After a far-right government: challenges for Brazil's Unified Health System

Massuda, Adriano; Dall'Alba, Rafael; Chioro, Arthur; Temporão, José Gomes; Castro, Márcia C.

doi:10.1016/s0140-6736(23)00352-5

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…HPM, in line with other prestigious journals such as Lancet and Science, 2,3 recognised it was timely to publish our analysis on the governmental transition in Brazil and the impact of the previous extreme‐right populist government on the national healthcare system.…”

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confidence: 87%

“…Universal healthcare systems, in particular, encounter significant challenges in terms of their sustainability and resilience. 1 HPM, in line with other prestigious journals such as Lancet and Science, 2,3 recognised it was timely to publish our analysis on the governmental transition in Brazil and the impact of the previous extreme-right populist government on the national healthcare system. Democratically, the journal provided an opportunity for rebuttal by publishing a letter signed by the Bolsonaro Government's health minister (2021 and 2022) and secretary of primary care (2020 and 2022).…”

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confidence: 87%

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‘Scorched Earth: The portrait of health in Brazil after the Bolsonaro's administration and the first 100 days of the Lula Government in health’

Chioro

Temporão

Massuda

et al. 2023

Health Planning & Management

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This article is a rejoinder to the rebuttal letter authored by Jair Bolsonaro's former Minister of Health and Secretary of Primary Care to our initial article, ‘From Bolsonaro to Lula: The opportunity to rebuild universal healthcare in Brazil during the government transition,’ published in the International Journal of Health Planning and Management. We aim to refute the claims that we consider unsubstantiated and disconnected from reality, while reiterating the risks posed by authoritarian and antidemocratic far‐right governments, such as Bolsonarism in Brazil, to the sustainability and resilience of universal health systems. This political threat is gaining momentum across several countries worldwide, thereby endangering the Democratic Rule of Law, institutions, and social policies. Furthermore, we emphasise the significant actions implemented during the first 100 days of President Lula's government, which align with the priorities established during the governmental transition process and strengthen the prospects of reconstructing and fortifying the Brazilian universal health system.

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confidence: 87%

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confidence: 87%

‘Scorched Earth: The portrait of health in Brazil after the Bolsonaro's administration and the first 100 days of the Lula Government in health’

Chioro

Temporão

Massuda

et al. 2023

Health Planning & Management

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“…This represents an increase of 50% in deaths compared to previous years. There are four main triggers of this humanitarian crisis: severe malnutrition, poor access to healthcare, mercury contamination due to illegal artisanal gold mining, and high malaria burden 21 .…”

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confidence: 99%

Investigating the Yanomami malaria outbreak puzzle: surge in mining during Bolsonaro’s government triggered peak in malaria burden

Dutra,

Fontes,

Braga

et al. 2024

Preprint

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The Yanomami, an Indigenous people from the Amazon, confront multifaceted challenges endangering their health and cultural integrity. Of immediate concern is the surge in malaria cases in their territory during Bolsonaro’s government. We investigated the impact of land use on malaria incidence among the Yanomami leveraging satellite imagery and ran difference-in-differences analyses to ask whether the Yanomami suffered disproportionately from malaria when illegal mining was rising in the region (2016-2022). We show a remarkable ~300% rise in malaria from 2016 to 2022 and point to mining as the primary driver of malaria among the Yanomami; when mining increases by 1%, malaria increases by 31%. After mining unfolded, the burden of malaria among the Yanomami was disproportionately higher, up to 15%, than in non-indigenous communities. Our findings underscore the impact of illegal mining on the high malaria burden suffered by the Yanomami and the importance of rainforest conservation and land sovereignty for Indigenous health.

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“…Setbacks in primary health care were introduced involving restructuration of public administration, flexibilization of labour laws, disruption of social participation and privatizing of assistance and management. 8 , 9 , 10 Mental health and Indigenous peoples’ health, as well as the HIV program, have suffered under Bolsonaro’s pernicious public health governance. 6 Health indicators have worsened in the last few years.…”

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confidence: 99%

“…Childhood vaccination decreased from 93.1% in 2019 to 71.5% in 2021. 10 Maternal mortality increased from 58 deaths for 100,000 live births in 2019 to 107 in 2021, 9 and child malnutrition led to an increase of 11% in the number of hospitalizations. 9 Technical staff was replaced by military personnel and scientific evidence by religious and ideological beliefs, with a direct impact on the large number of deaths during the pandemic (around 700,000) and the slow COVID-19 vaccination path.…”

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confidence: 99%