What legacy does Mandetta leave at the Health Ministry?

pandemic, Mr. Mandetta was a lower house backbencher who didn&#8217;t even run for re-election in 2018, as his chances of holding onto his place were slim. After <a href="https://brazilian.report/power/2020/04/14/luiz-henrique-mandetta-brazil-health-minister-time-being/"><a href="https://brazilian.report/power/2020/04/14/luiz-henrique-mandetta-brazil-health-minister-time-being/">intense lobbying from Big Agro</a></a><a href="https://brazilian.report/power/2020/04/14/luiz-henrique-mandetta-brazil-health-minister-time-being/"> representatives</a> in Brasilia, as well as Goiás Governor Ronaldo Caiado, he managed to wrangle a seat in the cabinet.</p> <p>So, with over a year in the shadows and a couple of months in the spotlight, what legacy does Luiz Henrique Mandetta leave on the Health Ministry, if any?</p> <p>According to Lucas Zambon, director of the Brazilian Institute for Patient Safety, Mr. Mandetta neglected to push forward any measures to strengthen the country&#8217;s public health system, and thus benefit the majority of the population. Dr. Zambon also criticizes the lack of policies to balance the distribution of resources between basic and specialized care. &#8220;One of the main examples of this is that most intensive care beds are found in private hospitals,&#8221; he says.</p> <p>Another point of contention surrounding Mr. Mandetta is his reluctance to approve telemedicine in Brazil. Greenlit this week by President Bolsonaro, the service of medical professionals providing diagnoses through digital means has been discussed in Brazil for over 20 years. Roberta Grabert, a doctor specialized in Health Management, says this agenda has stalled because Mr. Mandetta — true to his career as a lawmaker —&nbsp;refused to interfere with the corporate interests of insurance companies.</p> <p>&#8220;He only appeared during the pandemic. He was a so-so minister, who wanted to go about his business unscathed. If we had passed telemedicine in 2019, we would have much better logistics to monitor Covid-19, and we would have a better idea of how many people were infected and killed. We would not be flying blind,&#8221; she criticizes.</p> <div class="flourish-embed flourish-chart" data-src="visualisation/1999554" data-url="https://flo.uri.sh/visualisation/1999554/embed"><script src="https://public.flourish.studio/resources/embed.js"></script></div> <h2>Cuban doctors: you shall not pass</h2> <p>The Doctors for Brazil Program is, perhaps, the most visible public policy pushed forward by Mr. Mandetta —&nbsp;and also his biggest flop. Conceived to replace the More Doctors Program, created by the Workers&#8217; Party to <a href="https://brazilian.report/society/2018/11/17/brazil-needs-cuban-doctors/">allow Cuban doctors to come to Brazil</a> and work in remote areas, the program never really took off.</p> <p>Not since the 1904 Vaccine Rebellion — when part of Rio de Janeiro’s population took to the streets to protest the government&#8217;s compulsory smallpox vaccine program — has a healthcare program generated such a headache. When the program was launched, <a href="https://brazilian.report/power/2018/11/21/brazil-congress-cuban-doctors/">Cuban doctors</a> were called “slaves” upon arriving at Brazilian airports, while members of the Brazilian right-wing called Cuba&#8217;s entire <a href="https://jamanetwork.com/journals/jama/article-abstract/185603">whitecoat diplomacy</a> program a communist conspiracy.</p> <p>The former minister believes that sectors as pivotal as healthcare cannot be trusted only to foreigners — and used as propaganda by the government. &#8220;The minister should have offered a dignified federal career to health professionals, but he preferred to propose a simple measure with Doctors for Brazil, which only included doctors and forgot about the entire health chain,&#8221; says Ms. Graber.</p> <p>However, infectious diseases expert Artur Brito considers these criticisms to be unfair. &#8220;His time in office was less political than other cabinet members deemed as &#8220;technicians.&#8221; He only appointed experienced names to top positions at the Health Ministry. Wanderson Oliveira (Secretary of Health Surveillance) worked in the Dilma [Rousseff] government, and [Deputy Health Minister] João Gabbardo has been there for 40 years,&#8221; he notes.</p> <p>Despite this late flourish of popularity, Luiz Henrique Mandetta&#8217;s time in office as Health Minister was middle-of-the-road and largely forgetful. He followed in the footsteps of his predecessors by making basic reforms without tackling Brazil&#8217;s true healthcare bottlenecks. His stance during the Covid-19 pandemic must be commended, but much of the hagiography around Mr. Mandetta&#8217;s exit ignores that, according to those in the health area, the outgoing cabinet member did little more than the bare minimum during his time in office.