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In December 2020, when physician Victor Heitor Gomes became the health director for Rafard, a municipality 150 kilometers northwest of São Paulo, he knew he had a challenge ahead.

United statesSao pauloRio de janeiroEstado do rioAtlantic oceanMaria tereza apprilante gimenezVictor heitor gomesPorto alegreEduardo traniMariana silvaPan american health organizationBrazilian national institute of meteorologyAmerican development bankLatin americaBrazilian national instituteInter american development bank