The Secretary of Science, Technology, Innovation and Inputs of the Ministry of Health, Hélio Angotti Neto, rejected the appeals presented in favor of the guideline that contraindicates the Covid kit in the SUS (Unified Health System).
Among the six appeals denied, there is that of the doctor and professor at USP (University of São Paulo) who coordinated the group of specialists that prepared the guideline, Carlos Carvalho.
The appeal presented by Carvalho to the Ministry of Health stated that the secretary was negligent in rejecting the Covid-19 treatment guideline prepared by experts.
The text refused was against the use of medicines from the Covid kit, such as hydroxychloroquine, chloroquine and ivermectin. The guidelines were approved by Conitec (National Commission for the Incorporation of Technologies in the SUS) in December last year. It was 7 votes to 6.
Angotti also rejected the objections made by IATS (Institute for the Assessment of Health Technologies), Abrasco (Brazilian Association of Collective Health) and Repats (São Paulo Network for the Assessment of Health Technologies).
The secretary, who is pro-chloroquine, rejected two other inpatient treatment guidelines and another on outpatient care for patients. The appeal filed for these two guidelines was also rejected.
After Angotti’s refusal, the appeal is now going to be evaluated by the Minister of Health, Marcelo Queiroga. He has said he will evaluate the appeal, but without anticipating the decision.
“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 reporters this month.
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 appointed Carvalho, against ineffective drugs, to organize a group that would prepare the opinions.
On December 7, Conitec rejected the use of the Covid kit for patients with suspected or diagnosed Covid-19 in outpatient treatment. Under discussion in the collegiate was the approval or rejection of an opinion against the use of drugs such as chloroquine for mild patients.
It was up to the Ministry of Health to accept the text or not. On January 21, Angotti rejected the opinion.
In one of the justifications, the secretary said that, given the non-negotiable value of life and the importance of taking advantage of every opportunity to benefit the patient affected by Covid-19 or any other disease, the bioethical principle of beneficence, supported by evidence that demonstrates an impact positive, even if they are not yet of maximum quality, assumes great importance.
“If publications taken to future public consultations or hearings are not suitable for publication for methodological reasons that limit the scope of the guidelines under analysis, they will certainly be useful in the subsequent discussions that are already necessary”, he argued.
On December 21, in an interview with the Ministry of Health, Angotti said that the directive failed to reach the level of rigor that is required.
In addition, the secretary stated that it is difficult to give just one recommendation given that the pandemic scenario evolves fast with the emergence of new research, medicines.
“Giving a definitive statement and perhaps impacting professional autonomy at the end can bring some harm to the professional’s action and not serve the purpose of the therapeutic guideline, which is to be an instrument of institutional security”, he said.
report of leaf on February 4th showed that the technical note in defense of the so-called Covid kit cited scientific research conducted irregularly in the evaluation of Conep (National Research Ethics Commission).
The study is in the sights of the MPF (Federal Public Ministry) due to the high number of deaths recorded. The Covid CPI asked for the indictment of one of the authors for crime against humanity.
The technical note also brought research by doctors allied with the Jair Bolsonaro government (PL) in the dissemination of ineffective medicines against the coronavirus. The document defends hydroxychloroquine and ivermectin.
As there was contestation, it will now be up to Minister Marcelo Queiroga to define the position of the portfolio.
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