Category: Academic Reportage

Source: The Conversation – USA – By Menika Dirkson, Associate Professor of History, Morgan State University

In the midst of a civil war, married couple Ernesto and Linda Fuentes fled their home country of El Salvador and headed for Philadelphia, via Mexico, in November 1983.

Ernesto was an activist who dispensed food and medicine in Salvadoran refugee camps. Linda was a union organizer for banks and clothing factories.

The Salvadoran government viewed activists, especially suspected guerrilla fighters and union leaders, as threats to its regime. It placed activists’ names on “death squad hit lists.” The couple decided to leave after receiving threatening letters and phone calls.

With false documents and the help of a humanitarian church group, they arrived at the Tabernacle United Church in West Philadelphia on May 12, 1984. The congregation declared itself a public sanctuary for undocumented refugees from El Salvador and Guatemala. An estimated 500,000 undocumented Salvadorans lived in the U.S. around that time.

The Fuenteses used the pastor’s office as their bedroom. Church members were instructed to keep the doors locked and not admit strangers, including the Immigration and Naturalization Service.

As a historian of race and policing in Philadelphia after the Civil Rights Movement, and the daughter of an immigrant, I’ve been exploring Philly’s history of sanctuary and how religious congregations, activists and city officials have supported local refugees over the past 40 years.

A ‘welcoming city’ for immigrants

Philadelphia Mayor Cherelle Parker has emphasized since May 2025 that Philadelphia is a certified “welcoming city.” She notably does not call Philadelphia a “sanctuary city.”

Welcoming cities have immigrant-friendly initiatives that make education, housing, workers’ rights, legal aid and language services accessible to immigrants and refugees without using the term “sanctuary city” in their laws and policies.

The presumed goal of this phrasing is to keep Philadelphia off the Trump administration’s radar and protect its US$2.2 billion in federal funding for health and human services.

However, Philly was, at various points, an official sanctuary city.

In 2014, then-Mayor Michael Nutter signed an executive order detailing that local police were not required to assist Immigration and Customs Enforcement unless the case involved a warrant or violent felon.

Nutter later rescinded Philadelphia’s sanctuary city status in an effort to dissuade congressional Republicans from passing a House bill that would deny sanctuary cities federal money earmarked for law enforcement and recidivism reduction. However, the next mayor, Jim Kenney, reinstated the order on Jan. 4, 2016.

Throughout 2017, President Donald Trump and Attorney General Jeff Sessions used executive orders, speeches and the immigration raid Operation Safe City to force Philadelphia officials to assist ICE or lose federal grants.

In 2018, Philadelphia won a lawsuit against the Trump administration that denied ICE access to police databases to find undocumented immigrants and prohibited city employees from assisting ICE.

Roots of sanctuary cities

The sanctuary movement started back in the 1960s. But it wasn’t immigrants who were seeking sanctuary. It was Americans.

Around 1968, drafted resisters who were opposed to fighting in the Vietnam War sought refuge in churches in the U.S. Northeast. One of the earliest cases involved Robert Talmanson, who received sanctuary in Boston’s Arlington Street Unitarian Church. He was later arrested by U.S. marshals and local police and incarcerated in Virginia for three years.

In November 1971, Berkeley, California, became the first sanctuary city in the country when 12 local churches inspired the City Council to pass a resolution offering sanctuary to draft resisters. It also banned city employees from “assisting in the investigation or arrest of any sanctuary seeker.”

In the two decades that followed, several Quaker, Presbyterian, Catholic and Jewish congregations across America and Canada used their houses of worship as sanctuaries for Central American refugees who were fleeing civil war, government repression and genocide.

Philly joins national movement

Frustration and outcry over the United States’ low acceptance rates of Central American asylum-seekers sparked Philadelphia’s sanctuary movement.

In January 1984, members of Tabernacle United Church, where the Fuentes couple would soon take refuge, voted to join the national sanctuary network. As the Rev. James MacDonald explained at the time, the congregation chose to “violate a human law in order to respond in obedience to God’s law.”

