Brazil’s National Health System Celebrates 30 Years of Achievements and Challenges

RIO DE JANEIRO, BRAZIL – Created in 1990, with successes and setbacks in the implementation of health programmes and the organisation of its health system, Brazil has achieved nearly universal access to health-care services for the population. Recognized as one of the largest public health systems in the world, the National Health System (SUS) turned 30 on Saturday. The expansion of SUS has allowed Brazil to rapidly address the changing health needs of the population, with dramatic upscaling of health service coverage in just three decades.

According to Minister of Health Eduardo Pazuello, SUS has become essential. “There is no other way out for our country in terms of health, other than the strong and efficient National Health System,” he said. The next 20 years are already being prepared by the portfolio, he added, “We are setting up structuring actions with strategic projects in all areas, such as Digital Health, Genome Project, among others, which are being completed,” said the Minister.

The Ministry states that with the novel coronavirus pandemic (Covid-19), SUS is proving to be strong and valuable, serving approximately 70 percent of the population. Under the management of the three government levels – federal, state and municipal – the portfolio says that care for patients infected by Covid-19 and for those in need of specialized treatment were guaranteed.

The president of the Brazilian Medical Association (AMB), César Eduardo Fernandes, comments on the fight against the current pandemic. In his opinion, the SUS response was “from reasonable to good”. The doctor praised the fact that many hospitals have been re-equipped and healthcare teams restored in recent months, but raised doubts whether these achievements will be maintained or will return to the pre-pandemic state.

Fernandes added that the response could have been more efficient if basic care had not lost investments over the past few years. “In this pandemic period, the professionals would be better prepared to provide the first care and a correct filtering of these cases, there would have been no need for this mass allocation to the hospital services,” he assessed.

Challenges

Among the SUS’ major challenges are the offer of services and the financial aspect, according to the Ministry of Health. Amid ever-increasing demand, experts in the portfolio acknowledge that the service needs to be efficient to meet all these demands and needs adequately and promptly. They also believe that resources need to be distributed in order to achieve the best possible result.

Often targeted by fraudsters, the responsibility with public funds is also challenging. “We need to have efficiency, transparency and responsibility with public funds, because we are not talking about money, we are talking about people’s health,” argues the Minister of Health.

Achievements

Regarding the efficiency of SUS, the president of the Medical Association assessed that in 30 years of existence, the public health system has managed to offer outstanding services in a number of areas, but still suffers from precariousness. According to the doctor, more investment is needed in healthcare professionals’ careers and in basic care.

“We can’t be left with only these outstanding areas in large population centers, capitals and more developed regions. We have to interiorize SUS,” argues Fernandes, speaking of the challenges that public health still needs to face in the country.

The basic health units and family doctors must also be among the focuses of this expansion, said César Fernandes. “The basic health units need to be strengthened all over Brazil. It is there that patients go, that the first care is provided, the diagnosis is made, and the treatment begins,” he said.

The doctor emphasizes the value of also having investments in the public career of the medical profession. “Our issue is not a lack of doctors, but rather to build possibilities so that young and well-trained doctors are attracted to small towns and more distant cities. We have to create the figure of the State doctor, just like the career in the Judiciary”, he exemplified.