Brief presentation on key facts in Brazilian history, the participation of civil society in public policy and its relation with advocacy and patient advocacy groups. Presented by Leandro Machado, political scientist and founding partner at Cause.

1. SP/Brazil,2017

2. üThree context facts
üThree thoughts from a Brazilian advocacy professional
CivilSocietyandHealthCareSysteminBrazil

3. 1500 - Portuguese land in the area
and claim it for the Portuguese
crown.

4. 1808 – Portuguese Court transferred to Brazil

5. 1822 - Son of Portuguese king declares independence from
Portugal and crowns himself Peter I, Emperor of Brazil. 1st Coup
D’Etat

6. 1889 - Monarchy overthrown, federal republic established with
central government controlled by coffee interests. 2nd Coup
D’Etat

7. 1964 – President Goulart ousted in bloodless
coup, flees into exile.
X Coup
D’Etat

8. 1985 - Tancredo
Neves chosen as first
civilian president in
21 years under the
electoral college
system set up by the
military, but falls ill
before he can be
inaugurated and dies
shortly afterwards.

9. 1988 - New constitution

10. Two impeachments
1992 2016

11. Brazilian democracy is not
the most perfect in the
world, but…
01

12. ..in some sectors, civil society
participation is historical, i.e
health care system.
02

13. Since the early-20th century, the government and civil society
have been proactive in establishing health care as a common
good, while sharing the burden of paying for these services
through a myriad of taxes.

14. It was also sustained
with the help of
proactive social health
movements, such as
the sanitaristas,
comprised of medical
doctors, bureaucrats
and politicians.

15. This policy idea survived several democratic governments and
military dictatorships throughout the 20th century, lasting up
through the transition to democracy in 1988.

16. This idea of a shared
responsibility in
providing health care
was so popular that it
eventually became part
of the 1988
constitution. Through
the constitution's
introduction of SUS,
health care became an
official government
responsibility and
human right.

17. Our dream:
”Health is a right of
every citizen and a
duty of the State.”
1988 Constitutuion

18. Our reality:
There are several cracks in
Brazil's generous health
care system.
While the government has
certainly been committed
to providing a public
option, it is simply
overstretched. Federal
health care spending is
minimal at best, failing to
meet ongoing needs, while
several managerial, human
resource and
infrastructural, policy
problems remain.

19. 03
PAGs* are helping to fill in
the gap between dream
and reality
* P a t i e n t A d v o c a c y G r o u p s

20. üThree context facts
üThree thoughts from a Brazilian advocacy professional
CivilSocietyandHealthCareSysteminBrazil

21. 1. The scenario is favorable
a) The most prepared PAGs in
Brazil are less than 10. Yes,
ten. Most of them, for Cancer
Patients
b) They are growing and
desperately need help.
c) Health is Brazil’s major issue
by public opinion (Hello
politicians!)

22. 2. But there are
risks involved.
a) Lobby is not
regulated
b) Misuse of
resources
c) No track
record of most
of them.

23. 3. There are good options
available
1. Foster coalitions (more
transparent,
multistakeholder)
2. Expand to other states
3. Profissionalization in
general

24. üThree context facts
üThree thoughts from a Brazilian advocacy professional
CivilSocietyandHealthCareSysteminBrazil

25. T h a n k s !
L e a n d r o M a c h a d o
l e a n d r o m a c h a d o @ c a u s e . n e t . b r

26. Leandro Machado is a Brazilian business and civic entrepreneur. His previous background
includes leadership positions on Institutional Affairs at corporations like IBM, Shell, and Natura
Cosméticos. From 2009 to 2011, acted as Chief of Staff and Public Relations of Guilherme Leal,
Natura Cosméticos' co-chairman of the Board, and runnig mate of Marina Silva in the Green
Party ticket (2010 Brazilian national elections). Mr. Machado is a political scientist, with a
bachelor degree at Universidade de Brasilia, Brazil, with specialization courses at Siracuse
University/ABERJE and at George Washington University. He is one of the founders and Council
Member of RAPS - Political Action Network for Sustanability, a non-partisan organization that
aims to identify, select, train and monitor the future best Brazilian politicians. Cofounder and
managing partner at CAUSE, an advocacy consultancy firm that advocates for sustainable
development, human rights and democracy issues. Cofounder and coordinator at AGORA!, a
national political movement to regenerate Brazilian Politics. In 2015, Mr. Machado was
recognized by the World Economic Forum as a Young Global Leader.

27. backup

28. References
www.saude.gov.br
https://www.cia.gov/library/publications/the-world-factbook/geos/print_br.html
http://www.bbc.com/news/world-latin-america-19359111
http://edition.cnn.com/2012/07/13/opinion/gomez-brazil-health-care/index.html
https://pt.slideshare.net/julianelewis/overview-of-brazils-unified-health-system-sus

32. What is Brazil today (2017)
206MM people
US$ 8,727 GDP/capita
31,3 average age
75,2 life exp. at birth
Source: Statista