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Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure

OBJECTIVE: To examine the financing of the Unified Health System (SUS) from 2010 to 2019 and analyze the recent trends in the allocation of federal resources to large areas of operation of the system, as well as the possibility of achieving the Sustainable Development Goal (SDG) 3 of the 2030 Agenda...

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Autor principal: Vieira, Fabiola Sulpino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Saúde Pública da Universidade de São Paulo 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703550/
https://www.ncbi.nlm.nih.gov/pubmed/33331523
http://dx.doi.org/10.11606/s1518-8787.2020054002414
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author Vieira, Fabiola Sulpino
author_facet Vieira, Fabiola Sulpino
author_sort Vieira, Fabiola Sulpino
collection PubMed
description OBJECTIVE: To examine the financing of the Unified Health System (SUS) from 2010 to 2019 and analyze the recent trends in the allocation of federal resources to large areas of operation of the system, as well as the possibility of achieving the Sustainable Development Goal (SDG) 3 of the 2030 Agenda. METHODS: Data from the budgetary and financial execution of the federation entities were obtained. Transfers from the Brazilian Ministry of Health (MH) to the municipal and state departments and their direct applications were identified according to large final areas of SUS and middle areas. Basic descriptive statistics, graphs and tables were used to analyze the execution of expenses by these areas. RESULTS: Public spending per capita on health increased between 2010 and 2018. However, compared to 2014, it reduced 3% in 2018. There was a displacement of the allocation of federal resources to the detriment of transfers to the states (−21%). There are also losses of health surveillance in favor of primary care and pharmaceuticals. In the case of primary care, the increase in spending was tied to changes in policy and the expansion of resources allocated by parliamentary amendments. In the case of pharmaceuticals, the increase was due to the incorporation of new drugs, including vaccines, judicialization, increased spending on blood products and centralization, in the MH, of the purchase of items of high budgetary impact. CONCLUSION: If there is no change in the current SUS financing framework, something unlikely under Constitutional Amendment No. 95, associated with the redefinition of health policy priorities, the risk of non-compliance with the SDG 3 of the Agenda 2030 is very high.
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spelling pubmed-77035502020-12-04 Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure Vieira, Fabiola Sulpino Rev Saude Publica Original Article OBJECTIVE: To examine the financing of the Unified Health System (SUS) from 2010 to 2019 and analyze the recent trends in the allocation of federal resources to large areas of operation of the system, as well as the possibility of achieving the Sustainable Development Goal (SDG) 3 of the 2030 Agenda. METHODS: Data from the budgetary and financial execution of the federation entities were obtained. Transfers from the Brazilian Ministry of Health (MH) to the municipal and state departments and their direct applications were identified according to large final areas of SUS and middle areas. Basic descriptive statistics, graphs and tables were used to analyze the execution of expenses by these areas. RESULTS: Public spending per capita on health increased between 2010 and 2018. However, compared to 2014, it reduced 3% in 2018. There was a displacement of the allocation of federal resources to the detriment of transfers to the states (−21%). There are also losses of health surveillance in favor of primary care and pharmaceuticals. In the case of primary care, the increase in spending was tied to changes in policy and the expansion of resources allocated by parliamentary amendments. In the case of pharmaceuticals, the increase was due to the incorporation of new drugs, including vaccines, judicialization, increased spending on blood products and centralization, in the MH, of the purchase of items of high budgetary impact. CONCLUSION: If there is no change in the current SUS financing framework, something unlikely under Constitutional Amendment No. 95, associated with the redefinition of health policy priorities, the risk of non-compliance with the SDG 3 of the Agenda 2030 is very high. Faculdade de Saúde Pública da Universidade de São Paulo 2020-11-27 /pmc/articles/PMC7703550/ /pubmed/33331523 http://dx.doi.org/10.11606/s1518-8787.2020054002414 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Vieira, Fabiola Sulpino
Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure
title Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure
title_full Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure
title_fullStr Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure
title_full_unstemmed Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure
title_short Health financing in Brazil and the goals of the 2030 Agenda: high risk of failure
title_sort health financing in brazil and the goals of the 2030 agenda: high risk of failure
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703550/
https://www.ncbi.nlm.nih.gov/pubmed/33331523
http://dx.doi.org/10.11606/s1518-8787.2020054002414
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