SUS (Brazilian public health service) and malnutrition are discussed at the launch of the 78th issue of IEA‘s journal

The progress and challenges of 'SUS - Sistema Único de Saúde' in the last ten years and the studies on child malnutrition in Brazil were the themes of the guest speakers at the launch of the ‘Estudos Avançados’ journal’s 78th issue on September 13. (The digital version will be available soon at SciELO.)

Besides Ana Lydia Sawaya, professor at UNIFESP and coordinator of IEA’s Nutrition and Poverty Research Group, and Carlos Augusto Monteiro, from USP’s School of Public Health (FSP), both authors on the issue, the event was also attended by José Filippi Jr., Municipal Secretary of Health of São Paulo.

Ana Lydia reported the activities of the group that she coordinates and that completed ten years of activities at the IEA in 2013. She explained the origin of the six articles comprised in the dossier ‘Nutrition and Poverty‘ of the journal. According to her, the group has emerged as a result of the activities of the Center for Nutritional Recovery and Education (CREN), which started as a university extension program at UNIFESP 23 years ago.

The articles on nutrition and poverty in issue 78 deal with various themes: methodologies for the treatment of childhood obesity, socioeconomic and nutritional status of slum dwellers in Maceió, capital of the Brazilian state of Alagoas, beneficiaries of the ‘Bolsa Família’ program, a study on malnourished children and pre-school practices of reading and writing, pediatric and clinical aspects of the importance of treatment in partial hospitalization for children with primary malnutrition, conceptual and strategic thinking for the understanding and addressing of issues regarding nutrition and poverty, and a reflection from the Brazilian point of view on the obstacles to the implementation of healthy diets on a large scale by the government.

Monteiro presented the main ideas of the article he wrote with collaborators on the effects of socioeconomic inequalities in the stature of Brazilian children in the period from 1974 to 2007, published in the dossier ‘Public Health’. He explained that the working group in which he participated at FSP has as main line of research to understand the evolution of the health conditions of the population as if they were natural experiments, in order to understand the nature of the problems and the factors that determine them, in a way to inform policymakers.

The researcher said that child malnutrition in Brazil has been reduced a lot since the '70s: ‘We had 50% of children with severe malnutrition in the '70s and now we have 6% or 7%’. He commented that the most interesting of the research is that between 1996 and 2007, period of the last surveys on the issue, child malnutrition has fallen rapidly due to the reduction of social inequalities: ‘If we consider only families within the poorest 20% of the population, the rate has fallen from 31% to 11%‘.

SUS

Secretary Filippi Jr. said that Brazil is the only country with more than 100 million people that made ​​a commitment to adopt a free system of public health. However, he pointed out that there are still many challenges, of which one of the most important is the issue of underfunding of the system: ‘25% of the population are users of private health plans, with a consumption of 4.7% of the GDP, while SUS, with 3.9% of the GDP, has the challenge of taking health care to 75% of the population while its users consume less than one third of health resources per capita in the country’. Filippi Jr. defends taxing inheritances as a permanent source of more resources to the system.

A widely discussed article by Filippi Jr., Monteiro and one of the audience members, professor José da Rocha Carvalheiro, from IEA’s Innovation and Competitiveness Observatory and former visiting professor at the institute, was ‘Public Health in Brazil’, by Gilson Carvalho, an expert in public health and hospital administration, and former Secretary of Health Care at the Ministry of Health. In the article, Carvalho makes a scathing review over the last ten years of SUS, especially with regard to the non-compliance of the existing legislation and the distortions and deficiencies in the funding system, despite admitting that during the period Brazil ‘left indigence of ground zero to offer numerous individual and collective health care options’.

The launch was attended by the first lady of the city of São Paulo, Ana Estela Haddad, professor at USP’s School of Dentistry and coordinator of the ‘Cidade Carinhosa’ (‘Loving City’) program, that faces the early childhood care, promoting health, education, welfare, the right to play, the right to diversity and combating violence.