Recently, the World Health Organization (WHO), deemed the major global authority to the segment, published a report, praising the advancements in the Brazilian public health system. Public strategies, such as vaccination campaigns, visiting and field analysis of the “Family Health Program” teams are tools to the health promotion in the country. Results indicated in that report showed a reduction in the child mortality rate in Brazil, from 46 deaths per 1000 live birth in 1990 to 18 deaths per 1000 live birth in 2008. Such reduction will make the country to advance in 2012 to the fourth Target of the Development Objectives to the Millennium with three years advancement in the limit-date set by the United Nations (UN). Still, WHO reinforced that more than 75% of the Brazilian people depend exclusively on SUS (Unique Health System) to have access to health services, which “besides of offering primary health attendance, it makes available a wide range of hospital services, such as cardiac surgery, image diagnosis, and sophisticated laboratorial examinations”.
Also, that document points out the prevention programs and other programs as Popular Pharmacy and Smiling Brazil, National Immunization Program which accounts for the application of 130 million doses/year, added to more recent measures, such as the Influenza H1N1 (locally called the swine flu) vaccination campaign that immunized 89.4 million Brazilian people.
These data show that the sector is in an open growth in the country, and expecting to achieve and implement new plans and directives to assure to the whole population such essential asset to the country’s development: Health.
Vaccination campaigns: course for the immunization
Influenza H1N1
The Ministry of Health performed in 2010 a big program seeking to vaccinate the Brazilian population against the Pandemic Influenza (H1N1) locally known as the “swine flu”, creating strategies to identify such a contagious respiratory disease caused by a new subtype of the influenza virus.
The Ministry launched a national kit to the Diagnosis of the Influenza H1N1, a Brazilian technology developed to identify the virus. The country was able to produce biomolecular reagents used in the labs to detect the disease and to become more independent from the international market. The Federal Government funding to the project was of US$ 2.02 millions. With such test, the time spent in the analysis was reduced from 8 to 4 hours to get a result.
The vaccination was performed in several steps, according to the WHO recommendations, in order to first immunize workers of the health services, Indian people, pregnant women and persons with chronic diseases. Brazilian Government went beyond that, expanding vaccination to other three groups: from six months babies to less than two years old children, and 20-29 years old and 30-39 years old adults. In total, 89.4 million Brazilian people were immunized.
Measles and rubella
The country is deemed to be the first in the Americas to deliver its report to the measles elimination certificate, also pointing out advancements in interrupting the rubella virus and SRC (Congenital Rubella Syndrome) transmission.
The document was delivered in 2010 during the 50th Meeting of the Director OPAS (Pan-American Health Organization) Councilin Washington (USA). One of the most ancient diseases in the continent, measles had its last transmission in the Brazilian territory in 2000.
In 2008, Brazil performed the greatest vaccination campaign against rubella and Congenital Rubella Syndrome of the world, immunizing 68 million people.
The National Vaccination Campaign against Rubella occurred between August and December of that year, attaining a vaccination coverage above 95% among the priority groups of age.
Organ donations
Using the slogan “Be an organ donor, and only this way I will be happy, very happy”, the Ministry of Health launched in 2010 a wide media campaign to sensitize the society on the importance of the organ donation. Further to presenting the campaign, it was signed governmental decrees amounting US$ 76 million that together with the social mobilization and professional capability in that sector result in a 15% to 20% growth in the amount of transplantations performed by the Unique Health System (SUS). The amount of transplants performed in the country has presented a growth in the last few years. In 2003 it was performed 12,722 procedures, and in 2009 Brazil accounted for 20,253 transplantation surgeries – a 59.2% increase. The country also makes investments on the improvement of the system’s substructure, being one of them the National Qualification Program to Organ and Tissue Donation for Transplantation (Qualidott). The goal was to promote qualification to approximately 1.2 health professionals in the whole country – including doctors, nurses, psychologists and social workers – offering 150 scholarships. The initial investment of such action – that count on partnerships between the Ministry, excellence hospitals and colleges – is of US$ 6.02 millions.
Source: Ministry of Health
Advancements in the Health to Women area
The Brazilian Government also develops policies to improve the woman’s health. It is the Integral Attention to Women’s Health National Policy and the Pact for the Reduction of Mother and Neonatal Mortality (up to 2015). The proposal received an UN award as a mobilization pattern.
Other actions developed were: increase in the prenatal treatment – 19.4 million consultations performed in 2009 (a 125% increase related to 2003) – and major access to essential examinations, such as mammography and Papanicolau. According to the National Research by Home Sampling (PNAD/IBGE 2008), the proportion of 50 to 59 years old women submitted to mammography has an expressive growth in five years, attaining 75%. Approximately 49 million of 25 years old or more women made that examination in 2008 – equivalent to 84.5% of the whole female population with that age.