By May, the First United Methodist Church of Germantown also became a sanctuary church. A few months later, the church sheltered a young Guatemalan couple, Joel and Gabriela, and their 3-year-old daughter, Lucy. Joel, an activist who worked with unions and student groups, had been tortured by Guatemala City police.

On Jan. 14, 1985, INS staged nationwide raids of sanctuaries and arrested 60 undocumented immigrants and 16 sanctuary workers – including pastors, nuns and priests – for violating immigration laws. Joel and his family were among those seized. They were released when church members bailed them out as they awaited deportation hearings.

A new pathway to citizenship

By the mid-’80s, 42,000 people from 2,000 religious institutions in 60 cities nationwide had joined the sanctuary movement.

On Nov. 6, 1986, President Ronald Reagan signed into law the Immigration Reform and Control Act. It granted undocumented immigrants who arrived in the U.S. before 1982 one year to apply for amnesty. If eligible, they would begin a five-year pathway to citizenship.

Approximately 3 million people successfully became naturalized citizens through the amnesty program.

In the Philadelphia area, at least 5,000 to 7,000 people were undocumented in 1986. Advocates at the nonprofit Nationalities Service Center and American Friends Service Committee noted that many immigrants wanted to apply for amnesty but feared the program was a trick.

A decade later, immigration enforcement got tougher.

Local police assist ICE

In 1996, Congress passed Section 287(g) of the Immigration and Nationality Act. This granted local police the right to assist immigration officials in arresting and detaining unauthorized immigrants.

As of April 2026, over 1,600 law enforcement agencies in 39 states and two U.S. territories have a 287(g) agreement with ICE. The program offers local police free training in ICE procedures along with funding for equipment, vehicles and overtime pay.

While the Philadelphia Police Department has never signed a Section 287(g) agreement, about 68 Pennsylvania agencies have, including in neighboring Delaware County.

But these agreements aren’t always long-lasting. Between January and March 2026, two departments in Bucks and Chester counties rescinded their agreements with ICE to make residents feel safe after American-born protesters Renée Good and Alex Pretti were killed during ICE operations in Minneapolis.

Community activism continues

According to Pew Charitable Trusts, nearly 16% of Philadelphia’s 1.6 million residents are immigrants, largely from Asia and the Caribbean.

The exact number of undocumented immigrants in Philadelphia is unknown. However, the Migration Policy Institute estimates that 250,000 immigrants in Pennsylvania – 1.5% of the state’s total population – are undocumented.

Since January 2025, ICE crackdowns in sanctuary cities such as Los Angeles, Portland, Chicago and New York have resulted in the number of people held in ICE detention jumping from 40,000 to 73,000 people in January 2026.

Citizens and advocacy groups have stepped up to protect immigrants from ICE. The Party for Socialism and Liberation and the AR-12-toting members of the Black Lion Party for International Solidarity participated in protests in Philadelphia. Public school students from Northeast and Edison high schools have led anti-ICE walkouts.

On Jan. 29, 2026, City Council members Kendra Brooks and Rue Landau introduced an “ICE Out” package. The bills aim to codify the right of police to not share immigration, citizenship and personal data with ICE, or detain and hand over arrested individuals to the federal agency.

The legislation also proposes a ban on ICE agents who wear masks or hide their badges, use unmarked cars and city vehicles, or use municipal spaces as staging areas for enforcement and raids. And it would prohibit city employees from giving ICE access to libraries, shelters, health centers and recreation centers without a judicial warrant.

Community activists have long used civil disobedience and humanitarian aid to protect undocumented immigrants who are searching for a fresh start in the U.S.

An interfaith network inspired Philadelphia to become a sanctuary city. Today, churches such as Center City’s Arch Street United Methodist Church and North Philly’s Church of the Advocate, along with other congregations, uphold this tradition while a multicultural community across the city continues that fight.

Read more of our stories about Philadelphia and Pennsylvania, or sign up for our Philadelphia newsletter on Substack.

