The announcement that the private sector is negotiating the purchase of an Indian vaccine against Covid-19 has divided health experts between those who consider the measures useful for SUS and those who consider it “immoral” in the context of a pandemic. which has already killed nearly 200,000 people and is facing a shortage of doses.
Ophthalmologist Claudio Lottenberg, 60, president of the Sociedade Beneficente Israelita Brasileira Albert Einstein and Instituto Coalizão Saúde, says the private health sector could boost the Covid-19 vaccination process in the country and thus bring more economic benefits and agility to SUS.
According to him, the government should understand that the private sector has great value and try to organize an organization to manage the vaccination of a part of the population, which has health plans, quickly and efficiently.
However, Lottenberg believes it is possible that at some point this arrangement will result in some kind of injustice, such as people who are not from priority groups but who have the resources, to be vaccinated before the most vulnerable population. “I’d rather risk committing some particular injustice than risk committing the greatest injustice, and that’s not vaccinating anyone.”
Does the supply of vaccines against Covid-19 in the private sector create a dispute with SUS at a time when there is a shortage in the world?If we were to talk about an ideal country, well-structured, with reputable health leadership and prepared despite the difficulties of a pandemic, I would say that [a oferta no privado] it would be quite questionable.
The fact is that we live in a situation opposite to that, with an absolutely chaotic structure, leadership without compromise, which uses completely misleading information with a mere political role, hampering science.
In that vacuum, did the private sector decide to act in search of a vaccine?There is a sector of society, which has legitimate services, including a constitutional plan, and that is a complementary health sector that is trying to stimulate the vaccination process in some way.
Is it all bad? Not. This is good. It in a way brings economic benefits to SUS, it brings agility. If you consider only supplementary health care staff, that would be a quarter of the people in our health care system.
Therefore, [vacinar esse público] it is a way to make the immunity of the herd faster. The question is: will the election criteria be respected within a population that is considered vulnerable?
If by chance the state does not mobilize, if government leaders do not take a stand, then there is a great risk. Because, in fact, there may be a protagonism of advantages of a commercial nature. In the event of a pandemic, this may not be the most desirable.
Now the private sector involved in vaccination processes is part of the history of our country. There’s nothing new.
What can be done to minimize the risks? Do you follow, for example, the National Vaccination Plan?I think the plan should have a strong position as the leader of a constituted government, which is very problematic. The Minister of Health is not a physician and does not respect him as a medical body; the president was a person who was not sensitive to the problems of the pandemic, there is something new in what he is talking about every day.
It’s hard to find a voice … But still, there’s a way to do it. [O governo] it should strengthen the discourse of prioritization. Instead of criticizing, saying that it will create injustice, that it will favor those who are rich, the government should understand that this is the result of the liberal world we live in, which is, in fact, one of the flags of this government.
You should understand that the private sector has great value and try to organize yourself to cope with it [da vacinação] that part of the population quickly and efficiently. That would only help the Brazilian health care system.
But if we now want to talk about justice and injustice, we put the pandemic program on the 1988 agenda.
Social and racial inequalities are very clear in this pandemic, with an impact, including mortality. Wouldn’t that further widen the gap?Yes, this is an important fact. The most socially vulnerable people were those who had the highest mortality, internationally.
Perhaps when it comes to vaccination, you can give priority to the most socially vulnerable populations. In the composition between public and private there are conditions for the creation of this path. There are people who, although employed and have health insurance, do not always live in good housing conditions or have a healthy lifestyle. How many company employees live in one room and live with seven people? How many people are employed and live in communities, in slums?
I get the impression that the debate is not about whether he enters privately or not. Yes, the private sector needs to get in, but try to keep the agenda on priority. The government must use the virtues of the private partner. He is much more adept at buying, distributing, applying, and using his own resources, with no stamped funds.
But how can we guarantee that only priority groups will be vaccinated?Eventually, these private individuals will be able to vaccinate everyone within the priority groups and vaccines. But that is the second chapter. We haven’t done anything yet. Ideally, we would vaccinate everyone.
If you look at the United States, less than 45% of the population wants to get the vaccine. There is a strong suspicion that these vaccines were approved in record time. People wonder: have they done all the safety tests? But Brazilian vaccination projects, in terms of population commitment, are better than outside Brazil. So we can’t keep our hands tied.
We can’t give up a partner who is agile at a time when we have nothing. It may be that some kind of injustice has been committed at some point, but I would rather risk committing some particular injustice than risk committing the greatest injustice that does not vaccinate anyone. So far this is happening. Israel has already vaccinated more than 10% of the population, the U.S. 1.5% and, s [presidente eleito Joe Biden], will walk faster, England walk.
That’s us? Who gets vaccinated in Brazil? Only those who entered the trials [ensaios clínicos] and was lucky he didn’t get a placebo.