Brasilia, Brazil_ Municipal Health Secretaries and Brazilian mayors asked the elected president, far-right Jair Bolsonaro, to review his position on the permanence of Cuban professionals in the Más Médicos program, Radio Reloj publishes.

The entities call for the revision of the new government's position, which marked drastic changes in the rules of the program, which determined the decision of the Government of Cuba, a joint note of the National Council of Municipal Health Secretariats and the National Front of Mayors said.

The petitioners showed concern and appealed to the maintenance of Cuban professionals for the risk of missing basic health care to more than 29 million Brazilians.

Mayors indicated in their request to Bolsonaro that if the collaborators leave the island, at least 3 thousand 243 municipalities of Brazil will be harmed.

The withdrawal of Cuban doctors will be a disaster

In an emergent character, it is suggested the maintenance of the current conditions of hiring Cuban health specialists, reviewed by the Government of Michel Temer and confirmed by the Supreme Federal Court, highlights the note of the National Council of Municipal Health Secretaries and the National Front of Mayors.

It reveals that Cuban health professionals represent more than half of the doctors in the program and that their withdrawal could be disastrous, particularly for the indigenous population.

The entities remind that Más Médicos is widely approved by the population and that the program is a conquest of the Brazilian municipalities when the "Where is the Doctor" campaign.

In this sense, the note concludes, mayors’ offices and mayors evidenced the difficulty to hire professionals for the interior of the country and in the peripheral region of the big cities of Brazil.

Full text of the Declaration of Mayors and municipal health authorities

The National Council of Municipal Health Secretariats (Conasems) and the National Front of Mayors (FNP) deplore the interruption of the technical cooperation between the Pan American Health Organization (PAHO) and the government of Cuba, which made possible the work of 8,500 doctors in the More Doctors Program. With the decision of the Ministry of Health of Cuba, announced this Wednesday, to rescind the association, more than 29 million Brazilians will be unattended.

Cubans currently represent more than half of the doctors in the program. Therefore, the sudden rescission of these contracts points to a disastrous scenario in at least 3,243 municipalities. Of the 5,570 municipalities in the country, 3,228 (79.5%) have only doctors for the program and 90% of the consultations of the indigenous population are made by professionals from Cuba.

In addition, the Más Médicos is widely approved by users, 85% say that health care improved with the program. In the municipalities, it is also possible to verify a greater permanence of these professionals in the health teams of the family and their integration to the locality where they are inserted.

It is necessary to emphasize that the program is a conquest of the Brazilian municipalities, in response to the campaign "Where is the Doctor", led by the National Front of Mayors in 2013. On that occasion, the mayors’ offices and mayors demonstrated the difficulty of hiring and locating professionals in the interior of the country and in the periphery of large cities.

With the mission of working in primary care and disease prevention, the abrupt interruption of cooperation with the government of Cuba will negatively impact the health system, increasing the demands for consultations in medium and high complexity networks, besides aggravating regional inequalities.

For the so-called g100 (group of most populated cities with high socio-economic vulnerability) the situation is even more devastating. With the aim of reducing the lack of basic care services in these cities, the g100 is used as a basis to give priority to the reception of these professionals.

For this reason, the Conasems and the FNP alert the newly elected government to the imminent and irreparable damage to the health of the population, even for the sector that is not served by the Más Médicos program.

Therefore, both entities request the revision of the position of the new Government, which has signaled drastic changes in the rules of the program, decisive for the decision of the government of Cuba.

In an emergent character, they suggest the maintenance of the current contracting conditions, renewed in 2016 by the government of Michel Temer, and confirmed by the Federal Supreme Court in 2017.

The abrupt cancellation of current contracts will mean a cruel affectation for the entire population, especially for the poorest. We cannot renounce the constitutional principle of the universalization of the right to health and agree with that regression.

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