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Joneilda Moraes, Diogo Norte, Cintia Cerigatto, Kaah Sousa, Dario Silva, Freitas João Batista, Vera Lucia de Jesus, Regina Sandra, Wanda Almeida, Sidney Nunes. Some of the patients with hepatitis C who have been waiting for almost a year for sofosbuvir, a drug whose lots were in the warehouse of the Ministry of Health and are about to expire, are precipitated to the secretariats of the State for health
. The story requires rigorous investigation and punishment of those responsible for this congestion, which could cause damage to public coffers and, in one form or another, damage to 15,000 people (only 8,000 in São Paulo) waiting for treatment . 19659002] How many people contracted the disease during this period? How many died from lack of drugs? How much are depressed by the insecurity created by the situation? In the hepatitis support optimism group page, the reports are the most diverse and give the dimension of the drama faced by patients.
The official explanation for the imbroglio is as follows: the sofosvubir had been acquired in 2017 and was waiting in the departmental warehouses for the arrival of daclastavir, another cure to be taken together to achieve l & # 39; Expected efficacy of the treatment. 90%).
Due to delays in the offer, the purchase was made only last November, by emergency call. Fifteen thousand treatments were purchased. If one remedy must necessarily be badociated with another, is it wise to be bought only one year after the first?
The bomb is now in the hands of the state secretaries for health. In one document, the ministry recommends that drugs be dispensed until the 25th day, a little over a month from the expiry date of sofosbuvir. In all, 2,200 treatments will have to be used by February 28th. Otherwise, the damage in the public coffers will rise to $ 18 million.
Leonardo Vilela, president of Conbad (National Council of State Secretaries for Health), has already stated that there was no way to meet the deadline because of logistical constraints necessary for patients to be activated. "It's absolutely impossible," he said to Folha .
There is yet another concern: Will there be enough drugs to complete the treatment? In São Paulo, for example, there are none. Treatment regimens vary according to the type of virus and the severity of the patient and can range from 12 to 24.
The amount sent by the ministry is sufficient for a month, according to the Government of São Paulo. The treatment can not be stopped because there is a risk of loss of efficiency. Therefore, this only begins when there is stock for the entire diet (which may involve two or more drugs). The ministry ensures that there is enough medicine.
Imagine the desperation of patients. They are worried for a year and are waiting for essential treatment. And when they receive the news that it will finally happen, they risk receiving it about to expire or receive it, because the secretaries are able to do it under such conditions.
In addition, it is unclear whether examinations performed when treatment is requested, such as viral load, will be considered valid or if the patient will have to perform other tasks to receive the medication. If it is necessary to repeat the tests, meeting the deadline set by the ministry will be an additional problem.
Still with regard to hepatitis C, access to treatment has declined sharply in the last two years. According to Carlos Varaldo, from Optimism Support Group for Hepatitis Carrier, 36,627 treatments were performed in 2016. In 2017, 25,988 and in 2018, only 13,000. The new government is expected to process 50,000 patients this year.
It is also suspected that 13,000 hepatitis C treatments (sofosbuvir and daclatasvir) were purchased for a pregón in the extinction of the lights of Michel Temer's government. According to Varaldo, with the same amount paid for treatment ($ 2,500 for a 12-week treatment), it would have been possible to buy other types of cheaper drugs, as effective as hepatitis C, that could have been double the amount. therapies available. The entity complained to the Brazilian Court of Audit (TCU)
. Here are some of the issues that the new direction of the Ministry of Health is already starting to face. There are other urgent requests that should be addressed this week to Minister José Henrique Mandetta by representatives of State Councils and Municipal Secretaries for Health. Among these, Mandetta's proposal to create a third change in primary care.
Municipalities are already investing a lot in health care (23%, on average, when the Constitution determines 15%) and say that they can not take care of anything they do not have. There are no additional transfers from the federal government.
Most prefectures, under the Fiscal Responsibility Act, can not hire more employees. They have already reached the limit of 60% of income with active, inactive and retired. In other words, it is unnecessary for the Ministry of Health to transfer responsibilities without indicating the source of the resources.
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