During a recent visit to Brazil for COP30, environmentalist Chandra Bhushan experienced something unexpected: his first instance of falling ill outside India in more than thirty years of travel. What happened next became a revealing lesson in how differently India and Brazil approach antibiotics and why this difference has critical public health implications.
Bhushan explains that, like millions of Indians, he has grown accustomed to an informal network of doctors, neighbourhood chemists and well-intentioned advisers. For everyday illnesses such as coughs or colds, the advice he receives tends to be predictable. Even when doctors diagnose a viral infection, the prescription almost always includes an antibiotic, justified with the familiar line, “Take this to prevent a secondary bacterial infection.” It rarely matters that antibiotics do not work against viruses.
A few years ago, this overuse finally caught up with him. Following one course of antibiotics, Bhushan developed a persistent cough that lasted for months, prompting him to become far more cautious with such medication.
Routine Illness, a Surprising Reality Check
On his fourth day in Brazil, Bhushan fell ill. The source of such infections crowded airports, conference halls, air-conditioned taxis is often impossible to identify. He followed his usual home-care routine: steam inhalation, saline gargles, warm fluids and paracetamol. But by the sixth day, his symptoms worsened.
He reached out to his doctor in India, who responded with the expected list: paracetamol, an anti-allergic, a broad-spectrum antibiotic, vitamins, throat soothers and a cough suppressant. Bhushan took the prescription to a local chemist in Brazil, but what happened next challenged everything he had grown used to in India.
Chemist Who Says No to Antibiotics Without Proof
The Brazilian chemist refused to honour the Indian doctor’s prescription. Under Brazilian law, antibiotics can only be dispensed with a prescription issued by a local doctor. The chemist separated the non-restricted items paracetamol, vitamins and lozenges from antibiotics, which remained strictly off limits.
He then directed Bhushan to a government-run urgent-care centre that operated round the clock, assuring him that a local doctor would evaluate his condition properly.
A Public Health System That Puts Diagnosis Before Drugs
Despite his hesitation, Bhushan visited the centre. It was clean, efficient and welcoming. The staff spoke only Portuguese, he spoke only English, but a translation app was enough to bridge the gap. He was registered quickly, without any consultation fee.
The doctor examined him thoroughly. When Bhushan presented his Indian prescription, the doctor glanced at it briefly and set it aside without comment. The intention was clear: treatment would be based solely on clinical assessment, not on assumptions of infection or precautionary antibiotic use.