Thank you Brazilian National Health System

Leila Posenato Garcia About the author

The Brazilian National Health System (SUS), which was brought into being with the enactment of the 1988 Federal Constitution, has made Brazil the largest country in the world to have a public universal health system, based on the principles of equity and integrality, in particular with participation of the population in control of public health policies.11. Paim JS, Silva LMV. Universalidade, integralidade, equidade e SUS. BIS, Bol Inst Saúde [Internet]. 2010 ago [citado 2020 nov 25];12(2):109-14. Disponível em: http://periodicos.ses.sp.bvs.br/scielo.php?script=sci_arttext&pid=s1518-18122010000200002&lng=pt&nrm=iso
http://periodicos.ses.sp.bvs.br/scielo.p...
In just over three decades of existence, the SUS had become the Brazilian population’s main health care provider, present in all Brazil’s federal units, at all three levels of public administration, and in partnership with the private health sector.

Within the context of the COVID-19 pandemic, which represents an extremely complex global challenge, the relevance of the SUS in Brazil becomes even more evident.22. Duarte E, Eble LJ, Garcia LP. 30 anos do Sistema Único de Saúde. Epidemiol Serv Saúde [Internet]. 2018 mar [citado 2020 nov 25];27(1):e00100018. Disponível em: https://doi.org/10.5123/s1679-49742018000100018
https://doi.org/10.5123/s1679-4974201800...
The disease’s high transmissibility, including via mild or asymptomatic cases, along with its ability to result in severe clinical conditions and deaths, means that it affects not only individuals, but also families, communities and countries. Addressing it requires individual responsibility, collective solidarity, in addition to articulated measures based on the best evidence available at government level, as well as international cooperation.

Health Surveillance is the area of SUS activities in which the principle of universality is most explicit. Its actions in the immediate response to COVID-19 have been comprehensive33. Croda JHR, Garcia LP. Resposta imediata da Vigilância em Saúde à epidemia da COVID-19. Epidemiol Serv Saúde [Internet]. 2020 mar [citado 2020 nov 25];29(1):e2020002. Disponível em: https://doi.org/10.5123/s1679-49742020000100021
https://doi.org/10.5123/s1679-4974202000...
and continue to be essential as the epidemic advances in Brazil. Standing out among Surveillance actions during the epidemic in course are laboratory diagnosis and case and contact investigation,44. Sales CMM, Silva AI, Maciel ELN. Vigilância em saúde da COVID-19 no Brasil: investigação de contatos pela atenção primária em saúde como estratégia de proteção comunitária. Epidemiol Serv Saúde [Internet]. 2020 jul [citado 2020 nov 25];29(4):2020373. Disponível em: https://doi.org/10.5123/s1679-49742020000400011
https://doi.org/10.5123/s1679-4974202000...
information system management and publicizing of epidemiological information, health worker training, as well as actions in preparation for immunization within the scope of the National Immunization Program. The importance of articulation between Surveillance and Primary Health Care has been highlighted in the context of the pandemic.55. Sarti TD, Lazarini WS, Fontenelle LF, Almeida APSC. Qual o papel da Atenção Primária à Saúde diante da pandemia provocada pela COVID-19? Epidemiol Serv Saúde [Internet]. 2020 abr [citado 2020 jul 15];29(2):e2020166. Disponível em: https://doi.org/10.5123/s1679-49742020000200024
https://doi.org/10.5123/s1679-4974202000...

Moreover, the responsibility for the majority of hospitalizations in Brazil falls to the SUS. In response to the COVID-19 emergency, the severity of which requires hospitalization needing oxygen inhalation therapy for some 15% of cases and support in intensive care units (ICUs) for 5% of cases,77. World Health Organization - WHO. Oxygen sources and distribution for COVID-19 treatment centres: interim guidance, 4 April 2020 [Internet]. Geneva: World Health Organization; 2020 [cited 2020 Nov 25]. Available from: https://www.who.int/publications/i/item/oxygen-sources-and-distribution-for-covid-19-treatment-centres
https://www.who.int/publications/i/item/...
the hospital network has been expanded, including more ICU beds and setting up of field hospitals.88. Oliveira WK, Duarte E, França GVA, Garcia LP. Como o Brasil pode deter a COVID-19. Epidemiol Serv Saúde [Internet]. 2020 abr [citado 2020 nov 25];29(2):e2020044. Disponível em: https://doi.org/10.5123/s1679-49742020000200023.
https://doi.org/10.5123/s1679-4974202000...
SUS hospital care services have been responsible for saving the lives of thousands of people stricken by COVID-19 in Brazil.

