A saúde pública é um direito social fundamental, com o Estado responsável por assegurar o acesso universal e igualitário via políticas públicas. Esse dever é compartilhado entre União, Estados, Distrito Federal e Municípios, que possuem competências legislativas e administrativas para zelar pela saúde. Com a criação do Sistema Único de Saúde (SUS), a assistência integral, incluindo a terapêutica farmacêutica, tornou-se um direito institucionalmente assegurado. A coordenação intergovernamental, por pactos e repasses de recursos, busca promover a equidade no acesso a medicamentos na Atenção Primária à Saúde. Desafios sobre financiamento, distribuição de recursos, e os papéis de cada ente federativo, ainda geram debates entre gestores e pesquisadores. Este artigo examina os avanços e perspectivas no acesso a medicamentos na Atenção Primária à Saúde, discorrendo sobre a combinação de descentralização e centralização, aliada à cooperação entre os entes federativos, e a sua importância para garantir o acesso universal e integral aos serviços de saúde no Brasil. Consórcios intermunicipais, como o Consórcio Paraná Saúde®, exemplificam soluções bem-sucedidas para coordenar o acesso a medicamentos, mostrando a necessidade de flexibilidade para lidar com a diversidade regional e garantir a integralidade do sistema.
Public health is a fundamental social right, with the State responsible for ensuring universal and equitable access through public policies. This duty is shared among the federal government, states, the Federal District, and municipalities, which hold legislative and administrative powers to safeguard health. With the creation of the Unified Health System (SUS), comprehensive care, including pharmaceutical therapy, became a guaranteed right. Intergovernmental coordination, through agreements and resource transfers, seeks to promote equity in access to medications in Primary Health Care. Challenges related to funding, resource distribution, and the roles of each governmental entity still spark debates among managers and researchers. This article examines the advances and perspectives in access to medications in Primary Health Care, discussing the combination of decentralization and centralization, along with cooperation among governmental entities, and its importance in ensuring universal and comprehensive access to health services in Brazil. Intermunicipal consortia, such as the Paraná Health Consortium®, exemplify successful solutions for coordinating access to medications, demonstrating the need for flexibility in dealing with regional diversity and ensuring system comprehensiveness.
Keywords:
Federalism; Primary Care; Unified Health Care System; Decentralization
Federalism and primary healthcare access to medicines
Resumo (abstract):
Public health is a fundamental social right, with the State responsible for ensuring universal and equitable access through public policies. This duty is shared among the federal government, states, the Federal District, and municipalities, which hold legislative and administrative powers to safeguard health. With the creation of the Unified Health System (SUS), comprehensive care, including pharmaceutical therapy, became a guaranteed right. Intergovernmental coordination, through agreements and resource transfers, seeks to promote equity in access to medications in Primary Health Care. Challenges related to funding, resource distribution, and the roles of each governmental entity still spark debates among managers and researchers. This article examines the advances and perspectives in access to medications in Primary Health Care, discussing the combination of decentralization and centralization, along with cooperation among governmental entities, and its importance in ensuring universal and comprehensive access to health services in Brazil. Intermunicipal consortia, such as the Paraná Health Consortium®, exemplify successful solutions for coordinating access to medications, demonstrating the need for flexibility in dealing with regional diversity and ensuring system comprehensiveness.
Palavras-chave (keywords):
Federalism; Primary Care; Unified Health Care System; Decentralization