Menika Dirkson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Philadelphia’s 40-year history of protecting undocumented immigrants began with churches hiding refugees from El Salvador – https://theconversation.com/philadelphias-40-year-history-of-protecting-undocumented-immigrants-began-with-churches-hiding-refugees-from-el-salvador-278756

Source: The Conversation – USA (2) – By Yuanyuan (Gina) Cui, Assistant Professor of Marketing, Coastal Carolina University

Americans are skipping restaurant dinners, delaying car purchases and scouring for grocery deals. Amid tariff anxiety and broader stress over affordability, consumer confidence has dropped to levels not seen in over a decade, according to The Conference Board, a business think tank. At this point, it’s wealthier consumers who are powering the bulk of spending in the U.S. economy.

So what explains the success of Erewhon’s US$22 smoothie?

The Los Angeles grocery chain selling these fancy concoctions is doing so well, it opened three new stores in 2025 – its biggest expansion since 2011. The chain reportedly generates $1,800 to $2,500 in sales per square foot, up to five times what a typical U.S. supermarket earns.

These aren’t ordinary blended drinks; they include ingredients such as high-grade sea moss gel, adaptogenic mushrooms and collagen peptides. Often they come with a celebrity’s name attached.

It’s all part of the broader boom in the U.S. specialty food market, which has surpassed $219 billion – up nearly 150% in a decade, according to the Specialty Food Association. That far outpaces the roughly 47% growth seen in overall U.S. grocery sales over the same period.

Independent retail data from the market research firm Circana also confirms this growth: Even as inflation-weary consumers have traded down to store brands in many categories, premium and specialty products held up and even grew their dollar share of the market through 2025. On TikTok, creators who once filmed designer-bag hauls now post $12 tinned fish boards. Craft chocolate bars that cost $8–$12 are being marketed as, without irony, “self-care.”

So if consumers are this anxious, why are they still splurging? In fact, these aren’t contradictions – they’re two expressions of the same psychological reaction.

When people feel life is out of control, they reach for something small, expensive and signaling virtue. This is the real reason premium food is booming while some traditional luxury brands struggle, say consumer psychologists.

We are professors of consumer behavior and marketing who study how people make purchasing decisions amid economic uncertainty, and ask what explains the gap between how consumers feel and how they actually spend. Our work points to a consistent finding: When people feel they’ve lost control over the big things, they seek it in the small ones.

A quick detour through the makeup drawer

Economists have seen this before.

In 2001, Estée Lauder Chairman Leonard Lauder coined the term the “lipstick index” after he saw that lipstick sales rose 11% following the Sept. 11 attacks. When big luxuries feel out of reach, consumers find a small substitute. A $60 lipstick is extravagant for a cosmetic, but next to the Hermès handbag it psychologically replaces, it feels like a bargain.

Then, as now, people seek agency wherever they can find it. Consumer psychologists call this “compensatory consumption”: buying things to feel in control when life feels out of control.

While even beauty sales are softening, that impulse hasn’t disappeared. It has just found better hosts – such as food.

In many ways, food is an ideal product for this compensation. It’s experiential – something you taste, smell and savor. It’s also emotional – carrying associations with comfort, care and home. And it’s visible, because if you’re on social media, what you eat is now as public as what you wear. Premium food isn’t just eaten – it’s filmed, posted and performed.

Most importantly, it’s still relatively accessible. Twenty-two dollars may be an absurd price for a drink, but it’s cheap compared with a $400 wellness retreat.

Indulgence with a side of virtue

Here is what separates this moment from Lauder’s lipstick index. That example was purely about pleasure, as consumers sought indulgence as consolation. Today’s premium food purchases carry an additional layer: They are coded as virtuous.

An Erewhon smoothie isn’t just a treat. It’s organic, superfood-enriched and wellness-aligned. By the same logic, a $20 bottle of single-estate olive oil isn’t just cooking fat; it’s a commitment to craft and health. Premium tinned fish isn’t convenience food; it’s sustainably sourced protein caught in the wild with packaging beautiful enough to display.

