The national content of public health – 07/14/2023 – Marcos Mendes

In my last column I argued that national content policies impoverish the country. The substitution of imports for subsidized domestic production destroys opportunities to create new businesses and jobs, and contributes to our economic mediocrity.

In the draft of that column, I concluded with the following sentence: “Imagine if we had waited for the production of a 100% national vaccine to start the fight against Covid!” When sending the text to the newspaper, I decided to cut the sentence. I thought it was exaggerated. I would be mixing different debates: thousands of deaths were caused by the delay in importing the vaccine due to denial regarding the effectiveness of the vaccine, nothing to do with national content policy.

Three days after the publication of that column, the newspaper O Globo published: “Dengue: Ministry of Health prioritizes national industry, and vaccine should not reach the SUS this year”. In the article, the Secretary of Science, Technology and Innovation of the Ministry of Health declared that “the priority is to strengthen national production also in the case of the dengue vaccine”. Therefore, the importation of Japanese immunizer would be subjected to a slow internal evaluation process.

It is about letting Brazilians die or suffer the pain and consequences of the disease, in the name of seeking a national technology. As recorded in an editorial by Sheet, in the last decade there were 9.5 million cases and 5.4 thousand deaths. Loss of life, suffering of the sick, economic costs for inactive workers, overload of public hospitals.

The news took a bad turn, and the same secretary returned to the press to declare that “Brazil is interested in producing this vaccine nationally, but that does not prevent the purchase of the ready-made input from the Takeda laboratory […] At no time has the Ministry of Health been against, in case of need by the population, to import vaccines that have quality, efficacy and safety for people”.

To what extent is this more reasonable position real or just a tactical maneuver? Other government moves give no reason for optimism. In the renegotiation of the trade agreement with the European Union, a central point has been to prohibit the participation of foreign companies in government purchases in the health sector. UOL reported that, with this, “the national industry would be favored” and that “within the government, the fear is that the Europeans will find it very easy to get contracts in huge open tenders in the coming years”.

Now, if foreign companies will find it easy to win bids, it is because they will offer cheaper and better products, to the benefit of SUS and its users. The most curious thing is that the protectionist measure has been announced as “protecting the SUS”. Protect SUS or protect national SUS providers?

For decades, there have been repeated cases of cartels and fraud in the sale of medical supplies to the government, such as, for example, in cases of orthoses and prostheses, hospital gases or antiretroviral drugs. Have we already forgotten the bloodsucking scandal and their overpriced ambulances? It should be no coincidence that controlling the Ministry of Health is at the top of the list of physiological political interests.

Opening the SUS supply market to foreign companies increases competition and places companies subject to compliance rules in their countries of origin on the market. All this reduces the risks of manipulation and corruption.

It is true that we cannot be totally dependent on foreign countries for some strategic inputs, and that it is worth stimulating the production of some items in the country. But does this justify the goal of having 70% of all medicines, equipment and vaccines that supply the SUS produced in Brazil? Where did this exaggerated number come from? Which studies justify it? What is the cost and feasibility? Wouldn’t there be a smarter strategy for scientific and commercial cooperation with other countries, focused on essential items?

Or are we once again seeing the marriage of nationalism with unspeakable interests?

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