Apart from its huge physical structure, the SUS has a magnificent workforce. It has over 3.5 million health workers, who work in multiprofessional, qualified and specialized teams.99. Machado MH, Ximenes Neto FRG. Gestão da educação e do trabalho em saúde no SUS: trinta anos de avanços e desafios. Ciênc Saúde Coletiva [Internet]. 2018 jun [citado 2020 nov 25];23(6):1971-9. Disponível em: https://doi.org/10.1590/1413-81232018236.06682018
https://doi.org/10.1590/1413-81232018236...
In addition to nurses, doctors, physiotherapists, pharmacists, nutritionists, psychologists, dentists, technicians and auxiliaries in diverse areas of health care, and other health workers, equally important are other components of the workforce who are not specifically qualified in health professions, such as stretcher bearers, ambulance drivers, domestic services staff, catering staff and equipment maintenance staff, as well as those involved in burial and cremation services. This gigantic ensemble of workers has played a protagonist’s role in addressing COVID-19, notwithstanding being overworked and at risk of being infected and developing mental health problems.1010. Teixeira CFS, Soares CM, Souza EA, Lisboa ES, Pinto ICM, Andrade LR, et al. A saúde dos profissionais de saúde no enfrentamento da pandemia de Covid-19. Ciênc Saúde Coletiva [Internet]. 2020 set [citado 2020 nov 25];25(9):3465-74. Disponível em: https://doi.org/10.1590/1413-81232020259.19562020
https://doi.org/10.1590/1413-81232020259...

All over Brazil manifestations of recognition of these workers and the SUS have come to the fore. Applause, flowers, music and, above all, true gratitude for the untiring work in defense of health and life. However, an organized movement has not been built in our country, as has happened in the United Kingdom, for instance. There the slogan “Thank You NHS [National Health Service]” has become a social phenomenon in 2020, through which people and organizations disseminate messages in support of the NHS and its workers, for their efforts during the COVID-19 pandemic.1111. Wikipedia. Thank you NHS [Internet]. San Francisco: Wikipedia; 2020 [cited 2020 Nov 25]. Available from: https://en.wikipedia.org/wiki/Thank_You_NHS
https://en.wikipedia.org/wiki/Thank_You_...

The main way of acknowledging these people committed to health involves above all the valuing of their work and of SUS itself. 2020 has been a challenging year for all of Brazilian society. As at the end of November, Brazil has recorded 6 million confirmed COVID-19 cases and 170,000 COVID-19 deaths, in addition to almost 500,000 hospitalizations due to severe acute respiratory syndrome (SARS) cases confirmed as having COVID-19. Moreover, there are distinct epidemiological scenarios in the country’s different regions.1212. Ministério da Saúde (BR). Coronavírus Brasil: painel coronavírus [Internet]. Brasília: Ministério da Saúde; 2020 [citado 2020 nov 25]. Disponível em: https://covid.saude.gov.br/
https://covid.saude.gov.br/...
It is evident that strengthening and valuing the SUS and its workers are necessary not only for Brazil to overcome the COVID-19 pandemic, but also so that actions involving health surveillance, health promotion and health care for the population continue to be developed, with the aim of addressing other coexisting diseases and reducing inequalities.

