Medicine as a political act

This article was exclusively written for The European Sting by Ms. Gabriella Caroline Andrioni, a twenty-one-year-old woman and a fifth-year medical student at the Universidade Federal de Mato Grosso, in the interior of Brazil. She is affiliated with 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.

Universality, Integrality and Equity are the three key principles enshrined in the Brazilian Health Care System. Guaranteed by the Federal Constitution of Brasil in 1988, the “Sistema Único de Saúde” (SUS), a complex network of health care services and policies, ensures from health surveillance to treatments of rare diseases, free of charge and for the entire population.

Even if idealized for the formation of a Brasil without inequalities, what the SUS currently faces is the draw of a country where the rich get richer and the poor get poorer, and everyone loses in terms of health.

Accumulated over the last twelve months, the inflation is estimated at 7,7% in Brasil(1), leading to a decrease in the purchasing power of families and an increase in severe food insecurity, which affects around 15,5% of domiciles in the country this year(2). With the need to feed, cheaper processed foods have been prioritized over fresh foods among the poorest population. This leads to a malnutrition and a drop in health potential among young people. The number of overweight children grew in the last year(3), as did those with marked thinness(4), and the hospitalization of people up to 14 years old because of diabetes hit a record in 2021(5).
As poverty-related health problems increase, the Federal Government’s health budget decreases. According to the “Lei Orçamentária Anual de 2023”(6), health in Brasil will have the lowest budget in the last 10 years next year. Cuts range from indigenous health assistance to the supply of free high- and low-cost medicines, a complete breakdown of universality, integrality and equity of health.

It is in the political and social struggle for the permanence of principles that medical students take place. The social participation of medical students in defense of health for all in Brasil is old. The “Reforma Sanitária” and the creation of the SUS are a legacy of the public articulation of civil society groups, including sociologists, politicians, doctors and students, who tried to build a new possibility of life within the military dictatorship in the 70s.

It is necessary to learn, during graduation – a period in which there is the possibility of time dedicated only to health studies -, about the political and economic formation of the Brazilian Health System. From this, the medical student can understand what are the country’s public health policies and at what level are they, managing to claim more effectively the priority of some and avoid the disruption of others.

Taking the issue of food insecurity for children in Brazil as example, we have linked as a priority the public policy of integral care to children’s health, que public policy of food and nutrition and the public policy of care for chronic non-communicable diseases – the last two with a cut in the budget for 2023. Having access to this information and integrating it into the activity as a public health agent makes medicine a political act and opens the door to a less unequal Brasil in its future.

References

(1): Instituto Brasileiro de Geografia e Estatística. Inflação Brasil, IBGE. Available at: https://www.ibge.gov.br/explica/inflacao.php (Accessed: October 24, 2022).
(2): Olhe para a Fome. Available at: https://olheparaafome.com.br/ (Accessed: October 24, 2022).
(3): Obesidade e as DCNT. Available at: https://rezendelfm.github.io/obesidade-e-as-dcnt/ (Accessed: October 24, 2022).
(4): Magreza e Obesidade Infantil pioram no país. Fiquem Sabendo. Available at: https://fiquemsabendo.com.br/saude/magreza-obesidade-brasil/ (Accessed: October 24, 2022).
(5): “Espoca-bucho” com salsicha, Receita Pra Ficar Doente de Comida. Revista Piaui. Available at: https://piaui.folha.uol.com.br/espoca-bucho-salsicha-receita-ficar-doente-de-comida/ (Accessed: October 24, 2022).
(6): Orçamento anual de 2023. Ministério da Economia. Governo Federal. Available at: https://www.gov.br/economia/pt-br/assuntos/planejamento-e-orcamento/orcamento/orcamentos-anuais/2023 (Accessed: October 24, 2022).

About the author

Gabriella Caroline Andrioni is a twenty-one-year-old woman and a fifth-year medical student at the Universidade Federal de Mato Grosso, in the interior of Brazil. She is made of curiosity and touched by the sensibility in the social relations. Because of this, participates in every university extension she can find and still take a time to do research between the classes. She believes in a universal, free and quality health system and is searching for it.