This “virtue coding” does the most important psychological work in the sales transaction: It transforms indulgence into self-investment. You’re not splurging during a downturn; you’re doing something for your health. You’re not being frivolous; you’re supporting small producers. Research shows that people need reasons to justify pleasurable purchases, especially during financial anxiety – and premium food is powerful because the justification is built into the product. The organic label, the sustainability story, the wellness framing – they all dissolve guilt before it even kicks in.

Consumed in the kitchen and again on the feed

There’s a reason this trend is accelerating now. Many premium food purchases are consumed twice – once physically and once digitally. The Erewhon smoothie purchase isn’t really about the drink; it can be as much about the content as the drink. The tinned fish board is plated for Instagram before anyone takes a bite.

Social media doesn’t just amplify the trend; it completes it. When you post a photo or video of the smoothie, you’re broadcasting that you value wellness, quality and intentionality. In a cultural moment when flaunting a designer bag feels tone-deaf, food provides perfect cover. It’s the safest flex there is. It’s no surprise that one YouTube video of an Erewhon haul by food creator @KarissaEats has drawn over 14 million views.

All of this raises a fair question: Does the growing focus on the “K-shaped economy” explain this boom? As many economists see it, low- and middle-income shoppers are increasingly pulling back, as they face an affordability squeeze from health care to housing and education. But wealthier consumers are picking up the slack and then some, splurging on luxury and powering gross domestic product growth.

In this scenario, premium food thrives because it’s still affordable for the people who are doing fine, even as everyone else cuts back. That’s partly true. But this explanation doesn’t account for another shift – why affluent consumers are foregoing splurges on items like designer handbags in favor of premium groceries.

This is why the virtue framing matters so much. If the question was purely about having money to spend, traditional luxury would be booming as well. It isn’t. A case in point is LVMH, the conglomerate behind Louis Vuitton and Dior, which saw its fashion division’s profits decline 13% across all of 2025.

Even consumers who are flush with disposable income need psychological permission to spend during anxious times. The premium food phenomenon is about why food has become the thing they choose – not about who can afford to splurge.

And when a smoothie becomes a status symbol, it tells us something about economic security more broadly. Food prices have climbed nearly 30% since 2019, outpacing 23% for overall consumer prices, according to the Bureau of Labor Statistics. For a family stretching a tight grocery budget, $22 isn’t a smoothie. It’s dinner.

The need for control, the desire for identity, the comfort of virtue permission — these are universal. A single mother working two jobs feels the same craving for agency as the influencer filming her grocery haul. It’s just that the purchases that satisfy those needs are increasingly constrained by price. The justification only works if you can afford your indulgence.

What’s really in the cart

The next time you’re in a grocery store and you reach for something a little more expensive than what you might need, you should pause – not to put it back, but to think about what you’re actually reaching for.

Chances are it isn’t really about the product. It’s about the feeling of choosing something when the world feels out of hand.

A $22 smoothie is never just a smoothie. It’s what people seek out when they need permission to feel OK.

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Why Americans are buying $22 smoothies despite feeling terrible about the economy – https://theconversation.com/why-americans-are-buying-22-smoothies-despite-feeling-terrible-about-the-economy-279425

Source: The Conversation – USA (2) – By Renee Obringer, Assistant Professor in the Earth and Environmental Systems Institute, Penn State

When a drought turns into an urban water crisis, a city’s first step is often to limit lawn watering and launch a campaign to encourage everyone to conserve. It might raise water-use rates or offer incentives for installing low-flow devices.

While demand management techniques like these have had a lot of success in reducing water use, our new research suggests that they may not be effective enough in the face of climate change.

We looked at three cities in the Colorado River Basin – Phoenix, Las Vegas and Denver – to understand what each could do to increase demand management amid water shortages and how far those methods could go as temperatures rise and the Colorado River’s flow weakens.

The results suggest the region needs to be thinking about bigger solutions.

Colorado River states’ immediate challenge

The Colorado River provides drinking water to nearly 40 million people and irrigation for over 5.5 million acres of cropland. But it has experienced a significant drop in water availability in recent decades due in part to rising demand for water and a long-running megadrought in the Southwest.

