Brazilian president, Luiz Inácio Lula da Silva, signed on March 24 the Provisional Measure that creates the Special Secretariat of Indigenous Health Care. The new secretariat, to be part of the Ministry of Health structure, will have its own resources and will replace the National Health Foundation (Funasa).
Funasa, currently responsible for indigenous care, over the years, has been accused of corruption and diversion of funds.
The measure depends on the approval of the Congress. The creation of the secretariat has been a banner in the struggle of the indigenous movement for many years.
In 2008 the issue of indigenous health was highlighted in the Acampamento Terra Livre. This motivated the creation of the Indigenous Health Working Group, within the Ministry of Health, composed of members of government and indigenous leaders. It incorporated discussions on the creation of the secretariat.
In the same year indigenous leaders succeeded in preventing the government from creating the Secretariat of Primary Care and Promotion of Health, which would not have dealt specifically with the question of indigenous health.
The creation of the Special Secretariat totally changes the management of indigenous health care. It becomes responsible for oversight of all demands and for the creation of public policies exclusively for indigenous health, delineation of which are in turn to be based on directives approved by the National Conferences of Indigenous Health, through the Arouca Law, through Labor legislation and public administration, as well as the Federal Constitution.
For the Vice-President of the Indigenist Missionary Council, Robert Liebgott, the creation of the Secretariat returns these constitutional responsibilities to the competency of the federal government.
“The policy that had been developed was considered unconstitutional because it had been founded in the logic of outsourcing of services. Now the Federal Government is once again responsible for providing indigenous health care,” he stated.
As it is to be structured, the Special Secretariat will be a connective link with the Special Indigenous Sanitation Districts (DSEIs), which through the legislation will have administrative and financial autonomy in the provision of services to the communities.
The Districts are responsible for the development of district plans, in which all demands will be presented, services and actions carried out, as well as equipment, vehicles and necessary medicines.
These units are responsible for conjoining technical activities of health care. They promote the reordering of the health network and sanitation practices, organize administrative/management activities and stimulate social control.
With the administrative autonomy of the Districts the indigenous community is to be more proximate to the management of resources with regard to basic care. With this there will be greater agility in providing services, reducing response time in the actions developed by the institution.
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