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Brazilian federalism was important in the political game of combating the pandemic for three reasons. First, Brazil's public health system depends heavily on intergovernmental relations between Union, states, and municipalities because there is a policy portfolio based on federative cooperation. Second, the subnational governments' autonomy to act against COVID-19 was constantly questioned by the Federal Government – the conflict between the President and governors was a key piece in all health policy. Finally, states and local governments were primarily responsible for policies to fight against pandemic, but the absence and/or wrong measures taken by the Federal Government (such as the delay in purchasing vaccines) generated intergovernmental incoordination, increased territorial inequality, and reduced the effectiveness of subnational public policies, especially those linked to social isolation. In this context, Brazilian federalism played a dual role in the pandemic. On the one hand, the federative structure partially succeeded in averting an even worse scenario, mitigating the impact of mistaken presidential decisions. The role of subnational governments, especially of the states, was critical as a counterweight to federal decisions. On the other hand, the President actively acted against governors and mayors and, above all, sought to weaken intergovernmental articulations within the Unified Health System (SUS), the federative model designed three decades ago. One could say that the federative actors, such as the Supreme Court (Supremo Tribunal Federal – STF) and subnational governments, were the main obstacles for the Bolsonarist antiscientific agenda. The success of this reaction to President Bolsonaro's negationist populism was partial, but the results of the fight against COVID-19 would have been much worse without these federalist barriers.

This chapter analyzes governmental responses to the COVID-19 pandemic in a highly decentralized federal country. Canada has a decentralized approach in many policy areas, including health care, in which provinces are the primary decision-makers and service providers. This decentralized health-care system allowed provinces to respond according to regional and local contexts and needs. The capacity building and the policy learning related to previous crises and horizontal coordination were key to policy responses to the pandemic. Moreover, unlike other countries, Canada did not centralize decisions throughout the pandemic, and did not reinforce competition and uncoordinated actions. The federal government also has had a central role coordinating COVID-19 policy responses. Nevertheless, Canada faced some challenges stemming from the lack of uniformity across the country, especially related to regional and local restrictions, enforcement mechanisms, testing, and travel restrictions.