The TCU (Union Court of Auditors) points out, in a report from the technical area, the occurrence of full damage to public coffers if the invalidity of the Ministry of Health guidelines for the use of drugs such as chloroquine and azithromycin against Covid-19 is confirmed. .
The so-called Covid kit has no proven effectiveness to treat the disease and, even so, it was the flagship of Jair Bolsonaro (PL) during the pandemic. A chloroquine enthusiast, the president is critical of vaccines, the use of masks and social distancing.
The possibility of setting up “damage to the treasury referring to full amounts”, spent by the Bolsonaro government on chloroquine and other drugs, appears in a TCU auditors report completed on the 3rd.
The document is part of a process that analyzes possible irregularities in the production of chloroquine by the Chemical and Pharmaceutical Laboratory of the Army. Among the suspicions investigated are overbilling, explosion of quantities produced and Bolsonaro’s direct responsibility for production.
The same report pointed to “robust indications” of fraud in bids by the company that provided the Army with the necessary input for the manufacture of chloroquine, such as sheet showed on the 17th.
To fulfill a wish from Bolsonaro, the then Minister of Defense, General Fernando Azevedo e Silva, made it possible to manufacture 3.2 million chloroquine tablets in 2020. The last production by the Army laboratory had been in 2017: a total of 265 thousand pills, according to the TCU.
“Even recognition of the nullity of the Ministry of Health’s information note 17/2020 could, in theory, result in the irregular acquisition of inputs for the purpose of treating the pandemic disease, causing damage to the treasury referring to the full amounts used for such acquisition”, he quotes. the technical area document.
The aforementioned information note, published by the management of active general Eduardo Pazuello at the Ministry of Health, explicitly guided the use of chloroquine, hydroxychloroquine and azithromycin in patients with Covid.
The TCU auditors’ report does not advance the amount of possible damage to public coffers. The Covid CPI in the Senate, in its report approved in October last year, made a calculation on authorizations to spend public money with the Covid kit.
According to the CPI report, the commitments — spending authorizations — related to the acquisition of chloroquine, hydroxychloroquine, azithromycin and ivermectin in 2020 totaled BRL 41 million. In 2019, before the pandemic, it was R$ 2.4 million.
With chloroquine and hydroxychloroquine, the amount committed in 2020 was R$ 30.6 million, according to the CPI. The expense is attributed to the National Health Fund.
If the damage to public coffers in relation to full amounts is confirmed, “the question of the possibility of buying in excess of the drug would not remain, since all the purchase would be irregular”, said the TCU technicians.
They suggested suspending the investigation into irregularities in the production of chloroquine until there is a definition on the illegality of offering an “off-label” drug by the SUS (Unified Health System) without authorization from Anvisa (National Health Surveillance Agency).
This is the case with the Covid kit: the drugs were used to fight the disease, which is not provided for in the medication package insert. The acquisition and offer took place via SUS, and there was no authorization from Anvisa for this, as verified by a second audit by the TCU.
The report pointed out illegality in the use of SUS resources to supply chloroquine to patients with Covid. The document is part of a process that investigates irregularities in the management of public resources by Pazuello for the supply of chloroquine and hydroxychloroquine to people with the disease.
The possibility of damage to public coffers was also mentioned in this second process.
Both processes remain unfinished.
“If the good and regular application of the public resource is not proven, including in terms of efficiency, the court will certainly act with the adoption of the measures that prove necessary, including the accountability of those who may have caused damage to the treasury”, quotes a report from the court. .
The advance of investigations into illegality in the destination of chloroquine and the consequent damage to public coffers may explain the resistance of the current minister, Marcelo Queiroga, to validate the veto of the Covid kit in the treatment of the disease, in addition to the fear of contradicting the Bolsonaro’s speech.
In December, Conitec (National Commission for the Incorporation of Technologies in the Unified Health System) approved a document that rejects the use, in SUS, of the kit in patients with Covid. The following month, the ministry barred the publication of guidelines approved by Conitec.
The then Secretary of Science and Technology of the ministry, Hélio Angotti Neto, was responsible for blocking the guidelines. He did not approve chapters on inpatient and outpatient treatment of Covid patients.
The chapters did not recommend the use of chloroquine in these patients, given the evidence of ineffectiveness.
Angotti follows Bolsonaro’s booklet and is a drug advocate. Appeals against the decision were presented to the ministry. The secretary rejected these appeals. Now, the final decision rests with Queiroga.
The report questioned the Ministry of Health about the TCU’s notes related to damage to public coffers and whether this possibility makes the folder keep a resolution on the Covid kit undefined. There was no response.
Audits by the TCU have already confirmed that part of the chloroquine manufactured by the Army was used in hospitalized and critically ill Covid patients.
The court also confirmed that the Ministry of Health diverted chloroquine tablets manufactured by Fiocruz (Fundação Oswaldo Cruz) to Covid to combat malaria.
The TCU started to investigate this deviation after the sheet reveal, in reports published in February and March 2021, that the folder used Fiocruz to produce chloroquine for Covid. Of 3 million pills manufactured for malaria, 2 million were diverted to Covid.
The initiative even left the national malaria control program uncovered, with the risk of drug shortages, which required an additive on an urgent basis to produce another 750,000 pills.
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