President Lula is vaccinated by vice-president Geraldo Alckmin at the launch of the National Movement for Vaccination – Fabio Rodrigues-Pozzebom/ Agência Brasil
At the launch of the national movement, Vice President Geraldo Alckmin vaccinated President Lula with a bivalent booster dose against covid-19, publicly demonstrating support for vaccination and confidence in the safety of vaccines.
One of the obstacles to the success of the movement is precisely the action of anti-vaccination groups that spread lies with the aim of causing hesitation in the population that needs to be vaccinated. For the Minister of Health, this action is criminal.
“We have faced a strong campaign, since February 27, to fake news involving the bivalent vaccine. This is extremely serious and I have highlighted that it is not about disinformation, it is about criminal action”, declared the minister.
The president of the National Health Council sees the strengthening of these denialist groups directly linked to the actions and anti-science statements of the previous government, but points out that the threat of the return of diseases such as polio is an older problem, due to the successive drops in vaccination coverage since 2015. He assesses that the national movement for vaccination is a priority that is being well underway by the government.
“This movement is fundamental. We believe we are on a good path and we have to expand even more. The National Health Conference itself is dealing with this, and we believe that it will be possible for us to reverse the current situation, in which vaccination rates are very low”.
Representative of a category directly involved in vaccination, member of the Federal Nursing Council Daniel Menezes sees it as positive that the recovery of vaccination coverage is considered a priority. “It is a movement that has our support and counts on our work, especially in public health and primary care”.
nursing floor
Menezes points out that the priority for the category at this moment is the guarantee of minimum wageforeseen in approved law by the National Congress and sanctioned by the previous government, but suspended by an injunction from the Federal Supreme Court following an action by private companies in the sector. Minister Luís Roberto Barroso’s decision complied with the request due to the lack of a paying source for compliance with the floor, which awaits a solution.
The counselor evaluates that the dialogue with the federal government has been positive for the Executive to solve the problem, with a provisional measure that meets this requirement and allows payment according to the floor. The expectation, however, was that this solution would be faster, he says.
“We believe that it has taken a long time to implement all of this, which is being publicized by the president himself and even by the minister of health and the chief minister of the civil house. Nursing, in general, is concerned about the delay for this measure to be taken. Our assessment is positive, but with that caveat”.
The law passed last year provides for the payment of at least a salary of BRL 4,750 for nurses, BRL 3,325 for nursing technicians, and BRL 2,375 for nursing assistants.
The president of the National Health Council agrees that the guarantee of the national nursing floor is a priority measure enough to have been implemented in the first 100 days of government. Pigatto argues that the issue will be resolved in the coming days.
“The national nursing floor was for us set for the horizon of action of the first 100 days. We hope that the provisional measure will be signed by next week, because, for us, this is fundamental. The position of the National Health Council is that this is a priority that needs to materialize in real life”.
Impoundment of surgeries
Fernando Pigatto also evaluates as positive the inclusion of the reducing queues for elective surgeries among the priorities forwarded in the first 100 days of government, because the problem affects a large number of people and causes the worsening of health conditions. The council sees, however, that it is necessary to prioritize public health units with the program’s resources that will be forwarded to the federative units.
“We know that the system is complex. We know that, in some places, the private and philanthropic initiative system has a very strong force, but we believe that it has to, little by little, adjust so that more and more public resources are directed to public institutions, that have public monitoring and regulation. So that these resources are well used”, he opines. “We consider the initiative positive. We think it is important to allocate resources to face the queues. We know that the problems will not be solved this year. And, therefore, the programs increasingly need to be improved and have the look of social control, not only in inspection, but in how these resources will be invested”.
An amount of R$ 600 million in resources was guaranteed for the initiative by the Transition PEC, and the first remittance, around R$ 200 million, will be destined only to elective surgeries. In addition to surgical procedures, the program will respond in a second moment to the dammed demand for examinations and specialized consultations.
