Misinformation about vaccine will be punished, says minister – 06/04/2023 – Health

The Minister of Health, Nísia Trindade, says that the federal government is creating a working group to analyze a series of disinformation published on social networks by doctors and other people about vaccination.

Among the members of the WG are the Ministry of Health, Secom (Secretary of Social Communication), AGU (Attorney General of the Union) and Ministry of Justice and Public Security. The group will analyze the type of disinformation and the degree of culpability of those who published or passed it on. Based on this material, he will assess whether punishment is appropriate and how it will be applied.

According to the minister, the pilot project will involve vaccination, but the intention is to expand to other topics as well. “Criminal conduct by doctors and other people will have to be punished, people who go to the networks to talk nonsense, that people will die if they take the vaccine or have any sequelae”, she said.

Nísia recognizes that vaccination continues slowly in the country and says she will look for religious leaders and other actors to help improve the situation.

What are the portfolio’s main goals in this management? There is a guideline to consider health as a right and as a basis for sustainable development. Based on this vision, we set goals. The first was to recover and update successful programs from other administrations [PT], such as returning to the vaccination level of 2016, the resumption of Mais Médicos, a program to reduce queues, we are going to launch the Popular Pharmacy. For the four years, I define that the goal is to contribute to a program to prepare the country in the face of new health emergencies, in addition to strengthening the economic-industrial complex of health and giving health an integral dimension, articulating primary care with specialized care. A final goal is to make health participate strongly in the so-called digital transition. Inside the folder, the vision of equity returns with force.

How will this equity be implemented? Equity means treating differently those who have not been reached by universal policies. We are already carrying out actions with the Ministry of Racial Equality to act on those indicators in which people classified as black and brown have the worst indices, such as life expectancy, maternal mortality. Regarding the health of the indigenous population, we have just approved a resolution at the World Health Organization so that there is a specific look at the predominant diseases and their cultural specificity.

Were you able to map more indigenous territories in a critical situation like the Yanomami? Not with the dramatic picture we saw, but there are very difficult situations, many complaints of violence, illegal mining actions. Indigenous health was, in fact, very neglected.

How do you rate vaccination in the country? It’s slow, no doubt, with all the effort being put into it. The Ministry of Health went back to campaigning, again saying clearly that people have to get vaccinated. We have micro plans, starting in the Amazon region. We will work together with city halls, with religious leaders, other opinion makers, the Ministry of Education. We are far from being able to reverse the evil of recent years, we will have to do a very intense job.

Have you started looking for religious leaders yet? Some religious leaders have been willing to support since the beginning of the government. In an organized way, I intend to do it now.

How are you dealing with the anti-vaxcine movement? Will they propose tougher legislation? For sure. The so-called fake news bill is already on the agenda, which is broader than that. Furthermore, this is in an inter-ministerial action, the vaccine was taken as a model. Criminal conduct by doctors and other people will have to be punished, people who go to the networks to talk nonsense, that people will die if they take the vaccine or have any sequelae. I had a meeting with the Federal Council of Medicine, which made itself available to support us in a pro-vaccine campaign. There are practices out of context, but there are also criminal practices.

Folha showed medicines that were found expired and about to expire. What to do? We found a situation that was not only disorganized, there was vaccine left because there was also a campaign against the vaccine. What we have been doing is a policy for states and municipalities to seek the application of what is about to expire, and also, through international advisory, consult countries for donation.

Should More Medicines Win? Unfortunately there will be, even with this effort.

Are there possible consequences for public health policies in case of decriminalization of drug possession proposed by the STF? Actually yes. Our approach is to treat these issues as a public health issue, how we can contribute to a healthy life, to take care of people.

How does it impact exactly? The impact is not direct for the Ministry of Health, it is even broader on society. But we already have in the directorate of mental illness a whole concern to reduce the damage caused by drug use as much as possible, host policies, strengthen the psychosocial care center. Any decision by the STF will require reinforcement of these measures that we returned to the ministry.

How will the issue of abortion be dealt with in the folder? One approach as a public health issue, so there are studies being done for policies to occur. What we have already defined and is in progress is to comply with existing legislation, such as welcoming women into the health system so that they are safe in case the practice is necessary. [em casos permitidos].

