask the tobacco industry. When Serra took over the Health Ministry in late 1998, he declared war on cigarette makers, calling them purveyors of death. Brazil now boasts some of the toughest anti-tobacco legislation in the world, including a ban on all advertising. He bullied insurance companies into offering affordable medical coverage. Then he went after pharmaceutical companies, slashing “abusive prices” for brand-name drugs and flooding the market with cheap homemade generics. Says one advertising mogul, “He plays hardball.”
Big-fisted politics plays well in the grandstands, but it’s risky business for a country still trying to woo foreign investors. Riskier still for Serra, who wants badly to lead Brazil into the era of market-friendly reforms. Still, his public-health initiatives are feted at home and abroad. Delegations from as far away as Paris and Johannesburg make the pilgrimage to Brazil to learn about generic drugs, vaccination campaigns and how to combat AIDS. And Serra is considered a hero by everyone from the button-down bureaucrats at the United Nations to the denim-clad protesters who take to the streets as quickly as you can say globalization.
Serra was an odd choice for the job. A confessed hypochondriac, trained in engineering and economics, he is a famous pill popper and washes his hands obsessively. But maybe that was just what the doctor ordered. Before Serra, proposals to set clear rules for Brazil’s private health insurers languished in Congress for seven years. Now they are law. The ministry has brought flu vaccinations to 86 percent of the population, better than in the United States. And since generics hit the market, Brazilians have seen their drug bills plunge by as much as 40 percent.
If Serra’s tenure has been a bane for the likes of Big Pharma and Big Tobacco, it is a boon to President Fernando Henrique Cardoso. Immensely popular when he came to power in 1995, Cardoso has seen his ratings collapse in the autumn of his mandate. But Serra has brought him unexpected credit. It’s not clear whether Serra’s triumphs will help his own political career. He places dead last in most polls for the 2002 presidential elections. Sometimes doing good may have to be its own reward.
