The inclusion of Palliative Care in the Universal Health Coverage (UHC) in Brazil

(Credit: Unsplash)

This article was exclusively written for The European Sting by Ms. Jaquelini Fernanda Gomes dos Santos and Mr. Jhonatan Guilherme Fernandes, two 3rd year in medical school, member of the local committee of IFMSA Brazil-Uningá. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

In the work of Sophocles, from Greek mythology, Oedipus decipher the enigma of the sphinx making an allusion to the human condition from childhood to old age. In terms of health, all ages, according to their needs, should receive quality care in search of full health. In view of this, Universal Health Coverage (UHC) was shaped through negotiations by the World Health Organization (WHO) with the World Bank (WB) and the Rockefeller Foundation, becoming a goal in the Sustainable Development Goals (SDGs) for the 2030 agenda (STECKEL, 2020).

Thanks to scientific and technological advances, the human being has lived longer, which does not necessarily mean that there has been an improvement in the quality of life in old age or after becoming ill, as the struggle to find a cure leads to a culture of denying death, making health interventions that promote a dignified end of life take second place. Thus, palliative care has been seen as an innovative form of health care and its approach has been advocated by reinforcing comprehensive care, preventing and controlling symptoms of patients facing life-threatening diseases, and should be applied to patients and those involved, such as the family and the health team (GOMES et. al, 2016).

In Brazil, UHC and palliative care are guaranteed by the fundamental principles of the Unified Health System (SUS) of universality and integrality, defending the service to all in a multidisciplinary way. However, even though it is written in Law 8.080 / 90, SUS has difficulty to exercise UHC either due to lack of investments, or due to brazilian continental dimension in which each region has its own characteristics, thus revealing a need for effective decentralization of SUS.

According to the WHO (2019), investments in quality primary health care are the basis for reaching UHC worldwide, as it guarantees improved access to essential health care. The reality is different because, according to the Worldwide Hospice Palliative Care Alliance (WHPCA) (2020), the COVID-19 pandemic caused most governments to cut back on their investments in palliative care. In addition, according to the WB and WHO (2017), half of the world population does not have access to essential health services.

Another way to defend the inclusion of palliative care in UHC is through awareness, such as the International Day of UHC that is celebrated on December 12. With this, investments would not be seen as an increase in expenses, but as a fundamental measure to offer a dignified end of life to patients, understanding that death is a natural process of life.

Finally, it is important to remember that the quality of life of the population must be a priority until the end of their life, as well as the Brazilian federal constitution of 1988 and the current Medical Code of Ethics that emphasize the unethical nature of measures such as dysthanasia, in which the patient receives treatments that only prolong the biological life of the patient, without well-being and dignity (FELIX et al, 2013).


SÓFOCLES. Édipo Rei – Antígona. São Paulo: Martin Claret Editora, 2007.

STECKEL, Bibiana Mayer. Cobertura universal de saúde: reflexões sobre os sentidos e influências do global para o local. 2020.

GOMES, Ana Luisa Zaniboni; OTHERO, Marília Bense. Cuidados paliativos. Estudos avançados, v. 30, n. 88, p. 155-166, 2016.

BRASIL. Lei nº 8.080, de 19 de setembro de 1990. Lei Orgânica da Saúde. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Brasília, set. 1990.

WORLD HEALTH ORGANIZATION.Universal health coverage (UHC). Available on: <>. Access on 20 dec. 2020.

WORLDWIDE HOSPICE PALLIATIVE CARE ALLIANCE. Palliative Care, Covid-19 and Universal Health Coverage Report. Available on: <>. Access on 20 dec. 2020.

WORLD HEALTH ORGANIZATION.World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses. Available on: <>. Access on 20 dec. 2020.

BRASIL. Constituição (1988). Constituição da República Federativa do Brasil. Brasília, DF: Centro Gráfico, 1988

DE ÉTICA MÉDICA, Código. Resolução CFM nº 2.217, de 27 de setembro de 2018, modificada pelas Resoluções CFM nº 2.222/2018 e 2.226/2019. Conselho Federal de Medicina–Brasília: Conselho Federal de Medicina, 2019.

FELIX, Zirleide Carlos et al . Eutanásia, distanásia e ortotanásia: revisão integrativa da literatura. Ciênc. saúde coletiva, Rio de Janeiro , v. 18, n. 9, p. 2733-2746, Sept. 2013 . Available from <>. access on 22 Dec. 2020.

