For months, pharmacies and basic health units across the country have faced a blackout of some medicines, such as dipyrone, antibiotics, serum and diuretics. The shortage of medicines affects municipalities, public hospitals and also the private network, patients have reported difficulties in acquiring medicines and the service network is unable to meet the demand.
In an ordinary meeting last Wednesday (20/7), the National Health Council (CNS) discussed ways to face shortages. The implementation of an Economic-Industrial Complex was pointed out as an alternative to solve the problem, with the development of the secondary segment of the economy, such as the chemical, biotechnological, mechanical and materials industries.
“We have to place health and its economic, productive and technological base as a great bet for Brazil to overcome the blatant dependence we have on the foreign market”, evaluated the researcher from the Department of Administration and Planning in Health at the National School of Public Health at Fiocruz. (Daps/Ensp), Carlos Gadelha, who led the meeting.
An Economic Industrial Complex would guarantee autonomy to the Brazilian market, but it is a long-term solution to an urgent problem. The scarcity of these medicines is the result of many factors, such as the lack of access to raw materials (Ifa’s) in the international market, pressure by the pharmaceutical industry to increase prices, in addition to the lack of funding of the Unified Health System (SUS) determined by the Constitutional Amendment. 95/2016, which froze investments in Health until 2036.
According to Silvio Pereira, CEO of Pharbox, the first Brazilian pharmaceutical technology, Brazil basically has three pharmaceutical industrial centers, in the interior of São Paulo, in Anápolis, in Goiás and in Minas Gerais. “We often see products where only one or two industries have registration and authorization for production, and concentrating a large part of national consumption. Any break in this production chain affects our country, which has a hostage volume of continental consumption. Only with new players and new records we can increase competition in industrial production”, he said.
“Almost 95% of medicines in the country depend on raw materials originating, mainly, from China, which had its exports affected because it is once again in lockdown to contain the new wave of covid cases. In addition to the greater difficulty for the arrival of inputs to the country, we had a kind of domino effect, as other products that were lacking demanded more dedication from the industry, leading to a reduction in the manufacture of other products”, observed the CEO of the Brazilian Association of Pharmacy and Drugstore Chains (Abrafarma), Sérgio Miss Barreto.
The federal government had already been alerted by the municipal health secretaries, but the situation is getting worse every day. A recent survey by the National Confederation of Municipalities (CNM), carried out with 2,469 city halls, found that more than 80% of managers reported suffering from a lack of medicines to serve the population.
management issues
Despite all the chain reaction caused by the lack of supplies, aggravated by the pandemic, the Brazilian health system still faces serious problems in the management and distribution of these medicines, with a long history of medicines and vaccines that have expired before reaching the population. . In the midst of a pandemic, for example, more than 344 thousand doses of vaccines against covid-19 were lost, a loss of R$ 46.6 million.
According to health doctor Gonzalo Vecina, founder of the National Health Surveillance Agency (Anvisa), the main substrate of these losses is the lack of capacity of the logistics sector to manage inventories and distribute these products on time. “The logistics department does anything but logistics. So, in addition to losses, there must also be losses, which are not being reported. But the most important thing is the losses due to maturity, which are necessary products on the periphery of the system”, he pointed out.
Vecina, which is one of the largest health authorities in the country, also assessed the lack of management of the production system, affected by shortages. “The Ministry of Health is not playing its role of directing public policies to guarantee production. There are medicines that are not being produced here because the price is too high, because we cannot import and set a new price in view of the increase in materials cousins,” he added.
Silvio Pereira, CEO of Pharbox, the first Brazilian pharmatech, says that these problems cannot be solved only with the Economic Industrial Complex of health. “In my view, it is not a matter for the Ministry, but for Anvisa, which regulates the market and is responsible for granting new registrations, importing raw material processes, etc., developing new products and entering new players in the market. industry,” he said.
“Today there are large industrial conglomerates centralizing a large part of the national production of medicines, since there is a rupture in the supply of raw materials or an increase in the specific demands of the domestic market, as a large part of the production is centralized in a few companies, the retail market suffers , and consequently, the final consumer. With more agile registration granting processes, at least for large-scale drugs, we would have small and medium-sized laboratories also producing and competing in this market. This would help a lot in the regularization of supply national.”
According to Silvio Pereira, CEO of Pharbox, the first Brazilian pharmaceutical technology, Brazil basically has three pharmaceutical industrial centers, in the interior of São Paulo, Goiás and Minas Gerais. “We often see products where only one or two industries have registration and authorization for production, and concentrating a large part of national consumption. Any break in this production chain affects our country, which has a hostage volume of continental consumption. Only with new players and new records we can increase competition in industrial production”.