An appeal submitted to the Ministry of Health claims that there was neglect by the Secretary of Science and Technology of the folder, Hélio Angotti, in rejecting a guideline for the treatment of Covid-19 prepared by experts. The text refused was against the use of Covid kit medicines, such as hydroxychloroquine.
Signed by Carlos Carvalho, a doctor and professor at USP who coordinated the group of experts who prepared the guideline, the appeal asks the ministry to review the decision and accept the guidelines on combating the pandemic.
Carvalho says that the secretary showed “negligence with the hurried scenario of the pandemic” by taking six months to comment on part of the guideline, which addresses the hospital treatment of Covid and had been unanimously approved by Conitec (National Commission for the Incorporation of Technologies in SUS).
The appeal, presented on Friday (5), will be evaluated by Angotti and then, if there is a new challenge, by Minister Marcelo Queiroga.
The document signed by the USP professor has 111 pages, 22 of which are bibliographic references, and refutes each argument used by the secretary to veto the guidelines.
Sought, the Ministry of Health replied that “it will evaluate all the resources presented and will manifest itself within the stipulated period”. Earlier, this Monday (7), Queiroga had already commented on the issue.
“By the time the appeal reaches me, the secretary has a period of five days [para responder]. If he accepts, the matter is closed. If not, it goes up to the minister and the minister will judge,” Queiroga told the journalist.
Upon taking over the Ministry of Health, in March 2020, Queiroga announced that he would promote the debate at Conitec to end the discussion on the use of the Covid kit. He indicated Carvalho, against ineffective drugs, to organize a group that would prepare the opinions.
Queiroga, however, modulated the speech and has invested in the Bolsonarista agenda to hold on to the position.
In addition to this text, Angotti rejected, at the end of January, two other guidelines for hospital treatment and another on outpatient care for patients. The last one, approved by Conitec from 7 to 6, also rejected the use of hydroxychloroquine, among other ineffective drugs for Covid.
In the appeal, Carvalho also claims that Angotti used a slanderous and utopian argument to point out an “ideological conflict of interest” of entities that acted in the preparation of the opinion.
“The Secretary, despite his training in medicine, promotes confusion by mixing mistaken concepts of prophylaxis and treatment”, stated Carvalho.
Angotti is a doctor and follower of the writer Olavo de Carvalho, considered the guru of Bolsonarismo, who died in January.
The document also said that the themes “medical autonomy” and “off-label use [aplicação de medicamentos fora da indicação da bula]” were cited by Angotti in a warmed-up way and from a speech by the CFM (Federal Council of Medicine).
Carvalho states that the CFM itself recognizes in processes that “medical autonomy, as it is subordinated to scientific protocols, has limits conditioned to schools, methods and previous experiments and can never be understood as unrestricted professional freedom”.
“Therefore, the principle of medical autonomy is not justified as a prerogative of exceptionality in the situation of prescribing medications already extensively demonstrated as ineffective, as the secretary wants to believe”, says the professor, in the appeal.
The same document states that Angotti violated the Code of Ethics for Public Servants, as it delayed for more than six months the publication in the Official Gazette of opinions that had been approved by Conitec.
“And even having noticed that new scientific articles appeared that could generate important updates, he did not ask for any revision of the approved document”, stated Carvalho.
The appeal points out that the delay in publication prevented updates to the document, and that Angotti used the delay of some information as an argument to veto the text.
The appeal states that the secretary lacked “the least bit of personal transparency, given the total lack of scientific and technical independence” when he accepted an argument pro-hydroxychloroquine and against vaccines in a note used to justify the rejection of the guidelines.
Carvalho was referring to a text signed by Angotti that defended the drug ineffectively and said that immunizations do not work against Covid. This argument was removed from the secretary’s note, after negative repercussions, but the decision to veto Conitec’s guidelines was maintained.
The comparison between hydroxychloroquine and the vaccine had been included in the secretary’s note based on a document made in the Health Ministry led by Mayra Pinheiro, known as “Captain Chloroquine”. The appeal states that she is “a well-known advocate for unproven medications against Covid-19”.
The USP professor also cited in the resource that Angotti brought to the Conitec debate researchers who defended ineffective drugs, in addition to a doctor who was the subject of a request for indictment by the Senate’s Covid CPI.
He cites that biologist Regis Bruni Andriolo came to participate in meetings and public hearings on the guidelines. As Folha showed, this is a researcher that Angotti wants to put in charge of Conitec.
The Brazilian Medical Association’s Extraordinary Covid-19 Monitoring Committee released a note in support of Carvalho’s appeal.
According to the committee, the rejected technical opinions resulted from hard work carried out over months by a group formed at the invitation of the Ministry of Health itself, composed of notable scientists, physicians, university professors and researchers from various institutions and medical societies in Brazil.
“The CEM COVID_AMB reiterates its unrestricted support for the appeal filed by Prof. Carlos Carvalho and for the opinion “Brazilian Guidelines for Outpatient and Hospital Drug Treatment of the Patient with Covid-19″ for assessing that the veto of the secretary of SCTIE/MS appears to be an arbitrary gesture and unilateral that constitutes a serious disservice to the assertive confrontation of the Covid Pandemic in Brazil”, said the committee in a note.
The Ministry of Health blocked the publication of the guideline for the treatment of patients with Covid-19 prepared by a group of experts that contraindicated the use of Covid kit in the SUS on January 21.
The Senate Human Rights Commission approved the summons of Angotti and Queiroga to explain the rejection of the guidelines.
The text had been approved by Conitec, despite attempts by the government’s pro-chloroquine wing to boycott the discussion.
The texts that contraindicated the Covid kit were approved in June and December 2021 by Conitec, but the publication of the guidelines was being postponed by Angotti.
While Angotti will have five days to present a new response on the opinions after the appeal, in the last resort, and without a response deadline, Minister Queiroga decides on whether or not to publish the guidelines.
In addition to the appeal presented, the MPF (Federal Public Prosecutor’s Office) recommended the revocation of Angotti’s note. According to the agency, the regulation contradicts themes already pacified by the scientific community.
The Attorney General’s Office in the Federal District also asked the secretary to publish the approved guidelines. The government has ten days to position itself on the matter.
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