About the authors

Jaquelini Fernanda Gomes dos Santos, 24 years old, 3rd year in medical school, member of the local committee of IFMSA Brazil-Uningá. Jhonatan Guilherme Fernandes, 20 years old, 3rd year in medical school, member of the local committee of IFMSA Brazil-Uningá. These students are academics from Ingá University Center (Uningá) and articulated themselves with the objective of reporting a current problem that has occurred in their country and in the world.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Humanitarian aid: €24.5 million in Southern Africa and Indian Ocean region

Radio still a powerful worldwide tool for ‘dialogue, tolerance and peace’: Guterres

Cities are at the heart of our journey to net zero. Here’s why

UN chief condemns attack targeting international forces in northern Mali

Data capture, not disclosure, is the way to meet our climate goals

Data protection: Commission decides to refer Greece and Spain to the Court for not transposing EU law

President Juncker temporarily transfers portfolio responsibilities following departure of two Members of the European Commission

The world needs carbon-neutral flying. Here’s how to bring it one step closer

Two major EU projects falter; the Schengen Agreement now freezes and Eurozone fails to resolve the Greek enigma

How to build public trust in a sustainable energy future

Consumer protection: Commission welcomes political agreement by Council on the Representative Actions Directive

Sustainable transport can’t just depend on batteries. Here’s why

Conference on the Future of Europe: preparations continue

Global initiative launched to keep top sports events safe from terrorism

With security improving in DR Congo’s Kasai, thousands of refugees head home from Angola

EU long-term budget deal must be improved for Parliament to accept it

New energy Projects of Common Interest for the Energy Union built on European solidarity

How leaders can use ‘agile governance’ to drive tech and win trust

Trump’s self-centered politics unravels

Trump ostracized by his party and world elites but still remains in course; how can he do it?

Commission launches new edition of the Cultural and Creative Cities Monitor 2019

How we can win the war against antibiotic resistance

‘Maintain calm’ and ‘exercise patience’ UN envoy urges, as Nigeria heads to polls

The Recruitment of Children as Soldiers Explained

‘The time for action is now’ senior UN peacekeeping official says, urging support for regional force combating Sahel terrorism

Eurobarometer: Not a single answer about what the Banking Union will cost to citizens

LGBTQ+: The social evolution of a minority

What is ‘circular denim’ and why are top brands redesigning jeans?

‘Abhorrent’ ambulance attack in Libyan capital imperils life-saving work, warns UN

Removing deadly mines means ‘new horizons and hope’, clears a path to SDGs, says UN chief

FROM THE FIELD: Murals help heal wounds of bloody conflict in Guatemala

EU mobilises international donors to support Venezuelan refugees and migrants and countries in the region

Resolving Israel-Palestinian conflict, ‘key to sustainable peace’ in the Middle East: Guterres

Combatting terrorism: EP special committee calls for closer EU cooperation

This ceramic ink can 3D-print bones directly into a patient’s body. Here’s how

Tanzania’s Dual Burden

5 insights to guide ASEAN’s digital generation in a post-pandemic world

Children suffering ‘atrocities’ as number of countries in conflict hits new peak: UNICEF

Ageing: Looming crisis or booming opportunity?

UN mourns death of former Secretary-General Kofi Annan, ‘a guiding force for good’

Turkish and Greek Cypriot leaders ready for talks with UN chief on improved relations

Eurozone: Economic sentiment-business climate to collapse without support from exports

Can climate change wait for the US to rejoin the Paris agreement?

MWC 2016 LIVE: Gamelab founder talks Apple TV, VR and monetisation

We need to talk about mental health at work, say employees

Hungary: Commission takes next step in the infringement procedure for non-provision of food in transit zones

This is the ever-changing state of the world’s top cities

Women outliving men ‘everywhere’, new UN health agency statistics report shows

How to outsmart bias when you’re recruiting

Hackers can use public USB chargers to steal personal data. Here’s what you need to know about ‘juice jacking’

EU integration: MEPs want to end permanent opt-outs from EU law

5 things you need to know about water

FROM THE FIELD: Persons with disabilities bike towards sustainability

‘Everyone must be on board’ for peace in Central African Republic: UN’s Lacroix

Commission launches debate on a gradual transition to more efficient and democratic decision-making in EU tax policy

Meet the man who drove from the Netherlands to Australia without visiting a gas station

Building a Climate-Resilient Future – A new EU Strategy on Adaptation to Climate Change

UN study projects $32 billion loss for UK post no-deal Brexit

IMF launches a new offensive against Germany

‘Antagonistic gestures and accusations’ drown out Kosovo dialogue hopes, Security Council hears

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: