The pro-chloroquine wing of the Ministry of Health wants to end the discussion on vetoing medicines from the so-called “Covid kit” in the SUS for mild cases of the new coronavirus and maintain room for the use of ineffective treatments.
In a document, the group requests that the folder abort the publication of guidelines against non-hospital treatments, with drugs such as hydroxychloroquine and ivermectin, a flag of President Jair Bolsonaro (PL).
Five of the seven representatives of the ministry at Conitec (National Commission for the Incorporation of Technology in the SUS) questioned, in a letter of 29 pages, obtained by the Sheet, methods used to prepare the opinion.
The document was sent to secretary Hélio Angotti (Science, Technology, Innovation and Strategic Health Inputs), who has Conitec under his umbrella, and also to other members of the collegiate.
The group that defends ineffective drugs seeks support to stop the process in the commission. The Ministry of Health was contacted for comment, but until the conclusion of the report it had not spoken.
Ministry representatives at Conitec say it is “urgent that the initiative to establish centralized recommendations for the entire country is immediately aborted”.
The Covid anti-kit opinion was put under review by the collegiate on October 21st. The vote ended in a draw, with the Ministry of Health split. In addition to the five votes from the pro-chloroquine wing, the CFM (Federal Council of Medicine) rejected the opinion.
On the other hand, two Health Secretariats, Conass (council of state secretaries), Conasems (council of municipal secretaries), CNS (National Health Council) and ANS (National Health Agency) were in favor of the text that contraindicates the Covid kit. .
The members of the folder who sign the document obtained by the sheet they are: Vinicius Nunes Azevedo, director of the Health Work Management Department; Alessandro Glauco dos Anjos Vasconcelos, Deputy Executive Secretary of the Executive Secretariat; Maria Inez Gadelha, chief of staff at the Department of Primary Care for Specialized Health Care; Lana de Lourdes Aguiar Lima, general coordinator of Life Cycles at the Primary Care Secretariat; and Rodrigo dos Santos Santana, director of the Department of Environmental Determinants of Indigenous Health of the Special Secretariat for Indigenous Health.
“The process used to prepare the Brazilian Guidelines for the Treatment of Covid-19, requested by the Minister of Health, is riddled with procedural, technical and methodological flaws that seriously harm the basic precepts of evidence-based medicine”, says an excerpt of the document.
In addition, the members affirm that the guidelines “subject a significant risk to the credibility of the decisions taken by Conitec and, ultimately, by the Ministry of Health itself and its decision-making bodies, as will be demonstrated”.
In the text, the five members of the organ ask for Angotti’s intervention in the debate “to guarantee the correctness of the process”, as well as the replacement of the group of specialists who prepared the opinion that contraindicates the Covid kit.
In another excerpt, they also say that the group of experts is made up of entities that have shown themselves “repeatedly” against “medical autonomy” to prescribe medication.
The group is formed by the AMB (Brazilian Medical Association), SBI (Brazilian Society of Infectology), among other entities.
Pocket activists still mobilized so that there were many demonstrations in favor of “early treatment” in the public consultation that was opened on the subject at Conitec.
After the Conitec vote, which ended in a draw, the opinion was submitted to public consultation. As the Panel showed, there were thousands of contributions to the text, more than 2,000 in initial count.
At the end of the process, there were more than 20 thousand manifestations in favor and against the report, during the consultation, which lasted from November 16th to 25th. Other documents related to Covid-19 had a maximum of 60 contributions.
The high participation was due to the mobilization of pro-kit Covid groups so that there were engagements against the opinion. Physician Raissa Soares, who became known as Dr. Chloroquine, made an appeal on social networks.
“We [os médicos] we came across a document that says we do nothing, do not use antiviral medication, do not treat the inflamed phase, do not give corticosteroids, do not use anticoagulants. Like this? Brazil, manifest yourself,” he said.
Conitec began evaluating a protocol on Covid-19 in the SUS at the request of Minister Marcelo Queiroga (Health). Upon entering the portfolio, in March, he asked for a standardization on the subject, to end disputes over the use or not of ineffective drugs.
Queiroga, however, has been modulating the discourse and investing in the pocketbook agenda. He started to avoid the topic of the Covid kit, even though he admits to colleagues that he sees no benefit in using these drugs.
After the public consultation, Conitec must consolidate a new opinion, considering the suggestions presented, and open a new vote. Then, the Ministry of Health will decide whether or not to follow the recommendation.
The protocols for SUS treatments, discussed at Conitec and approved or not by the ministry, also guide public purchases.
In May 2020, Health issued a note encouraging the use of ineffective drugs, but the document is not a SUS protocol. For public network managers, the measure was a way, at the time, to promote ineffective treatment without having to go through Conitec.
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