A escassez de profissionais de saúde em áreas remotas e vulneráveis é um importante obstáculo para a universalização do acesso à saúde em diversos países. Este artigo examina as políticas de provimento de profissionais de saúde na Austrália, nos Estados Unidos da América e no Brasil. Apesar do sucesso parcial de iniciativas anteriores, foi apenas com o Programa Mais Médicos que a provisão de médicos em áreas vulneráveis teve a magnitude e a resposta em tempo adequado para atender a demanda dos municípios brasileiros. Estão em curso, no país, mudanças quantitativas e qualitativas na formação médica, que buscam garantir não apenas a universalidade, mas, também, a integralidade e sustentabilidade do Sistema Único de Saúde. O êxito dessas iniciativas dependerão da continuidade da articulação interfederativa, de políticas regulatórias de estado, bem como, do constante monitoramento e aprimoramento do programa.

Abstract

INTRODUCTION: The More Doctors Program created in 2013 made possible the phenomenon known as the "importation of Cuban doctors". Although it has generated controversy in Brazil, this case has rarely been addressed from the perspective of international migration of doctors, a phenomenon that has been occurring in the world for decades. Especially through, the Global Code of Practice of International Recruitment of Health Professionals of the World Health Organization, established in 2010. METHODOLOGY: the present case study carried out a literature review, the analysis of the chronology, the analysis of the negotiation and the elements of the agreement; the regulation of activities, performance characteristics, successes and problems encountered in the actions of Cuban doctors in Brazil. Qualitative research was also promoted to verify the opinion of the governmental institutions in Cuba and Brazil and of International Organizations related to the WHO Code, through the Brazilian Transparency Law. RESULTS: The analysis of the study concluded that Brazil, during the period from 2013 to 2016, maintained the provision of 18,240 doctors in rural and remote areas. However, as of 2016 the number of doctors decreased, there were four serious violations of the Global Code, failure to expand and internalization of medical courses, and to achieve the goal of universalization of residence until 2018, the possibility of registration of Brazilian Individual Interchange doctors, who graduated in countries where the proportion is less than 1.8 doctors / 1000 inhabitants, Resolution CIT No. 17/2017, which threatened municipalities with a sanction of disengagement from the Project, and the termination of the Triangular Cooperation between Brazil-PAHO-Cuba. CONCLUSION: The study observed four breaches that permeate the field of health and denounce the changes in the structuring axes of the Program from 2013 to July 2019, in the economic sphere, politics and the attempt to suppress ethics around the logic of the profit and the fight against the social inequalities that historically devastate the country.