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Saúde / 04/01/2021


ABIN involved in the SUS dismantling strategy

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ABIN involved in the SUS dismantling strategy

Fonte OUTRAS PALAVRAS

Appointment of a spy agency staff to a key post in the Ministry of Health is the tip of the iceberg. Investigation suggests that Bolsonaro uses arapongas to interfere with vaccines, privatize the system and monitor civil society

SUPREME DIDN'T UNDERSTAND NIBP

In the week following the vaccine trials, the Supreme Court shows that it may not have understood the National Immunization Program, the role of public institutions, and also its limits. This is because the most important Court of the Brazilian State sent Fiocruz a letter asking if the foundation could reserve seven thousand vaccines for its ministers, servants and ‘collaborators’. The justification follows a logic very similar to that of health insurance companies when they want benefits: the STF argues that running a vaccination campaign of its own would relieve SUS, allowing “the destination of public health equipment for other people”. It turns out that these ‘other people’ are all Brazilians. Second-class citizens, perhaps?

The Supreme loads more in paints. In the letter sent to the foundation on November 30, he says that the parallel campaign would be “a way to contribute to the country at such a critical moment in our history” and to collaborate “with the National Immunization Policy”.

The news gets worse because the office of the Supreme Court was not the only one. The Superior Court of Justice also approached Fiocruz, wanting to guarantee immunizations for its patients. It is to be asked whether it does not occur to the magistrates that if each body followed this example, in the end, vaccination would end up creating another priority audience: functionalism. In a scenario of scarcity of vaccines in the first months of 2021, they would pass in front of health professionals who are attending at the end, elderly in general, indigenous people, etc. when it was proved that the work can be performed at a distance in the case of the Judiciary. It also seems inconsistent to charge both an immunization plan the Ministry of Health and patch it out, without public debate. Fortunately, Fiocruz has already denied the STJ's request and should do the same with the Supreme Court.

It is also noteworthy the fact that the higher courts report that they have been running parallel vaccination campaigns for some time - in the case of the STF, since 1999. Questioned, the STJ even says that their intention was to “purchase vaccines”. A branch of the Brazilian State supported by the Treasury buying another. Does the discretion in the use of public resources apply in this case?

According to Estadão, the request was not unanimous among the members of the STJ. There were those who realized that the reserve would also end up serving young and healthy people who make up the staff and that it might sound like a privilege, in a case similar to the request of a group the Public Ministry of São Paulo to skip the vaccination queue in that state. But there were also those who didn't think anything was too much.

ARAPONGA IN HEALTH

The news that General Eduardo Pazuello appointed a staff the Brazilian Intelligence Agency (Abin) to lead the area responsible for the industrial health complex, responsible for negotiating the purchase of vaccines, is frightening, but not surprising. The military does not seem to feel any constraint in advancing on tasks that require robust technical knowledge - and in this they are not far the politicians of the center, even if their motivation is not only the search for DAS, but distrust of civilians.

Myron Moraes Pires was promoted to this coordination on August 10 - and the “appointment of the Abin agent, without the necessary technical training for a strategic position in the ministry, generated a 'climate of terror' among the employees of the portfolio”, according to found UOL.

It turns out that underneath this site find there is an iceberg. And, yes, not only is it very frightening, but it causes some surprise. There would be other agency staff in the portfolio, dedicated to (predictable) extension, but also involved in the dismantling of public policies. “Abin agents work in the [Health] ministry on matters of direct interest to President Jair Bolsonaro, such as the vaccine against covid-19, privatization projects for primary care and mental health units, in addition to monitoring entities in the civil society that is part of the National Health Council, informs one of these sources with direct access to several servers in the portfolio ”, says reporter Igor Mello, who also heard interlocutors people close to Pazuello's office. The Presidency's Communication Secretariat denies that there are other Abin agents in the ministry and says that Myron Moraes Pires does not deal with the purchase of vaccines. What do you do then?

Last week, the Public Agency found that Abin's staff are spread over other bodies: Government Secretariat, Civil House, Federal Comptroller General, Economy, Infrastructure and Citizenship. The reporter Vasconcelo Quadros called the maneuver “flap of arapongas”: “Sources heard by the Public estimated that there are more than a hundred agents spread across different ministries, much of which are remnants of previous governments. An official who attended the meeting, heard by Pública with a commitment not to have the name mentioned, said that about a month ago, on a visit to the Superior Council of the Federal Public Ministry, the director of Abin, Alexandre Ramagem, said to interlocutors, that this number should increase: he would have said that the intention would be to reinforce the intelligence structure in all agencies, creating in ministries and relevant companies and state agencies, advisory services similar to what was the General Investigation Commission (CGI), a mega structure of intelligence that fed the defunct National Information Service (SNI), used to spy on opponents of the military regime. Sought by phone, Ramage did not return the call ”.

VACCINES IN BRAZIL

Fiocruz has a date to start delivering Oxford / AstraZeneca vaccines to the Ministry of Health: February 8. The information was given by the institution's president, Nísia Trindade, in an audience with the Chamber's external committee that monitors the actions against the covid-19. According to her, until the 19th, two million doses will be delivered and, thereafter, 700 thousand doses daily.

Eduardo Pazuello, who every hour announces a different probable date for the beginning of the vaccination, said yesterday that the first Brazilians should be immunized by the end of January - but he did not say with which vaccine. As AstraZeneca's would not be available, CoronaVac and Pfizer / BioNTech remain among the options put forward by the government today. If the agreement to purchase the latter is finally released, there will be eight million doses in the first half of 2021.

As for CoronaVac, the Ministry of Health decided to negotiate with the Butantan Institute an expansion of the dose purchase contract: instead of 46 million, it would be 100 million over the first half. Today, the results of the safety and efficacy of this vaccine should be released, based on data phase 3 of the trials. Anvisa created a commission to expedite the approval and has a meeting with Butantan today, at 16h.