For the vice-president of Abrasco, there is already a positive result in this matter due to the coordination work of the federal government in relation to other instances of the SUS. “Because of the scale at which health policies occur, they are quickly perceived by the population. They are experienced. Why haven’t significant improvements been achieved before? Because, to achieve this, it must be a priority, the available technical competence must be mobilized, and the SUS must function at its various levels. And why wasn’t it done before? Because there was a confused agenda, which did not prioritize essential health issues and was dispersed in ideological and political disputes, and, because it was disaggregating, it was unable to articulate with the states and municipalities”.
More Doctors
the rlaunch of the Mais Médicos program is also a measure highlighted by the vice president of Abrasco, who points out that the program was adequate for the current scenario, in which there are already a greater number of doctors in the country than when it was launched for the first time, in 2013 Even so, the challenge of keeping doctors in interior regions and on the outskirts of large cities is great, he assesses.
“The proposal will still undergo necessary adaptations so that it can present results. But we had a successful experience the first time, so our expectation is that this updated version will also be able to greatly increase the offer of health care for populations that today lack the presence, not only of doctors in these locations, although the absence of this specific professional ends up being very striking”.
On the 20th, the federal government announced the resumption of the program. By the end of 2023, there will be 28,000 professionals across the country, with priority in areas of extreme poverty. The government estimate is that more than 96 million Brazilians may be assisted by these physicians in primary care.
For the National Health Council, the relaunch of the program was very important to replace Doctors for Brazil, implemented in the previous government. Pigatto claims that the program did not reach its objectives, and the country, on the contrary, lost doctors in regions whose populations had less access to health, such as indigenous peoples.
wanted by Brazil Agency, the Federal Council of Medicine stated that it is preparing proposals that will be forwarded to the National Congress with a view to improving the provisional measure that provides incentives for training participants in Mais Médicos. When formulating the measure, the federal government justified that 41% of the Mais Médicos participants give up working in more remote locations and go in search of training and qualification opportunities. In view of this, the proposal provides incentives for these professionals, such as compensation for settling in places of difficult access and lato sensu training and professional master’s degrees for participants.
The CFM advocates that the government only consider the participation of doctors with CRM, that is, with revalidated diplomas. The council argues that passing this exam is a measure that brings security to patients, ensuring that only people who prove knowledge, skills and specific attitudes of medicine can make the diagnosis of diseases and prescribe treatments. In Provisional Measure 1165, of March 21, 2023, the government provides for the exemption of the exchange doctor from the obligation to revalidate his diploma while practicing medicine exclusively in the teaching, research and extension activities of Mais Médicos.
In addition, the CFM claims that any initiative of this type must provide for the guarantee of offering professionals adequate working conditions, such as access to beds, equipment, exams, multidisciplinary team and referral and counter-referral network, in addition to offering remuneration compatible with the dedication and responsibility required.
SUS budget
The president of the CNS points out that an issue under debate in the council is the new fiscal rule presented by the federal government, which will be discussed at a national seminar on April 18th and 19th. Pigatto sees the replacement of the spending ceiling as essential, which caused many losses in the SUS.
“Constitutional Amendment 95 removed more than R$ 60 billion from the SUS. This means death. This means illness, this means sadness and pain for families. This means people waiting for an exam, not having medicine, not having surgery” .
For Abrasco, the tax framework advances by removing the SUS from the suffocation caused by the spending ceiling that has been in force in recent years. In addition to reducing the health budget, points out Paes de Sousa, the spending ceiling impacted income and access to social programs, increasing the population’s demand for public and free health.
“PEC 95 was doomed to failure, because the degree of restriction it imposed on the public budget was not sustainable. The deadlines and rigidity of this model are unlikely to survive, and fortunately they will not. On health, the effect was brutal, ”he says. “If we disregard the investment that was made towards the pandemic, we had budget constraints in the area of health”.
The sanitarista points out that growing demands demand investments in the health area, whose specific inflation is always more intense than general inflation. “The recomposition of the health budget is always more critical. And in Minister Haddad’s proposal, the preservation of the health area is very important. The spending ceiling is the type of definition that will need to be reviewed later on. Something would emerge to replace that model, which would not be sustainable. The degree of suffocation of the public budget would be such that it would be unfeasible”.