References

  • 1
    Paim JS, Silva LMV. Universalidade, integralidade, equidade e SUS. BIS, Bol Inst Saúde [Internet]. 2010 ago [citado 2020 nov 25];12(2):109-14. Disponível em: http://periodicos.ses.sp.bvs.br/scielo.php?script=sci_arttext&pid=s1518-18122010000200002&lng=pt&nrm=iso
    » http://periodicos.ses.sp.bvs.br/scielo.php?script=sci_arttext&pid=s1518-18122010000200002&lng=pt&nrm=iso
  • 2
    Duarte E, Eble LJ, Garcia LP. 30 anos do Sistema Único de Saúde. Epidemiol Serv Saúde [Internet]. 2018 mar [citado 2020 nov 25];27(1):e00100018. Disponível em: https://doi.org/10.5123/s1679-49742018000100018
    » https://doi.org/10.5123/s1679-49742018000100018
  • 3
    Croda JHR, Garcia LP. Resposta imediata da Vigilância em Saúde à epidemia da COVID-19. Epidemiol Serv Saúde [Internet]. 2020 mar [citado 2020 nov 25];29(1):e2020002. Disponível em: https://doi.org/10.5123/s1679-49742020000100021
    » https://doi.org/10.5123/s1679-49742020000100021
  • 4
    Sales CMM, Silva AI, Maciel ELN. Vigilância em saúde da COVID-19 no Brasil: investigação de contatos pela atenção primária em saúde como estratégia de proteção comunitária. Epidemiol Serv Saúde [Internet]. 2020 jul [citado 2020 nov 25];29(4):2020373. Disponível em: https://doi.org/10.5123/s1679-49742020000400011
    » https://doi.org/10.5123/s1679-49742020000400011
  • 5
    Sarti TD, Lazarini WS, Fontenelle LF, Almeida APSC. Qual o papel da Atenção Primária à Saúde diante da pandemia provocada pela COVID-19? Epidemiol Serv Saúde [Internet]. 2020 abr [citado 2020 jul 15];29(2):e2020166. Disponível em: https://doi.org/10.5123/s1679-49742020000200024
    » https://doi.org/10.5123/s1679-49742020000200024
  • 6
    Teixeira MG, Medina MG, Costa MN, Barral-Netto M, Carreiro R, Aquino R. Reorganização da atenção primária à saúde para vigilância universal e contenção da COVID-19. Epidemiol Serv Saúde [Internet]. 2020 ago [citado 2020 nov 24];29(4):e2020494. Disponível em: https://doi.org/10.5123/s1679-49742020000400015
    » https://doi.org/10.5123/s1679-49742020000400015
  • 7
    World Health Organization - WHO. Oxygen sources and distribution for COVID-19 treatment centres: interim guidance, 4 April 2020 [Internet]. Geneva: World Health Organization; 2020 [cited 2020 Nov 25]. Available from: https://www.who.int/publications/i/item/oxygen-sources-and-distribution-for-covid-19-treatment-centres
    » https://www.who.int/publications/i/item/oxygen-sources-and-distribution-for-covid-19-treatment-centres
  • 8
    Oliveira WK, Duarte E, França GVA, Garcia LP. Como o Brasil pode deter a COVID-19. Epidemiol Serv Saúde [Internet]. 2020 abr [citado 2020 nov 25];29(2):e2020044. Disponível em: https://doi.org/10.5123/s1679-49742020000200023
    » https://doi.org/10.5123/s1679-49742020000200023
  • 9
    Machado MH, Ximenes Neto FRG. Gestão da educação e do trabalho em saúde no SUS: trinta anos de avanços e desafios. Ciênc Saúde Coletiva [Internet]. 2018 jun [citado 2020 nov 25];23(6):1971-9. Disponível em: https://doi.org/10.1590/1413-81232018236.06682018
    » https://doi.org/10.1590/1413-81232018236.06682018
  • 10
    Teixeira CFS, Soares CM, Souza EA, Lisboa ES, Pinto ICM, Andrade LR, et al. A saúde dos profissionais de saúde no enfrentamento da pandemia de Covid-19. Ciênc Saúde Coletiva [Internet]. 2020 set [citado 2020 nov 25];25(9):3465-74. Disponível em: https://doi.org/10.1590/1413-81232020259.19562020
    » https://doi.org/10.1590/1413-81232020259.19562020
  • 11
    Wikipedia. Thank you NHS [Internet]. San Francisco: Wikipedia; 2020 [cited 2020 Nov 25]. Available from: https://en.wikipedia.org/wiki/Thank_You_NHS
    » https://en.wikipedia.org/wiki/Thank_You_NHS
  • 12
    Ministério da Saúde (BR). Coronavírus Brasil: painel coronavírus [Internet]. Brasília: Ministério da Saúde; 2020 [citado 2020 nov 25]. Disponível em: https://covid.saude.gov.br/
    » https://covid.saude.gov.br/

Publication Dates

  • Publication in this collection
    16 Dec 2020
  • Date of issue
    2020
Secretaria de Vigilância em Saúde - Ministério da Saúde do Brasil Brasília - Distrito Federal - Brazil
E-mail: leilapgarcia@gmail.com