The Brazilian Constitution of 1988 establishes that health is a right of a citizen and a duty of the State. But up to what point such rights and duties go has increasingly become the subject of debate, including in the courts. The number of citizens and groups that have sued various levels of government, seeking access to medicines and treatments, has increased significantly in recent years. In 2010, the federal government spent R$122 million on the purchase of medicines mandated through court order, a sum that reached R$1.6 billion in 2016. The process of judicialization of health care has allowed thousands of people to receive the medicines they needed, but has posed a complex challenge to municipal, state and federal authorities.
The magnitude and impact of this phenomenon has attracted the attention of researchers and members of the various levels of government involved. A series of research studies has, recently, helped us understand the notion so that public authorities can do more than just react to these demands.
In this issue’s cover story, Assistant Editor Bruno de Pierro demonstrates that there are lawsuits demanding medicines that are not available through the United Health System (SUS), while at the same time, there are a not insignificant number of cases that are asking for medicines already offered in the public system or their available equivalents. There are also additional demands for products such as coconut water, sunscreen and diapers–all requested through medical prescriptions, most of which were issued by professionals in the private sector. In the state of São Paulo, nearly 30% of the medicines purchased with public funds in response to lawsuits in 2016 were never picked up by the plaintiffs.
Article 196 of the Constitution states: “Health is a right of all and a duty of the State and shall be guaranteed by means of social and economic policies aimed at reducing the risk of illness and other hazards and at providing universal and equal access to actions and services for its promotion, protection and recovery.” Does this definition justify the spending of R$654.9 million in 2016 alone on the purchase of 10 types of medicines for 1,213 patients? Rare diseases and their costly treatments may require an expansion of the list of medicines available under the public network, but there are some demands that can hardly be justified by social criteria. Furthermore, should the public health service be ruled indiscriminately by cost-benefit analyses? The issue is multifaceted and expanding our understanding of it will certainly help us think of answers.
Researchers in fields such as the life sciences or engineering regularly read–and write–scientific papers. In Brazil, however, it is much less common for them to have contact with patents. These documents can be an important way to disseminate knowledge and a valuable source for learning about the state of the art in various fields. Familiarity with patents can also help prepare the ground so that scientists, still in the initial stages of their research studies, can think about how to ensure the originality of, and protect, their findings–where such possibility exists. The Careers section of this issue argues that the culture and practices of intellectual property have been changing at Brazilian institutions of higher learning and research, but that researchers still have not acquired the habit of analyzing patent databases or using this tool to communicate and protect their findings.Republish