Brazilian senators have voted to recommend charging President Jair Bolsonaro over his handling of the devastating Covid pandemic.
A Senate panel backed a report calling for charges against Mr Bolsonaro including crimes against humanity, after 600,000 deaths from coronavirus.
The findings will be sent to the chief prosecutor, a Bolsonaro appointee.
The president has maintained he is "guilty of absolutely nothing" but the crisis has dented his popularity.
Brazil's death toll is second only to that of the United States.
There is no guarantee this vote will lead to actual criminal charges, as the report's recommendations must now be assessed by Prosecutor-General Augusto Aras, who is expected to protect the president.
The report alleges that Mr Bolsonaro's government pursued a policy of allowing coronavirus to rip through the country in the hope of achieving herd immunity.
It describes the president as "the main person responsible for the errors committed by the federal government during the pandemic".
The report's lead author, centrist Senator Renan Calheiros, called for the panel's recommendation to charge President Bolsonaro with crimes against humanity to be submitted to the International Criminal Court (ICC).
Brazil is a party to the Rome Statute, which created the ICC, so the international court could take up the case.
But a referral would only be a first step in a lengthy process in which it would be up to the ICC to determine the merits of the case and whether to take it forward.
In addition to crimes against humanity, the Senate committee has recommended eight further charges be brought against Mr Bolsonaro in Brazilian courts, including incitement to crime, falsification of documents and the violation of social rights.
Mr Bolsonaro is also accused of misusing public funds and spreading fake news about the pandemic.
The 1,300-page report also recommended bringing charges against two corporations and 77 other people, including three of the president's adult sons.
Following the announcement, Senator Calheiros said that the "chaos of Jair Bolsonaro's government will enter history as the lowest level of human destitution".
The vote concludes a six-month inquiry which has highlighted scandals and corruption inside the government.
The Senate's recommendation is expected to be delivered to the prosecutor-general on Wednesday morning. His office said it would be carefully reviewed as soon as it was received, the Associated Press reports.
Throughout the process, Mr Bolsonaro has insisted that his government "did the right thing from the first moment" of the pandemic and his allies have been quick to dismiss Tuesday's recommendations as being driven entirely by "political and electoral" motivations.
"It is a totally political report, without any legal basis," said Flavio Bolsonaro, one of the president's sons accused in the report.
"The intent of some senators on the investigative committee is to cause the maximum amount of wear and tear on the president."
Former US President Donald Trump, a Bolsonaro ally, said in a statement he endorsed the Brazilian president because "he fights hard for, and loves, the people of Brazil".
Today marked the end of a long process. Six months of hearings, scandals uncovered, a light shone on a government accused of recklessness.
Just before the vote, leading senators delivered impassioned speeches. Senator Calheiros said the inquiry had slowed down the clock of death in Brazil.
The inquiry's vice-president, Randolfe Rodrigues, underlined how important the process had been to put pressure on the government and speed up vaccinations, and he paid tribute to those on the front line of containing the pandemic.
But for many, it's too little, too late - the families of the dead will be wanting to know where this inquiry will lead. Will Mr Bolsonaro have to stand up in court to defend his actions?
The inquiry's president, Omar Aziz, said the federal prosecutor had a duty to investigate the evidence gathered these past few months - but not everyone thinks justice will be done.
In March, Mr Bolsonaro caused outrage when he told Brazilians to "stop whining" about Covid, a day after the country saw a record rise in deaths over a 24-hour period.
He has continued to spread misinformation on social media and, on Monday, Facebook removed a video in which the president falsely claimed a link between Covid-19 vaccines and Aids.
YouTube blocked the video and suspended Mr Bolsonaro's channel for a week.
Brazil, a country of 208 million people, has recorded at least 606,000 deaths and 21.7 million cases of infection, Johns Hopkins University reports.