Important: the federal government contract for the purchase of 330 million syringes has not yet been made. An electronic auction is open until December 29 - but the material is expected to arrive in February only.

The National Health Council published yesterday a recommendation for the national immunization plan to be expanded. The text indicates that more people are included in the priority groups (such as the non-villagered indigenous population and people in therapeutic communities) and that the entire population be vaccinated in 2021. According to the federal government's schedule, it will take 16 months for this to happen.

MEANWHILE…

Mexico should become the first country in Latin America to launch an immunization campaign against covid-19. The country, which bought the vaccine Pfizer, plans to start applying doses tomorrow. Chile, which also has a contract with Pfizer, and Argentina, which bet on Sputnik V, plan to start their campaigns for next week. In all cases, however, this vaccination start will happen with few doses. In Argentina, for example, there are 300 thousand.

NOBODY CHECKED

The news that street vendors already sell fake vaccines against covid-19 in Rio spread faster than the virus. Both lesser-known sites and even major vehicles, such as Folha and UOL, published headlines about the tragicomic case. But, in groups of journalists, what most caught the attention was the fact that these reports had forgotten the zero rule of the profession: they did not investigate the fact reported.

The reporters based themselves on the account of cultural producer Jonas MFJay, who posted a photo of the alleged fake vaccine on his Facebook account on Thursday. According to him, in Madureira, a street vendor announced at the top of his lungs the sale of the vaccine box at R $ 50, also saying that there was a scheme with the pharmacy next door to apply it for R $ 10 extra. Folha even went to the Rio Municipal Guard, which replied that it had not noticed the sale of the product in its patrol. But, with MFJay's story being the focus of the news, it would have been necessary to go to the field to seek other evidence to support it. Nobody did that.

Marco Faustino, a contributor to the e-Farsas website, said on Twitter that it is a case of fake news. “ the beginning, this story had a gigantic 'red flag': a single photo. Just a picture? No video? And the application? And the photo of the certificate? If that were so common, given the ‘blind belief’ (to say the least) of people, hundreds would have already bought it and several photos and videos would be popping up around, but there’s absolutely NOTHING. A part of the press gave voice to mere anecdotal evidence, “he criticizes. According to him, the photo that illustrates all the articles is identical to the one taken in Abu Dhabi. And, on top of that, it shows the box of a vaccine Chinese state-owned Sinopharm, which has no contract with Brazil.

Anvisa and the Federal Police are investigating the case. But, in the face of so much repercussion, MFJay himself has softened the story, saying that he made the post to play with something unusual that he would have witnessed.

It is not at all unlikely that fake vaccines will start to circulate (counterfeiting in the pharmaceutical industry is a longstanding problem). But, for now, we don't have enough information to say that this is already happening in Brazil.

NEW LINE IN RIO

Researchers UFRJ and the National Laboratory for Scientific Computing published a study this week (still without peer review) indicating the discovery of a new strain of SARS-CoV-2 in the state of Rio. According to them, it emerged five mutations in B.1.1.28, a strain that was already in circulation in Brazil since the beginning of the pandemic. But there is still no indication that it is more transmissible or aggressive, nor that it would reduce the effectiveness of vaccines.

THE CURRENT FRAMEWORK

Brazil has presented successive records of new cases (although these numbers are never reliable) and deaths that are increasing steadily. The moving average, which takes into account the daily records of the previous seven days, was yesterday at 776, with 963 new deaths in the last 24 hours. This is an average 60% higher than that of November 22, when the number was 483. And we haven't yet spent Christmas and New Year.

Southern states account for a quarter of all deaths recorded in the week of December 13-19. This was exactly the region in which the coronavirus took longer to arrive and, as El País recalls, for a moment it seemed that it could be controlled. But it didn't happen that way. Every, ICU occupancy is around 90%. The Piauí story explains that one of the causes may have been a mismatch in the confrontation: in March, when there were barely any cases, there were tougher restrictions on mobility. After a few months, just as the infections spread, everything started to reopen - and even the measures in force were no longer respected.

In São Paulo, Governor João Doria (PSDB) decided that the entire state will be in the red phase (only essential services are allowed to operate) December 25 to 27 and January 1 to 3… when the population is no longer used to fill the trade. On the eve of Christmas, when the streets and shopping malls are really full, everything is still free. The agglomeration scenes at the bus station and airports in São Paulo went viral and are really impressive.

BOLSONARISMO AS HYPOTHESIS

Paulo Capel Narvai, a professor at USP, is also closely examining the role of bolsonarism in the mortality indicators of covid-19. Studies of this type have been published since May (here and here), but the novelty of the article published the day before yesterday in A Terra é Redonda is the look with a magnifying glass directed at 19 cities in São Paulo. What explains the disease mortality rates in these municipalities? Two variables are tested: coverage of primary care and the vote for Jair Bolsonaro in the first round of the 2018 presidential elections. According to Narvai, the second variable better explains the tragic outcome, probably because “when following the leader, his voters adopted attitudes and practices that contributed to aggravate the spread of the pandemic in their territories and that are the cause of the deaths ”.

TO READ WITH CALM

The pressure health plan operators on ANS is the focus of the recently launched ‘Saúde em Jogo ″ (Editora Fiocruz). The book faces the lobby at the National Supplementary Health Agency, showing characters and groups involved in the main political disputes in the period the creation of the body, in 2000, to 2017. The author of the work, Marcello Fragano Baird, follows closely behind the scenes of the regulatory agencies it is time and prepares for next year another launch, this time on the arm wrestling that took place at Anvisa at the time of the regulation of food advertising.


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