Ministry of Health celebrates 70 years under the command of the 1st woman – 07/25/2023 – Health

The Ministry of Health turns 70 this Tuesday (25) commanded by the first woman, sociologist Nísia Trindade, and at a critical moment of greed for the center. Positions are coveted by the group while portfolio funds are used to expand the base of support for the Planalto Palace.

With a budget of around BRL 190 billion, the third largest among ministries, Health is a preferred target of political pressure largely because of the volume of amendments —an instrument through which parliamentarians can send resources to destinations of their choice.

There are more than R$ 14.7 billion reserved in the portfolio for nominations of deputies and senators in 2023. For managers of the SUS (Unified Health System), the advancement of the instrument brings losses.

As shown to SheetAlagoas and municipalities in the state —political cradle of the mayor, Arthur Lira (PP-AL)— were privileged in sharing the funds inherited by Health with the end of the rapporteur’s amendments.

The minister says that Health acts in line with the government, including discussions on the formation of a political base. She minimizes the allocation of resources and claims that the funds have been distributed based on technical criteria and in the most positive way possible for the public system and for democracy.

“I don’t make a distinction between the general political orientation of the government and the technical issues that lead the portfolio, every government needs a base of support”, says Nísia. “So everything that is met is within these criteria and based on demands that come from our municipalities.”

“I don’t have any kind of counterpoint to the Legislative Power”, adds the minister. “To the extent of my possibilities, I want to contribute to the government so that this relationship is as positive as possible for the benefit of SUS and democracy.”

Negotiations unfold while the portfolio command itself has already become part of discussions between politicians, calling into question the minister’s permanence.

In early July, however, President Lula (PT) publicly praised her and said, in a message to the centrão, that the command of the folder is not under negotiation. “Nísia, go to sleep and wake up calm, because the Ministry of Health belongs to Lula, it was chosen by me and will stay as long as I want”, said the representative at an event alongside the minister.

The current scenario of the ministry under a PT command and in the sights of the centrão is observed after a peculiar phase, during the management of Jair Bolsonaro (PL), when the Health leadership aligned itself with scientific denialism and contradicted the technicians themselves by editing rules to defend the use of ineffective drugs against Covid-19.

The moment of the last years differed in great part from the history of the portfolio, created by law of 1953 signed by the then president Getúlio Vargas, which separated Education from Health. The ministry’s historical milestones include the creation of the PNI (National Immunization Plan), in 1973, and the regulation of the SUS, in 1990.

During that time, the 51 managers who passed through the portfolio faced several health crises, such as yellow fever, zika and H1N1. Covid-19 was the most recent and killed more than 700,000 people in the country.

“There was a great political struggle by sanitarians and part of society at the beginning of the 20th century for Brazil to have a Ministry of Health. We are celebrating 70 years, but the strength of the ministry comes with the SUS, we must not dissociate the ministry from the SUS”, he tells the Sheet the minister.

The ministry was also instrumental in consolidating the free care policy for people living with HIV/AIDS.

Nísia affirms that it is among the portfolio’s priorities to resume the national coordination of the SUS, “greatly compromised by the actions of the previous government”, in addition to strengthening vaccination programs and the national production of medicines and vaccines.

The regulation of the SUS was one of the main milestones in the history of the portfolio. Physician Alceni Ângelo Guerra, minister during the process (between 1990 and 1992) says that the left and the right came together to remove the system from paper – the universalization of health was foreseen in the 1988 Constitution, but needed to be implemented.

For the former Minister of Health and president of the Brazilian Company of Hospital Services, Arthur Chioro, public health actions developed at a faster pace after the creation of Saúde.

“Brazil would not be what it is today, it would not have produced interiorization, we would not have changed the profile of mortality, of infectious and contagious diseases if the ministry had not produced a great development of public health actions”, he says.

“Usually we tell the story of Oswaldo Cruz, Carlos Chagas, when the ministry did not yet exist, but thinking about expanding public health policy aimed at positive actions, it was a very important moment in the history of the Ministry of Health [período da década de 50 até 63]“, he says. [durante a ditadura].”

Director General of PAHO (Pan American Health Organization), Brazilian doctor Jarbas Barbosa says that the ministry played a relevant role in the standardization of health surveillance rules and access to health. “There was a process of nationalization of policies. Before, it was different in each state.”

For Barbosa, one of the ministry’s biggest challenges is to increase the number of public servants, as the workforce in various areas of the ministry is made up of hired employees and consultants.

“These contracts should serve for more temporary activities, such as updating a technical guide. But the ministry needs a larger, specialized permanent technical body, with more epidemiologists, people in the area of ​​health service management”, says Barbosa, who also presided over Anvisa (National Health Surveillance Agency) and acted in several managements of the Ministry of Health.

Minister during the Covid-19 pandemic, doctor Marcelo Queiroga (PL) says that the health crisis led SUS to improve surveillance of possible new threats to health.

“We need to move forward in terms of financing, allocate more resources to Health, and that these values ​​reach the most vulnerable regions. Another point that needs to be improved is the efficiency of the system, as a whole, the structure is tripartite, with states and municipalities, which are fundamental.”

Asked about Bolsonaro being a vector of misinformation about Covid-19, Queiroga minimized the former president’s interference in Health actions. “The president has a very assertive speech, right? When I took over the ministry, he called me and said ‘look, I’m not a doctor and you’re the one who is going to conduct this here and harmonize this relationship.'”

Minister of Health in the Michel Temer (MDB) administration, Ricardo Barros (PP-PR) states that Brazil has the best health model in the world, built by many hands. According to him, there is still room for improvement, mainly in the production of vaccines and medicines in Brazil and in computerization. He criticizes the judicialization that occurs in Health.

“SUS is a system like any other and has a budget and expenses. So, what is not foreseen in the coverage cannot be available. We cannot keep buying R$ 6 million medicine.”

Milestones of the 70 years of the Ministry of Health

Pasta faced health crises and implemented immunization and SUS policies

1953: creation of the Ministry of Health, under the Getúlio Vargas administration, from the division of the Ministry of Education and Health

1973: Creation of the PNI (National Immunization Program)

1975: Creation of the SNVS (National Health Surveillance System)

1988: new Federal Constitution determines that health is everyone’s right and the duty of the state

1988 – Creation of the National AIDS/STD Program

1990: regulation and creation of SUS

1994: Brazil receives polio-free certificate after a decade of vaccination campaigns

1996: enacted law guaranteeing free distribution of medication for HIV/AIDS

2004: Creation of the National Policy for Integral Attention to Women’s Health

2013: Creation of the Mais Médicos Program

2020: declaration of the Public Health Emergency of National Importance due to Covid-19; under pressure from Bolsonaro, ministry adopts denialist stance

2023: sociologist Nísia Trindade becomes the first woman to take charge of the Ministry of Health

Source: Ministry of Health.