Does the Ministry of Health intend to create discussion? It is not up to the Ministry of Health to lead a debate in this regard. He will exactly uphold the law and protect women and girls because that is our commitment. We will follow any debate in society on the subject and also look for scientific evidence and studies.

Specialists have said that, even with support from the Ministry of Health, it will still not be possible to pay the nursing floor. Have you received complaints? There is no demographic of the profession that would give a perfect and accurate picture. This is work that takes time and will be done, but while it is not done, we will get as close as possible to this reality. The work was based on available data, reliable data for this definition. Some mayors, municipal secretaries are saying that [o valor] does not match what it should be. We are collecting and working on this information to signal to the government if there is a need for additional resources.

With this demographic ready, can something change in the distribution? Sure.

There are complaints from medical entities about the performance of doctors without a degree in Mais Médicos. What partnerships should be made with the MEC regarding Revalida, medical residency? We already offer a greater number of medical residency vacancies, the Ministry of Health is financially responsible for about 40% of medical residency in Brazil. Regarding Revalida, the Mais Médicos provisional measure itself already recognizes that, as it has been done in Brazil, it does not bring any positive results, prevents many doctors from performing the exam, an excessive number of hours of exam in one day, the very issue of practical test is a problem. There is a suggestion that the work at Mais Médicos counts as a field of practice for these professionals.

Will it facilitate the Revalida? It will certainly make it easier, it will give more quality.

What should be the type of private sector regulation? In health under Queiroga, there was talk of Open Health. Regulation of the private sector has to take place based on the needs of the SUS. Today, 60% of medium and high complexity care in the SUS is carried out by philanthropic hospitals. There is another type of regulation that is made by the ANS [Agência Nacional de Saúde Suplementar], this model has to be improved to protect citizens because 25% of the population uses health plans. There is another level of regulation that concerns the development and manufacturing production and access to health inputs, medicine, equipment. We have work from Conitec [Comissão Nacional de Incorporação de Tecnologias no Sistema Único de Saúde] and we launched the Complexo Industrial da Saúde group.

Previous governments even evaluated proposals for co-participation in the SUS, charging per procedure. What’s your assessment? Our vision is a free, universal SUS and the participation of the private sector takes place through contracting on adequate bases. This is where we want to improve and move forward.

The judicialization of high-cost drugs is something that happens frequently. Is there a strategy to reverse this? For sure. We have already been talking to courts of law so that these processes can be improved so that judges are properly informed about the treatments that the SUS has incorporated. Judicialization is not seen by us as an evil in general terms, because the Constitution defends health as a right, so a citizen seeks this right. But, in fact, it is an excessive cost. In addition to these conversations, on our side we are going to improve the technology and national production process.

Any new form of collection by SUS? There is an important discussion about the possibility of the return of the so-called cigarette seal. With taxation, the value would be reversed to reduce evils. There are other proposals on the agenda as well, it is important that the health budget is sustainable.

When should the Popular Pharmacy program be released? It’s being assembled. Let’s go accredit new pharmacies to reach all of Brazil. For that, you have to have a good management system here at the ministry, we work to improve it.

Would you like to add something else? Next week we are going to launch a program to eliminate tuberculosis and other diseases that have a great impact on the poorest population, together with other ministries. I was invited to participate in COP-28 because the general committee of COP-21 considers it essential to address the issue of climate change and health. It is an agenda that I will be working on with Minister Marina Silva [Meio Ambiente].

What will this health and climate work be like? Climate change has an impact on epidemiological conditions and natural disasters. You have a change that sometimes changes the geographical pattern of diseases. Today you have dengue in places where there was none. The Ministry of Health can act both with studies that show this relationship, as well as in surveillance and mitigation plans.

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Nísia Trindade, 65

First woman to hold the position in the nearly 70-year history of the Ministry of Health. Graduated in social sciences, master in political science, doctor in sociology, Nísia assumed the presidency of Fiocruz (Oswaldo Cruz Foundation) for two terms. She has been an employee of the foundation since 1987.