What constitutes the SUS? Health units, emergency rooms, medicines, vaccines, dressings, stretchers and respirators. However, despite this indispensable structure, the greatness of a system like this goes much further. The true essence lies in the people who make the SUS happen and allow it to be a living part of an entire nation. Provided for in the 1988 Constitution, regulated by law two years later and inspired, especially, by the model of the British National Health Service, the Unified Health System reaches the most distant corners of a country of continental size. This is enough to understand its importance, especially if we consider that two thirds of the 203 million Brazilians depend on it to, literally, live. As a bridge between nations, SUS is a testimony that we can learn from the world, create something unique for our people and then become a reference for other countries.
And when we talk about unique, the interpretation must go beyond a universal system for all Brazilians. First of all, we must think that it needs to be unique for each individual. Being in every corner of Brazil, often as the only service option, gives each participant in this system the role of a transformative agent in the lives of each Brazilian touched. These are patients who find more than just treatment, but also discover a space for listening and acceptance.
Even though there were already plenty of reasons for all Brazilians to be proud of the Unified Health System, the Covid-19 pandemic came to prove the importance of having such a comprehensive and widespread system. Certainly one of the greatest civilizing achievements of Brazilian society, the SUS organized the national vaccination campaign with broad popular support, guaranteeing immunization rates against Covid-19 much higher than in several more developed countries. Amid so many challenges posed by the most serious health emergency since the Spanish flu, its essential points were only highlighted in a country with social and economic inequalities as profound as Brazil.
The network of actions and services that make up the SUS would not fit into a single text. Among the highlights, which cannot be left out, is the most comprehensive public organ transplant program on the planet. From organizing the waiting list for an organ, going through preparatory exams to providing post-transplant medications, the entire process is managed by the Unified Health System. With around 87% of organ transplants carried out with public resources, the Brazil is the second largest transplanter in the world, behind only the United States. And our leading role is only possible because we have SUS to weave stories of hope and allow life to have new beginnings.
In 33 years of an arduous trajectory, the SUS remains standing, firm and strong. The system is the only refuge for seven in ten Brazilians who need medical care, a number that tends to increase due to the economic effects of the pandemic. It is the largest universal and free healthcare system in the world, recognized by the United Nations (UN). In a scenario like this, any geographic, economic and social barriers must be broken in favor of equal and humanized care. In the depths of hospitals, those who wear white coats already know that care needs to go beyond clinical protocols, extending to the soft touch of a hand and words that bring comfort.
Without forgetting the ground we have covered so far, we must recover the initial reasons for the existence of the SUS and evaluate the best direction to take. In fact, it is time to promote comprehensive care, which solves the roots of problems and, at the same time, promotes well-being as a whole. Details that may seem small, but that make all the difference in treatment adherence and clinical results. Faced with the inherent challenges of public health, our greatest victory will be to transform them into opportunities to build a more resilient, humanized and accessible system.
The achievement of a public and universal healthcare system cannot end with its creation. On the contrary, constant actions and policies are needed to improve and strengthen the SUS. Even so, the new and old challenges cannot overshadow the greatness and relevance of the Unified Health System for the Brazilian population. It is time to reinforce our commitment to the future, in which humanized care is the rule, compassion is the driving force and the SUS is the greatest national treasure. More than just nice words on paper, good practices need to be part of the daily lives of those on the front line and experienced by patients who arrive to receive care. It is in concrete implementation and everyday experience that the true value of public health reveals itself.
We cannot forget that the multiple arms of this system serve to reach the most distant points, but also to gently and individually touch those who need it most.
Juliano Gasparetto He is general director of the Cajuru University Hospital.
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