Fiscal austerity measures, such as Constitutional Amendment 95/2016, which has frozen health spending for 20 years, as well as the retreat of the Mais Médicos Program, should directly impact Brazil’s mortality rates for years to come. So is a study led by the Institute of Collective Health of the Federal University of Bahia (ISC / UFBA), in collaboration with researchers from Stanford University and Imperial College London, published April 26 in BMC Medicine, a of the world’s leading medical journals.
This is the first survey to predict the impact of fiscal austerity measures on Primary Health Care (PHC) coverage in a middle-income country. The study analyzed data from 5,507 Brazilian municipalities in a projection from 2017 to 2030, a date set by the United Nations General Assembly to meet the “Global Goals for Sustainable Development” in 193 countries, including Brazil.
According to projected data, reducing Family Health Strategy (ESF) coverage, with the hypothetical extinction of the More Doctors Program, would increase premature (before age 70) mortality rates from causes sensitive to primary care in the developing country. 8.6% by 2030. This amounts to an increase in deaths of almost 50,000 people for the period in question.
It should be noted that if under-five mortality is added to this scenario, as another study by the same authors, which will be published shortly, shows, the number of preventable premature deaths could reach a total of almost 100,000 deaths by 2030. “It would still be an underestimation of the total effect because the study does not include deaths over the age of 70 and for some causes classified as not sensitive to primary care, but that the Family Health Strategy could have mild effects, ”adds researcher Davide Rasella, who led the study.
According to the research, reductions in primary care coverage will account for many preventable deaths, especially those caused by infectious diseases and nutritional deficiencies in people under 70. “The Family Health Strategy is the main vehicle for achieving universal health coverage in SUS and is one of the largest Primary Health Care programs in the world, covering 123 million people. Since 2013, it has been strengthened through the Mais Médicos Program, with the adhesion of professionals in remote areas or with more vulnerable populations, ”explains the researcher.
The study also shows a greater impact on the poorest municipalities, as well as an increase in inequalities by affecting mainly the black population (blacks and browns). For researchers, despite making a projection for Brazil, the work is a warning to all low and middle income countries. “The main importance of this research, as well as others that apply micro-simulations, is precisely to subsidize managers and policy makers with accurate information about the likely future effects of their decisions,” concludes Luis Eugenio de Souza, researcher and co-author of the study.