Convergences between the Brazilian National Health Plan and scientific articles on Neglected Tropical Diseases

In Brazil, the National Health Plan (NHP) was the central instrument for public health planning from 2016 to 2019. In this paper, we show that there is a convergence between the Plan and the publication of scientific articles written by institutional researchers in the context of Neglected Tropical Diseases. The methodology used consisted of the following stages: identification of the universe of researchers, data collection, thematic characterization of Neglected Tropical Diseases in the Plan, organization of information, and production of indicators. In total, there were 2,719 researchers and 18,023 journal articles from 2015 to 2018. Of these, 2,541 articles, or 14.09%, were related to Neglected Tropical Diseases. Regarding the convergences, there was strong alignment with leishmaniasis, Chagas disease, dengue, leprosy, schistosomiasis, and Chikungunya fever. However, the coverage of topics by scientific publications was broader than that of the political instrument due to the inclusion of other themes: snake bites, helminthiasis and lymphatic filariasis.

Brazilian’s Health Policy and its misalignment with international guidelines for Health Promotion

Following the First Health Promotion Conference in Ottawa in 1986, several other global level Conferences were held, and Shanghai was the last City to host the 9th Health Promotion Conference in 2016, where several world leaders assume commitments that meet the common cause of the topic in question, presenting robust outcomes such as the Letters, Declarations and Implementation Guides. This work aimed to analyze the coherence of the development of the current National Health Plan in Brazil in relation to the central axes of the most recent international documents, referring to the Shanghai Declaration and the Guide for the National Implementation of the Shanghai Declaration. The results showed that Brazil presents a National Health Plan that definitely does not include the actions proposed in the most recent international documents, such as the Shanghai Conference report and the Guide for National Implementation of the Shanghai Declaration. Paradoxically, Brazil has other institutionally implemented instruments that consider the activities recommended from these international documents in a very satisfactory way. Among these instruments are a specific National Policy on Health Promotion, and several Health Care Programs and Networks aimed at some of the National Policy on Health Promotion strengthening axes, such as the National Tobacco Control Program, the Health at School Program, the Health Gym Program, in addition to other related National Policies, such as the National Policy on Integrative and Complementary Practices and the National Policy on Medicinal Plants and Herbal Medicines. It is concluded that the National Health Plan is a symbolic instrument that is not in line with international recommendations and, contradictorily, it is also not in line with the own policies and programs that are successfully implemented and developed in national territory. Key messages There is a misalignment between the real meaning that a National Health Plan should present and its current content, what leads to an insuficent instrument for enhancing health promotion. While the national health plan is out of alignment with strengthening health promotion, other nationwide specific policies developed reinforce international guidelines.

Health Promotion in the National Health Plan in Brazil and the incompatibility with global objectives

The First International Conference on Health Promotion held in Canada in 1986 resulted in the Ottawa Charter, which objectively presents the goals to be achieved by the year 2000, which would contribute to the progress achieved since the Declaration of Alma-Ata and with the debate that took place at the World Health Assembly, in order to contemplate the goal of “health for all in the year 2000”. Obviously, even with all the advances, the goal expected for the year 2000 is far from being reached, which requires a continuous effort by the government and an engagement of the global population for the changes to occur in a sensitive and effective way. Thus, it is necessary to monitor the actions that should be developed so that health promotion is an issue that is increasingly present in health services. This work aimed to analyze the current Brazilian National Health Plan to verify if the proposed actions are in line with what has been recommended in the official international documents for the development of health promotion. The results demonstrate that the Plan is composed of epidemiological data, incidence rates about the monitoring of mortality and comorbidities, demographic indicators and issues based in the surveillance of endemic diseases, in addition to thirteen objectives and seven thematic axes that guide disease control and issues related to the structure of the Health System and its organization. In its entire content, there is no mention of the goals defined in the report of the 9th Global Conference on Health Promotion or even the Ottawa Charter, and the expression 'health promotion' appears only once, in a context of mentioning the surveillance and violence prevention actions. It is concluded that the Plan is a mere formal instrument that does not include actions for the development of health promotion, prepared according to the braszillians protocol and bureaucratic requirements, following the procedures to be approved by the National Congress. Key messages The National Health Plan presents a global overview about brazillians health situation, but doesn’t bring factive solutions and do not support the engagement to health promotion. The National Health Plan is not in line with the Global engagement for enhancing Health Promotion and the Sustainable Development Goals.