It became well known throughout the covid-19 pandemic that the SUS (Unified Health System) is the largest public health system in the world. Inspired by the NHS (National Health System), in the United Kingdom, it has become an instrument for the population’s access to care, treatments and health services in general. And such a civilizational milestone was listed among the non-negotiable rights of every Brazilian citizen in the Magna Carta, the 1988 Constitution.
The recently completed 30 months in which we lived and lived with (and survived) Sars-Cov-2 put this system to the test. Every healthcare service in the world has actually been tested. And that test made clear many shortcomings, both here and abroad. In the United States, for example, the number of deaths related to covid-19 has exceeded one million. The country has been struggling with the creation of affordable health systems for a long time, and the ACA (Affordable Health Plan), better known as Obamacare (established during the administration of President Barack Obama) is still faces strong resistance. Europe was also hit hard, and in addition to the strain caused by the pandemic, it has to deal with other issues that also compromise official budgets, such as the energy crisis resulting from the war between Russia and Ukraine.
In Brazil, the presidential elections are approaching and it is time to look more carefully at proposals and measures in different areas – health, of course, among them. What needs to be borne in mind – perhaps the most important – is that the public health service is a State equipment. When the elected official takes office, there are certain structures that are in place, and it is up to him to manage them so that they serve the Brazilian population. It is the Brazilian State that offers these structures, not one or another government – it is up to them to manage this public machine.
It became clear, for example, that we need to be able to produce both the essential inputs for the manufacture of vaccines and the vaccines themselves. An immediate response to possible new health crises can make all the difference and save thousands of lives. We need structuring measures, which take into account the increase in demand, with the increase in population. When the constitutional text that established the right to health care was promulgated, Brazil had just over 143 million inhabitants. Today, we are about 215 million Brazilians, according to an estimate by the IBGE (Brazilian Institute of Geography and Statistics).
There also need to be consistent, feasible and implementable proposals in a relatively short space of time for telehealth. Telemedicine (part of the concept of digital health) has gone from being an incipient innovation to a consolidated way of providing care and carrying out consultations in these two years, with great approval from those who use it. The newly arrived 5G speed of the mobile internet, innovations in AI (Artificial Intelligence) and machine learning (machine learning), among so many potential advances ahead, could bring health to Brazilians who live in distant corners, ensuring equity. The technology will also help to reduce system costs, which will certainly be a great support to the sustainability of the system. And it is necessary that the public health service offers quality care to all. The right is guaranteed by law, technology will be able to extend this right to more and more people – but it is necessary that the patient’s journey is resolute, that bureaucratic obstacles and inefficiencies are eliminated.
The Brazilian State received the mission, in the form of a right guaranteed in the Constitution, to provide health services to all Brazilians. The Chief Executives, who democratically succeed each other in each electoral cycle, bring programs and teams to manage the State apparatus. This one, however, remains: the public health service will continue to be a right of every Brazilian, in as many governments as the country will have. It is important to think about the SUS in order to structure and train it so that, in addition to being bigger, it can become the best in the world.