The Health Ministry has also increased the maternity-license from four to six months, with the direct participation of the Ministry. Furthermore, the Ministry performed a campaign to incentive the creation of breast feeding rooms in the companies. Together with the National Agency of Sanitary Vigilance (Anvisa), it was elaborated directions to allow companies to adopt such action safely, following adequate health and hygiene requirements.
Also, there was a reinforcement of the familiar planning policy in the country – including higher access to vasectomy and tubal ligation, distribution of condoms and enlargement of the access to contraceptive methods – and reduction of pregnancy in the adolescence, whose index among 10 to 19 years old girls fell 20%, thus consolidating the trend towards a fall since the beginning of the decade. This is due to the higher access to contraceptive methods in the public health services and in covenant drugstores of the program “Here, There Is a Popular Pharmacy”, as well as the strengthening of prevention actions and familiar planning.
Family Health
The Family Health is understood as a reorientation strategy of the assistant model, made feasible through the implantation of multi-professional teams in basic health units. These teams follow a defined amount of families located in delimited geographical areas and actuating to promote the health, prevention, rehabilitation of more frequent diseases, as well as seeking the health maintenance of those assisted communities. The program strategy is to grant dynamism to the SUS project, limited by the historical evolution and organization of the health system in Brazil. Initiated in 1994, it has presented a growth.
24 Hours UPA
The Units of Prompt Attendance – 24 Hours UPA, have an intermediary complexity between the Basic Health Units and hospital emergencies, that together form the organized network of Emergency Attendance. They are integrant part of the fixed pre-hospital component, and it was implanted in strategic places to configure the network to attend emergencies following the National Attendance to Medical Emergencies Policy. Such strategy is related to the work of the Mobile Emergency Service – SAMU that organizes the attendance flow, conducting patients to appropriate health services.
STD/AIDS
Actions performed by the STD (Sexually Transmitted Diseases), Aids, and Viral Hepatitis Department connected to the Ministry of Health to optimize the quality of life of serum-positive patients are breaking barriers. These actions comprise strategies to disseminate vaccines, medication, microbiocides, preservatives, diagnosis and monitoring kits to the public health services.
Federal government aims to stimulate the national involvement in researches of anti-HIV vaccines. In Brazil, the Brazilian Plan for Anti-HIV Vaccines seeks to develop anti-HIV vaccines from the basic research and improvement of clinic research centers supported by socio-behavioral studies and from the ethical point of view. The country makes partnerships with international organizations such as WHO, USA National Health Institute, French National Agency for Research on AIDS and Viral Hepatitis B and C, and the International Initiative for AIDS Vaccine. The assurance of access to laboratorial examinations to patients in order to diagnose HIV and other STDs is a Government’s compromise, and having such premise in mind, Government priorizes the national capability in the sector by supporting the research, technological development and quality assessment in the laboratorial diagnosis.
One of the advancements is the national production of antiretroviral medication. Today, Brazil produces nine antiretroviral and it is discussing the compulsory license for more medication, putting on the table the debate to the universal and free access to the AIDS treatment into the international scenery.
Recently, Brazilian Government and the World Bank signed a loan as funding to the Aids-SUS project. The agreement will increase actions related to AIDS and other STDs. For the first time, the funding repassing will be conditioned to the accomplishment of goals up to 2014. The agreement focuses the improvement of access to preventive services, HIV diagnosis and treatment to states and cities.
Innovative policies to medication
After implanting the generic medication, medicaments with the same characteristic and producing the same effect are called “brand medication” (products commercialized by a pharmaceutical industry) are sold by its active principle (substance that produces therapeutic effects). The country has several programs to distribute them by means of partnerships with pharmaceutical industries and institutes to make medications cheaper. One of them is the Brazilian Popular Pharmacy Program that counts on its own network of Popular Pharmacies, added to partnership with private drugstores. Units of the own system are managed by the Fundação Oswaldo Cruz (Fiocruz), that buys the medications and grants capabilities to the health professionals. The condition to purchase cheaper medications in those units is to present the medical or dental prescription. The Ministry of Health also announced recently an US$ 750 thousands agreement to change technology into biotechnology between the American multinational company Pfizer, the Israeli Protalix and that entity through the public lab Biomanguinhos. Within five years, the medication to treat the Gaucher disease, taliglucerase alfa) will be produced in a Brazilian industry. The sum represents the total purchased to treat patients attended by SUS (US$ 150 million/year). The agreement assures the acquisition of the product, transfer of technology and it will generate US$ 42 million savings in the period to the country.