To ensure that water is shared across boundaries, the seven states within the basin agreed to the Colorado River Compact in 1922, setting limits on water withdrawals from the river. Since then, the region has adopted additional rules, agreements and policies, collectively termed the “Law of the River.” But despite this compact, which the states are renegotiating in 2026, the basin’s water supply is shrinking.

Research shows that the region is likely to experience more intense, frequent droughts that last longer due to climate change, putting the water supplies for farms, people and energy systems at risk.

As researchers who study the impact of climate change on water systems, we wanted to see if demand management techniques could help under these intensifying conditions.

Getting people involved can change attitudes

Many demand management policies are reactive and only go into effect when sources run low.

These reactive policies can be successful during the scarcity period, but there is often a rebound effect: Water consumption can actually increase afterward.

We integrated survey data with a computer model of water availability and demonstrated that there can be long-term benefits to the local water supply if communities encourage positive attitudes toward conservation.

The survey focused on how people think about water conservation and climate change, drawing on a large body of research that shows people who care about the environment often take eco-friendly actions. Building off these ideas, we segmented the population into groups that shared similar views on water conservation and found that a large proportion of residents supported water conservation but weren’t actively participating in conservation programs within their communities.

We then used the computer model to explore how changing attitudes, and subsequent conservation behavior, could affect water supplies under climate change.

When participatory demand management works

Our research shows that individual actions, when implemented by a lot of people, can measurably improve water supplies’ reliability.

A great example of the benefits of long-term behavioral changes is Las Vegas.

Las Vegas is in many ways viewed as a city of excess; however, since 2002, the city has reduced its per-capita water use by nearly 60%, even as the population grew by more than 50%. It reached these savings through efforts to reduce seasonal irrigation, replace water-intensive landscaping and require new developments to be sustainable, along with the treatment and reuse of wastewater. Today, Las Vegas recycles nearly all of the water used indoors and returns it to Lake Mead.

Phoenix, another desert city, also runs successful conservation programs. These programs focus on converting grass lawns to desert-friendly landscaping and encouraging owners to fix leaks and install smart meters and low-flow devices. These programs led to a 20% reduction in water use over 20 years, while the population grew by about 40%.

Demand management is not always enough

These cities have shown that demand management can work, but there are limits on how much these techniques can do as water supplies dry up.

When we added projections of future climate change to our model, we found that conditions could lead to so little water being available that these demand management methods won’t be able to keep up.

In other words, climate change may create situations where water supplies are still severely limited, even after people reduced their consumption by up to 25%.

For example, under a plausible, moderately high emissions scenario, Phoenix’s available surface water supply was forecast to drop below the historical average by 2060. Even when we simulated higher participation in conservation programs, there was no noticeable change in the water availability, suggesting that any savings from reducing demand were counteracted by losses from upstream flow reductions. Encouraging people to use less water is a start, but there is a limit to how much people can conserve.

We found similar results in Denver under a moderate emissions scenario and in Las Vegas under a moderately high emissions scenario, indicating that even moderate climate change could lead to extreme scarcity conditions that are not manageable through demand-side changes alone.

What else cities can do

In these cases, it may be necessary to find other creative water sources, such as water reuse, desalination or limiting consumption in other sectors, such as agriculture or energy, to maintain the municipal supply.

These solutions, however, take time and money to implement. Desalination is incredibly expensive. A recently built desalination plant in Carlsbad, California, cost US$1 billion – four times the initial estimate.

Other solutions, such as reducing agricultural water use, require significant buy-in from local farmers and could result in producing less food.

Reducing the water consumed for electricity generation would require significant investment in renewable energy technologies that have lower water requirements than fossil fuels and nuclear energy.

While large-scale solutions like water reuse systems and desalination can be expensive, these costs might be necessary to maintain adequate water supply in the region, because simply encouraging people to use less won’t be enough.

Renee Obringer received funding from the National Science Foundation.

Dave White received funding from the National Science Foundation.

