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CHILL’s Stephen Timmons’ visit to Brazil


I was at the University of Sao Paulo last month, running a workshop on Improvement Science. However, that’s not the topic of this blog post. My arrival coincided with the impeachment of President Dilma Rousseff. It looks like, at the time of writing, that the incoming government will be making reductions in public expenditure in Brazil.

The Sistema Único de Saúde (the Brazilian equivalent of the UK NHS) is one of the main achievements of successive Brazilian governments since the end of the military dictatorship. Brazil’s progress in improving the health of citizens has been substantial, albeit uneven. It is one of the few low/middle income countries to have a commitment to universal health care, though the system is not as comprehensive as the UK NHS.

Like most health care systems in the world, Sistema Único de Saúde faces the challenges of an ageing population, shortages of health care professionals,  and the rising costs of pharmaceuticals. Despite the existence of universal health care for 20 years, stark health inequalities persist. How Sistema Único de Saúde will deal with these problems, when it looks like publicly funded resources will be reducing, in the short term at last, remains to be seen.


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