A Brazilian Senate committee has recommended President Jair Bolsonaro face a series of criminal indictments for actions and omissions related to the world's second highest Covid-19 death toll.
The seven-to-four vote was the culmination of a six-month committee investigation of the government's handling of the pandemic.
It formally approved a report calling for prosecutors to try Mr Bolsonaro on charges ranging from charlatanism and inciting crime to misuse of public funds and crimes against humanity, and in doing so hold him responsible for many of Brazil's more than 600,000 Covid-19 deaths.
Mr Bolsonaro has denied wrongdoing, and the decision on whether to file most of the charges will be up to Prosecutor-General Augusto Aras, a presidential appointee who is widely viewed as protecting him.
The allegation of crimes against humanity would need to be pursued by the International Criminal Court.
Senator Omar Aziz, the chairman of the inquiry, said he would deliver the recommendation to the prosecutor-general on Wednesday morning.
Mr Aras's office said the report would be carefully reviewed as soon as it is received.
Regardless of whether charges are filed, the report is expected to fuel criticism of the divisive president, whose approval ratings have slumped ahead of his 2022 re-election campaign - in large part because of Brazil's outsized Covid-19 death toll.
The investigation itself has for months provided a drumbeat of damaging allegations.
Since the start of the pandemic, Mr Bolsonaro has sabotaged local leaders' restrictions on activity aimed at stopping the virus's spread, saying the economy needed to keep humming so the poor did not suffer worse hardship.
He also has insistently touted an anti-malaria drug long after broad testing showed it is not effective against Covid-19, assembled crowds without wearing masks and fuelled doubts about vaccines.
Mr Bolsonaro has defended himself by saying he was among the few world leaders courageous enough to defy political correctness and global health recommendations, and that he has not erred in the slightest.
The report says that by insisting on treatment with the anti-malarial drug hydroxychloroquine as "practically the only government policy to fight the pandemic, Jair Bolsonaro strongly collaborated for COVID-19's spread in Brazilian territory" and as a result is "the main person responsible for the errors committed by the federal government during the pandemic".
Committee members in the so-called G7 group of senators who are not from Mr Bolsonaro's base agreed on most of the points in the report.
They met on Monday to hammer out final adjustments to the text.
Changes include recommending charges for 13 additional people, many of them current or former health ministry employees, as well as the governor of hard-hit Amazonas state.
The final report recommends charges against two companies and 78 people in all, including Mr Bolsonaro, administration officials, dozens of allies and the president's three sons, who are politicians.
It also adds an additional violation for allegedly spreading false news following Mr Bolsonaro's live broadcast on social media last week claiming incorrectly that people in the UK who received two vaccine doses are developing AIDS faster than expected.
The report also contains recommendations for two counts of "crime of responsibility", which are grounds for impeachment.
But lower house speaker Arthur Lira, a staunch ally of Mr Bolsonaro, would have to bring a vote on whether to open impeachment proceedings - something seen as highly unlikely considering Mr Lira is currently sitting on more than 120 other impeachment requests, according to information from the legislative body.
Senator Flavio Bolsonaro, one of the president's sons, called the report legally weak and politically motivated.
"The intent of some senators on the investigative committee is to cause the maximum amount of wear and tear on the president," he told journalists.
Minutes after the inquiry was finished, former US President Donald Trump said in a statement that he endorses the Brazilian leader.
He said: "President Jair Bolsonaro and I have become great friends over the past few years. He fights hard for, and loves, the people of Brazil - just like I do for the people of the United States.
"Brazil is lucky to have a man such as Jair Bolsonaro working for them. He is a great President and will never let the people of his great country down!"
An earlier draft had recommended the president also be indicted for homicide and genocide, but that was scrapped even before its presentation last week.
Some committee members opposed such charges, while others expressed concern that bombastic claims could undermine the report's credibility.
The Senate committee's final hearing on the inquiry ended with a moment of silence for victims of the virus in Brazil.
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