Claiming the Right to Health in Brazilian Courts: The Exclusion of the Already Excluded?

Silva, Virgílio Afonso da; Terrazas, Fernanda Vargas

doi:10.1111/j.1747-4469.2011.01252.x

Cited by 53 publications

(25 citation statements)

References 18 publications

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“…Akin to diabetes, the main diseases reported in the suits were of a chronic nature and included metabolism, cardiovascular, central nervous system and gastric disorders as reported in previous studies (Vieira, Zucchi, 2007;Silva, Terrazas, 2009;Appio, 2007;Freire, 2003) explaining the cumulative nature of suits involving medication provision and consequent elevated expenditure with this component.…”

Section: Discussionmentioning

confidence: 74%

“…Some authors hold that lawsuits have become instruments of inequality in access and irrationality in use of public resources when they rule the provision of drugs which are not standard under the public health system or when they contravene SUS and Pharmaceutical Assistance regulations (Vieira, Zucchi, 2007;Silva, Terrazas, 2009). On the other hand, others recognize legitimacy in control 466 of public policy by the Judicial Powers in as far as this broadens the democratic debate to include the adoption of counter-majoritarian positions (Appio, 2007;Freire, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Social inequalities in lawsuits for drugs

Provin

Leite

Amaral

2013

Braz. J. Pharm. Sci.

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The aim of this study was to characterize the lawsuits requesting drugs considering the economic profile of their petitioners. All lawsuits (1378) accepted against Goiânia, GO from 2003 to 2007 were analyzed. Petitioners' demographic characteristics, reported diseases, requested drugs, origin of healthcare service, and lawsuit agent were described. Complainants' addresses were georeferenced and distributed into 4 regional groups classified in accordance with the population's average income. Dwellers of wealthier regions filed court actions requesting drugs more frequently, with an average rate of 1.7 lawsuits/1000 inhabitants versus 0.55/1000 in the poorer region. Lawsuit costs were 4-fold higher in wealthier regions compared with the poorest region. Chronic diseases were involved in most lawsuits, where acute and low complexity diseases predominated among complainants living in poorer regions. Thus, social differences were reflected in the granting of health rights.Uniterms: Health rights. Drugs/access. Health inequalities. Health care.Este estudo teve como objetivo caracterizar as ações judiciais que solicitaram medicamentos considerando o perfil econômico de seus impetrantes. Foram analisadas as ações judiciais deferidas contra Goiânia, GO, no período de 2003 a 2007, totalizando 1378. Descreveram-se as características demográficas dos impetrantes, as doenças relatadas, os medicamentos solicitados, a origem do serviço de assistência e o condutor da ação. Os endereços dos impetrantes foram geoprocessados e distribuídos em quatro grupos classificados de acordo com a renda média da população. Foi observado que os moradores de regiões ricas impetraram mais ações, 1,7 ações/1000 habitantes em comparação com 0,55/1000 na região mais pobre. Os custos das ações judiciais também foram maiores nessas regiões, sendo quatro vezes mais caros dos que as das regiões mais pobres. As doenças crônicas estavam presentes na maioria das ações; entre os impetrantes que moravam em regiões mais pobres, as doenças agudas e de menor complexidade tiveram mais destaque. Assim, as diferenças sociais são refletidas na concessão do direito à saúde.Unitermos: Direito à saúde. Medicamentos/acesso público. Saúde/desigualdades de acesso. Assistência a saúde.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Social inequalities in lawsuits for drugs

Provin

Leite

Amaral

2013

Braz. J. Pharm. Sci.

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show abstract

“…This could configure health services in response to litigation that may give rise to inequities in access for others. Evidence of this is found in countries that have made this right justiciable within their constitutions, such as Brazil, where this right has become 'a strategy of the pharmaceutical industry, to take advantage of the large number of judicial decisions granting individuals a right to receive expensive medicines this industry produces' [103]. The cost to the public health systems of financing such patent medicines may be at the expense of expansion of primary health care services known to disproportionately benefit the poor.…”

Section: Methodsmentioning

confidence: 99%

Framing health and foreign policy: lessons for global health diplomacy

2010

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Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do not appear to dominate practice. While political momentum for health as a foreign policy goal persists, the framing of this goal remains a contested issue. The analysis offered in this article may prove helpful to those engaged in global health diplomacy or in efforts to have global governance across a range of sectoral interests pay more attention to health equity impacts.

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“…In this case however, it is unclear what the direct distributive effects are, some scholars argue that there is a general trend toward a progressive redistribution of resources through this system; Gauri, 2012;Piovesan, 2008) others offer evidence of middle--class cooptation of the system and a net regressive impact (Ferraz, 2011;Silva;Terrazas, 2011)"container-title":"Litigating Health Rights: Can Courts Bring More Justice to Health? ", "collection-title":"Harvard Law School Human Rights Program Series", "publisher":"Harvard University Press", "publisher--place":"Cambridge, Mass.…”

Section: B Theoretical Frameworkmentioning

confidence: 99%

Realizing Social Rights: The Material Impacts of Constitutional Entrenchment

Rosevear¹

2017

Contemporânea - Revista De Sociologia Da UFSCar

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Claiming the Right to Health in Brazilian Courts: The Exclusion of the Already Excluded?

Cited by 53 publications

References 18 publications

Social inequalities in lawsuits for drugs

Social inequalities in lawsuits for drugs

Framing health and foreign policy: lessons for global health diplomacy

Realizing Social Rights: The Material Impacts of Constitutional Entrenchment

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