– ref. Water conservation works, but climate change is outpacing it: Phoenix, Denver and Las Vegas offer a glimpse of the future – https://theconversation.com/water-conservation-works-but-climate-change-is-outpacing-it-phoenix-denver-and-las-vegas-offer-a-glimpse-of-the-future-279837

Source: The Conversation – USA (2) – By Daniel T. Blumstein, Professor of Ecology and Evolutionary Biology, Institute of the Environment and Sustainability, University of California, Los Angeles

The urban monkeys in New Delhi are so bold they’ll steal the lunch right off your plate. If you’ve spent time in New York, you’ve probably seen squirrels try to do the same. Sydney’s white ibises got the nickname “bin chickens” for stealing trash and sandwiches.

This brazen behavior isn’t normal for most species in the countryside, yet it shows up in urban wildlife, and not just in these cities.

Studies show that animals living in urban environments around the world exhibit common sets of behaviors. At the same time, these urban animals are losing traits they would need in the wild. This process of urban animals’ behavior becoming more similar is known as “behavioral homogenization,” and it accompanies the loss of species diversity with urbanization.

We study animals in urban settings to understand how humans can help wildlife thrive in an urbanizing world. In a new study, we explore the causes and the long-term consequences of these behavior changes for urban wildlife.

What makes animals in cities similar?

Cities, despite their local differences, share many of the same features worldwide: They are warmer than the surrounding countryside, noisy, polluted by light and, most importantly, dominated by people.

New York’s squirrels, New Delhi’s monkeys, gulls in coastal cities of the U.K. and other urban wildlife have learned that people are a source of food. And because people typically don’t harm the animals, city-dwelling animals learn not to fear people.

Cities drive evolution as well. Humans and the changes we’ve brought to cities have led to the survival of bolder animals, and those bolder animals pass on their traits to future generations. In genetics, scientists refer to this as the environment “selecting” for those traits.

It’s not just sandwich-stealing that is more common among city wildlife; urban birds also sound more alike.

Why? Cities are loud and filled with traffic noise, so those who can effectively communicate in that environment are more likely to survive and pass on those traits.

For example, urban birds may sing louder, start singing earlier in the morning or at higher frequencies to avoid getting drowned out by low-frequency traffic noise.

Cities select for smart individuals and species because that’s what it takes to survive.

Animals may behave similarly in cities because they learn from each other how to exploit novel human food sources. For instance, the cockatoos in Sydney have learned to open trash bins. In Toronto, the raccoons are in a race to outwit humans as urban wildlife managers try to design animal-proof trash bins.

The buildings and bridges in cities become home to bats, birds, and other urban dwellers, at the cost of learning to use more natural nesting sites. Roads and culverts modify how and where animals move.

While rural animals may forage at a variety of places and eat a variety of foods, urban animals may concentrate on garbage bins or rubbish dumps where they know they can find food, but they end up eating a potentially unhealthy diet.

Consequences of similar behaviors

The loss of behavioral diversity is happening everywhere that humans increase their footprint on nature. This is worrisome on several levels.

At the population level, behavioral variation may reflect genetic variation. Genetic variation gives species the ability to respond to future environmental change. For example, for animals that have evolved to breed at a specific time of the year, urban heat islands can select for earlier breeding.

Reducing genetic variation leaves populations less able to respond to future changes. In that sense, having genetic variation resembles a diversified investment portfolio: Spreading risk across a variety of stocks and bonds lowers the risk that a single shock will wipe out everything.

Moreover, as animals become tamer, new conflicts between animals and humans may emerge. For instance, there may be more car crashes, animal bites, property damage and zoonotic disease transmission. Such conflicts cost money and may harm both the animals and humans.

Losing behavioral diversity is also troubling for conservation.

When a species loses behavioral diversity, it loses resilience against future environmental change in the wild, making reintroducing urban animals to the wild harder.

Losing behavioral diversity also risks erasing socially learned, population-specific behaviors, such as local migration routes, foraging techniques, tool-use traditions or vocal dialects.

For example, Australia’s regent honeyeater populations have been shrinking and are critically endangered. The isolation of having fewer of their own species around has disrupted normal song-learning behavior, making it harder for male birds to sing attractive songs that help them find mates and breed successfully.

