Queiroga defends primary care to reduce death by heart attack and denies health cuts

The reduction of mortality from cardiovascular diseases in the country depends on the joint action of agents of primary health care and specialized care, with the provision of medicines to quickly treat patients who suffer from myocardial infarction or stroke.

According to the Minister of Health, Marcelo Queiroga, it is these coordinated strategies that can help to reduce the indicators of death from heart disease in a continental and unequal country like Brazil, where there are no specialized centers for surgical care, in the most serious cases, in the entire territory.

“We have a strong structure of primary care through SUS [Sistema Único de Saúde] and this one year we have implemented a target remuneration model, which pays better the municipalities that have more actions to control cardiovascular disease risk factors”, said the minister, who is also a cardiologist, at a roundtable on public health policies cardiovascular disease, at the Brazilian Congress of Cardiology, which takes place this week in Rio de Janeiro.

Also according to the minister, allied to primary care is the offer of five new drugs at the Popular Pharmacy indicated for the treatment of risk factors for heart disease, such as high blood pressure and type 2 diabetes. 2023 foresees a cut of more than 50% of program funds.

The incorporation of new drugs, he declared, allows access to these drugs beyond hospital use, thus releasing the federal government from the acquisition of these drugs in the SUS.

“It’s not that story of setting the goal and then doubling the goal, no: we’re going to meet the goal to reduce by the end of 2023 18% of mortality in the country due to heart attack and stroke”, said Queiroga. He made reference to a 2015 speech by former president Dilma Rousseff (PT) that went viral. It is not the first time that the minister has criticized PT administrations and defends the Jair Bolsonaro (PL) government in the electoral campaign.

The results of Queiroga’s program, called Previne Brasil, however, have not been successful so far, with only 3% of municipalities meeting the targets set by the ministry.

According to the minister, the reduction is long-term, and the change in municipal remuneration has already enabled an increase of around R$8 billion in the health budget for primary and basic care for municipal entities: from R$17 billion, in 2018, to R$ 25 billion, in 2022.

Asked if the recent cut of 42% of the health budget by the federal government cannot harm the program, the minister denied the reduction. “There are no cuts. Where did you hear that? What there is is the allocation of R$10 billion to be controlled by Congress. It will not be diminished a penny,” he said.

The minister refers to the so-called amendments of the rapporteur, which will control about R$ 10.42 billion of the health budget next year.

The Secretary of Primary Care of the Ministry of Health, Raphael Câmara Parente, also said that “Congress can change [o valor] next year.” “This budget is fictitious, it will not be what it will be,” he said. The secretary and the minister did not give further explanations about how these reallocations would be in the next year.

In the same session, the president of the World Heart Federation (WHF), the Portuguese cardiologist Fausto Pinto, said that the actions that work the most at a global level to reduce deaths from heart diseases are the prevention of risk factors risk, with health promotion and smoking reduction.

Pinto recalled that about 75% of deaths from cardiovascular diseases worldwide occur in low-income countries, according to data from the WHO (World Health Organization) published recently, in partnership with the WHF.

Public health policies that take treatments to places with high social vulnerability, such as countries in Africa, also help to reduce mortality from cardiovascular diseases, including vaccination against rheumatic heart disease.