Brazil's 2006 Health Pact: Unifying Public Healthcare Reforms

Pact for Health 2006: Unifying Brazil's Public Healthcare

The Pact for Health 2006 represents a crucial set of institutional reforms for the Unified Health System (SUS), agreed upon by the three levels of government (federal, state, and municipal). Its primary aim is to foster innovation in processes and management tools, leading to greater efficiency and quality in the SUS's responses. Concurrently, this health pact redefines the responsibilities of each manager, aligning them with the population's health needs and the pursuit of social equity.

Setting Priorities: Three Integrated Covenants

The Pact for Health 2006 articulates and integrates priorities through three distinct covenants:

• Covenant for Life
• Covenant in Defense of the SUS
• Management Pact

This comprehensive agreement also:

• Replaces the accreditation process with joint adherence to management commitment terms.
• Establishes regionalization as a structural axis of the decentralization process.
• Integrates various forms of federal fund transfers.
• Unifies various existing agreements.
• Is regulated by Decree GM 399, February 2006.

The Covenant for Life

The Covenant for Life signifies a commitment among SUS managers regarding priorities that directly impact the health status of the Brazilian population. Priorities are defined through national, state, regional, or municipal targets. States, regions, and municipalities are expected to endorse the actions necessary to achieve these goals and objectives.

Key Agreed Priorities under the Covenant for Life:

• Health of the Elderly (60+ years)
• Cervical and Breast Cancer Control
• Reduction of Infant and Maternal Mortality
• Strengthening Response Capacity to Emerging and Endemic Diseases (e.g., Dengue, Leprosy, Tuberculosis, Malaria)
• Health Promotion
• Strengthening Primary Health Care
• Occupational Health
• Mental Health
• Strengthening Healthcare Response Capacity for People with Disabilities
• Comprehensive Care for Victims or Those at Risk of Violence
• Men's Health

Covenant in Defense of the SUS

This covenant expresses the commitment among SUS managers to consolidate the Brazilian Health Reform, upholding the principles of the Health System as established in the Federal Constitution. It aims to develop and coordinate actions, within their competence and in conjunction with other managers, to qualify and secure the National Health System as a robust public policy.

Key Initiatives of the Covenant in Defense of the SUS:

• Advance the Brazilian Health Reform, aligning it with current SUS challenges.
• Promote citizenship as a social mobilization strategy, emphasizing health as a fundamental right.
• Establish dialogue with society, extending beyond the institutional limits of the SUS.
• Expand and strengthen relations with social movements, especially those advocating for human rights and citizenship.
• Advocate for Regulatory Amendment No. 29 by the National Congress.
• Ensure the adoption of the SUS budget, comprising budgets from the three levels of government, highlighting the commitment of each level to health services under the Federal Constitution.

Management Pact

The Management Pact outlines key areas for effective healthcare administration:

• Decentralization
• Regionalization
• Financing
• Planning
• Agreed and Integrated Programming (PPI)
• Participation and Social Control
• Work Management
• Health Education