Ultimately, behavioral homogenization is making wildlife in cities such as Los Angeles, Lima, Lagos and Lahore behave in similar ways despite living in different environments and having different evolutionary histories.

Many of these behaviors influence survival and reproduction, so understanding this form of diversity loss is important for successful wildlife conservation, as well as future urban planning.

Daniel T. Blumstein is on the Board of Trustees of the nonprofit environmental organization The Rocky Mountain Biological Laboratory.

Peter Mikula and Piotr Tryjanowski do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. City animals act in the same brazen ways around the world – https://theconversation.com/city-animals-act-in-the-same-brazen-ways-around-the-world-279977

Source: The Conversation – USA (3) – By Jessica A.J. Rich, Assistant Professor of Political Science, Marquette University

Public health institutions are under threat by populist governments across the globe.

From Budapest to Jakarta, Indonesia, public health agencies are being stripped of funding and independence. Meanwhile, disinformation has sown distrust in scientific experts. The results are already visible through the return of diseases once thought eliminated or controlled, like measles and whooping cough.

The United States is no exception to this trend. Since Robert F. Kennedy, Jr. was confirmed as secretary of Health and Human Services in February 2025, he has fired over 10,000 staff, cut budgets and attempted to gut childhood vaccine recommendations. Though medical and public health groups have pushed back with some success, key government health institutions face a leadership vacuum, and national public health policy has fractured into “health alliances” formed by groups of states.

Doctors and scientists across the country worry about long-term damage to the country’s health system.

As a researcher studying the politics of health care, I believe it’s helpful to look to countries that have successfully managed similar threats. As my co-authors and I have argued, Brazil’s experience offers insights into how public health institutions can preserve power and authority in the face of assault.

Much like the U.S., Brazil has a fragmented and polarized Congress, it has powerful self-interested lobbies, and it has a federal system of government. And much like in the U.S., health outcomes suffer from stark race and income gaps.

But when a populist president attacked the Brazilian health care system during COVID-19, the public successfully rallied to its defense

A health system under attack

Brazil’s health system, established in its current form in 1990, provides free universal health care to all its citizens. Despite some significant flaws, including unequal access to care in poor and rural areas, its focus on preventive care is widely considered a model worldwide

Prior to the administration of right-wing populist Jair Bolsonaro, from 2019 to 2022, Brazilians had trust in vaccines. They had what public health experts call a vaccine culture, thanks to the hard work of health workers who had spent years promoting them and making them easily accessible. Vaccines even had a beloved national mascot in Zé Gotinha (Joe Droplet), a cartoon vaccine droplet with a Pillsbury Doughboy-like visage.

When COVID-19 hit Brazil in March 2020, Bolsonaro – dubbed by many as the “Trump of the Tropics” – launched unprecedented attacks on Brazil’s vaccine program. Among other measures, he fired the senior leadership of the health ministry and appointed as minister an active-duty military officer with no health credentials.

Bolsonaro’s attacks on the vaccine program – a backbone of Brazil’s preventive health efforts – were especially strong. He pressured Brazil’s drug regulatory agency to ban pediatric vaccines. He blocked resources for vaccine procurement, and he spread misinformation, notoriously suggesting the vaccine could give people AIDS.

After Bolsonaro’s initial attacks on Brazil’s COVID-19 response efforts, the entire health system appeared on the verge of collapse. However, Brazil’s public health workers then marshaled broad support to defend their vaccine program.

Opposition governors offered important but limited help by producing their own vaccine guidance and procuring their own vaccines. But political support, on its own, couldn’t overcome Bolsonaro’s attacks.

That’s because Brazil’s vaccine program depended not just on independence, but also on resources to operate. And governments with an anti-science bent have many ways to deprive even well-established agencies of resources without broad congressional approval.

Brazil’s vaccine program ultimately survived because allies outside government stepped in to defend it not only with political advocacy, but by donating money and resources and with social activism.

Business leaders to the rescue

Businesses filled gaps in government resources with donations of private-sector funding. Two business coalitions gave a total of over 270 million real (US$54 million) to help two public laboratories, the Institute of Technology in Immunobiology, known as BioManguinhos, and the Butantan Institute.

