Ministry of Health defends hydroxychloroquine and says vaccine does not work

In a document used to justify the rejection of Covid-19 treatment guidelines to the SUS, the Ministry of Health contradicts scientific entities and claims that there is efficacy and safety in the use of hydroxychloroquine against Covid-19.

In the same technical note, the folder states that the vaccines do not demonstrate these characteristics. The archived texts contraindicated the use of medicines from the so-called Covid kit.

The anti-vaccine demonstration was made in a table within a document signed by the secretary of Science, Technology and Strategic Inputs, Helio Angotti, a government wing leader who defends the denialist banners of President Jair Bolsonaro (PL).

The rejected guidelines had been prepared by specialists from medical and scientific entities and approved by Conitec (National Commission for the Incorporation of Technologies in the SUS).

In the same table, the ministry states that hydroxychloroquine is cheap, has no studies “predominantly funded by the industry”, but is not recommended by medical societies. The vaccine, according to the ministry, is expensive, has studies funded by the industry and is recommended by these entities.

This argument reinforces distortions already raised by President Bolsonaro that there are improper interests in the approval of vaccines.

The director of Anvisa (National Health Surveillance Agency) Meiruze de Freitas reacted to the Health note and told the leaf that “all vaccines authorized in Brazil have passed the highest technical requirements in the field of randomized clinical trials (phase I, II and III) and sanitary regulation”.

“It is not expected and admissible that science, technology and innovation in Brazil are going against the world,” said the director. “It is necessary for everyone to be united in the same direction, that is, to save lives”, he added.

The Ministry of Health points out that there is no demonstration of the vaccine’s effectiveness “in controlled and randomized studies” or safety “in adequate experimental and observational studies”.

He also says that other treatments against Covid have not worked, such as prone maneuver and non-invasive ventilation. In the table, the folder says that monoclonal antibodies work.

Sought after, the Health Advisory and Minister Marcelo Queiroga have not yet commented on the table.

The table contradicts official health statements. In a note sent to leaf on Friday (21), the folder said that “vaccination is safe and was authorized by Anvisa”.

Upon taking over the Ministry of Health, in March 2021, Queiroga announced that he would promote the debate at Conitec to end the discussion on the use of the Covid kit. He appointed the doctor and professor at USP Carlos Carvalho, against ineffective drugs, to organize a group that would prepare the opinions.

Queiroga, however, modulated the speech and has invested in pleasing Bolsonaro to hold on to the position. He began to avoid the topic, although he admits to colleagues that he does not see benefits in the use of these drugs.

The minister also alternates, in speeches, praising the purchase and delivery of vaccines with nods to the Bolsonarista wing that doubts the safety and effectiveness of immunization. SUS managers demand that Queiroga, in addition to acting in the purchase of doses, make a campaign to encourage the immunization of children.

In social networks, however, Saúde is betting on reinforcing that the immunization of the youngest It is a decision of parents and guardians.

Specialists and medical societies that participated in the drafting of the guideline are preparing an appeal to the ministry to reverse the decision to reject the text.

The appeal must be signed by Amib (Association of Brazilian Intensive Medicine), SBI (Brazilian Society of Infectious Diseases), SBPT (Brazilian Society of Pulmonology and Tisiology) and AMB (Brazilian Medical Association).

“There is no logic and no technical basis for this analysis [do ministério]”, says infectologist Julio Croda, researcher at Fiocruz and professor at UFMS (Federal University of Mato Grosso do Sul). “It clearly shows that it is a political decision [rejeitar a diretriz] and not technique”.

“It has already passed from the act of medical autonomy to something criminal, of inducing the use of medications without any scientific evidence”, said Croda.

Professor at the Bahia School of Medicine and Public Health, Luis Correia said that the Health table is “caricatural”. He states that the note selects poor quality studies to affirm that hydroxychloroquine is safe and effective against Covid.

“It is still simplistic to say that the cost of the vaccine is high and that of hydroxychloroquine, low. The vaccine is very cost-effective, it makes the pandemic decrease. It is an advantageous investment. Hydroxychloroquine does not solve the pandemic”, said Correia, who also represents Conass (National Council of Health Secretaries) at Conitec.

Angotti also questioned, in the Health note, the methodology used by the specialists, the technical rigor of the studies and even possible conflicts of interest of the group.

The secretary rejected three chapters of the Covid hospital guideline, all unanimously approved by Conitec. In addition, it filed the text on outpatient treatment, approved by seven to six in the same collegiate.

“These vaccines that are targets of attack by the secretary are authorized in all agencies in the world”, said Nelson Mussolini, executive president of Sindusfarma (Union of Pharmaceutical Products Industry).

“All studies are sponsored by the patent holder”, he also stated, regarding the ministry’s mention of industry sponsorship of vaccine research. Mussolini is a member of Conitec as a representative of the CNS (National Health Council).

In a movement led by the secretary, the government tried to boycott the Conitec debate. Now, the same group wants to remove from the command of the commission the servant Vania Canuto, who voted in favor of the text that contraindicates hydroxychloroquine, among other medicines.