One of the largest foundations in Brazil, the Lemann Foundation, paid for AstraZeneca’s clinical trials in Brazil. Ambev, one of the largest firms in South America, lent its logistics team to help BioManguinhos acquire supplies and equipment.

Women of Brazil, a nonpartisan network of female business leaders, even built a campaign called United for the Vaccine to help towns and cities acquire the vaccine distribution equipment they needed. They provided local health officials with cheap supplies, like coolers and refrigerators, as well as costlier investments, such as boats and even planes for carrying vaccines to the isolated communities of the Amazon.

As pulmonologist Margareth Dalcolmo, who consulted for United for the Vaccine, emphasized to me in an interview: “All their requests were met, without one cent of government money being used.”

From the ground up

Another hugely important component of defending Brazil’s vaccine program was support from trusted local grassroots groups.

When vaccines became available, community-based groups across the country jumped in to combat disinformation with their own locally produced information campaigns – especially in underserved communities.

One group I spoke to distributed 5,000 informational posters across their neighborhood. Another, Tamo Junto Rocinha, or We’re in it Together Rocinha, published a book with lessons for kids to do with their parents while school was canceled – all with vaccination information embedded. Voz das Comunidades, or Voice of the Communities, a neighborhood news service, even created a smartphone application to combat misinformation while also notifying community members of daily death tallies.

So many grassroots groups organized to counter Bolsonaro’s attacks on COVID-19 vaccines that researchers began to map the campaigns bubbling up across the country. By early 2021, one map had identified over 1,300 grassroots efforts and over 800 organized by universities.

By August 2022, despite Bolsonaro’s disinformation campaigns, 81% of Brazil’s adult population was fully vaccinated against COVID-19. These vaccination rates equaled those of New Zealand and the Netherlands and were well above that of the United States, where only 67% were fully vaccinated at the time.

This is not to say that Brazil was immune to disinformation campaigns. Vaccination rates for some diseases, such as measles, declined, as they have across the world.

But in many ways, the attacks on Brazil’s vaccine program paradoxically strengthened it. By the end of 2022, thanks to donor support, BioManguinhos had already built a new testing laboratory, and Butantan was constructing a new vaccine production facility. Brazil even had a new national health surveillance institute. By 2024, once Bolsonaro was voted out, overall spending on the health system had increased from the prior year by 27%.

Playing the long game with public health

In my view, these emergency countermeasures in Brazil worked effectively because the country had already spent years building a foundation of trust in – and ownership of – the shared goals of its public health system.

Decades ago, in the 1980s, Brazilians successfully demanded that their politicians make health care accessible to all – driving the genesis of the country’s universal public health system, known by the acronym SUS.

Brazil’s health ministry continues to invest heavily in making sure citizens take ownership of it. Cities and towns are postered with signs declaring “SUS is ours!” or “Health care is your right!”

As I found in my recent research in Brazil, this kind of advertising makes people feel their institutions are an earned right and reduces the power of partisan messaging.

Brazil also invests in integrating health workers into the communities they serve and cultivating public trust in their expertise. Government health care workers routinely set up shop in public plazas to advertise cancer screenings or give vaccinations. They regularly visit schools, where doctors or nurses talk to young people in accessible language about what the nation’s public health system offers its citizens. As one health care worker told me: “It’s like they are constantly saying, ‘Look, the doors are open. You can come. You’ll be seen and supported.’”

These long-term relationships between communities and the public health system helped lay the groundwork in Brazil for mounting a unified defense when political turbulence threatened public health agencies. Worldwide, a long-term view toward building or strengthening these relationships may help the public embrace the idea that public health institutions are worth defending.

Jessica A.J. Rich does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. From a vaccine mascot to business leadership, lessons for the US from Brazil’s public health system in building public trust and keeping it – https://theconversation.com/from-a-vaccine-mascot-to-business-leadership-lessons-for-the-us-from-brazils-public-health-system-in-building-public-trust-and-keeping-it-267611