Almost no one questions the good intentions of the Minister of Health of the Nation, Mario Russo.
However, those who lead some of the 22 provincial Health portfolios that this Monday participated in the first Federal Health Council (COFESA) convened since the inauguration of President Javier Milei, felt, this afternoon, a
lack of focus on what is urgent
.
Basically, dengue and severe financing problems.
What a source related to the sector defined as “a climate that, for a while, was cut with scissors and a knife.”
Almost all the Ministers of Health of the 24 jurisdictions of the country said “present” to COFESA - which at the closing of this note was still taking place in the CCK.
There were two failures
: Formosa and Río Negro
, whose ministers announced this morning that they would not be able to attend.
Although they did not give further explanations, from the second of those provinces
Clarín
was able to find out the reason for the absence, an issue that in some way symbolizes the tense atmosphere that prevailed for a while in COFESA.
It so happens that Rio Negro Minister Ana Senesi had to face, at the beginning of this week, two hot topics: joint negotiations in the sector and a meeting with Governor Alberto Wereltilneck, in which she had to discuss the salary update and debts with providers.
The uniqueness of Río Negro is projected in that the closure of these lines was the greatest moment of tension for COFESA.
In the words of a source who shared details with this medium, “the minister (Mario Russo) is a gentleman and the meeting began talking about quality health issues.
There was agreement to
continue the guidelines of the previous management
.”
However, he continued, "after discussing the issue of digitalization of the system, several ministers, in a friendly tone, claimed that 'everything is very nice, but
what is going to happen with dengue
and the financing of the programs'."
In practice, this took shape in a tense exchange between the Minister of Health of Salta, Federico Mangione, and the Secretary of Access and Equity in Health, Andrés Scarsi.
Everything would have arisen after, “in good tone” (said a source who was there), the ministers of Buenos Aires, Entre Ríos, La Pampa, Santa Fe, La Rioja, Santiago del Estero and Salta raised the need to change the agenda from “
superfluous issues
to urgent issues,” in the words of one of the sources who spoke with
Clarín
.
In this framework, Minister Mangione would have expressed his anger regarding the Nation's debts with Salta in relation to the
vector management program
.
And he would have complained (warmly) about a certain neglect suffered by the province in the fight against the current dengue outbreak.
As it turned out, Scarsi's response was quite frontal and in one way or another he took advantage (or forced) to make the cut for the lunch that was scheduled on the agenda.
Russo's entourage
denied tensions
: “There were exchanges with the ministers, with queries that were answered by the national authorities.
The break was scheduled on the agenda.”
The Ministers of Health of the provinces, gathered in the first Federal Health Council (COFESA) that was created during the administration of Javier Milei.
Photo: Ministry of Health
COFESA and the topics on the agenda of the Ministry of Health of the Nation
From the national Health portfolio they shared some of the topics addressed until the closing of these lines.
In addition to announcing that in the coming days the regulatory decree of the digital medical prescription will be published and discussing the launch of the flu vaccine campaign, "the need to
redefine powers between the Nation, provinces and municipalities
was explained , with the aim of improving quality of the health system.”
An example of what would fall in this distribution to the portfolio that Russo now leads (so questioned, for years, due to its lack of governance) is “vaccines and high complexity” (the latter, in reference to national hospitals), they pointed out from the Ministry.
From the shoes of those around the Minister, there was a feeling of “good reception from the provinces in the idea of moving forward to have data on the health results of the investment.”
However, not everything was so “smooth” and several during these hours qualified Russo's good will with some
lack of definition and even some lukewarmness
in the work of pulling objectives that at times appear like fires.
There are several examples.
The first is the issue (which several ministers mentioned) of the coverage of high-cost medications, an unresolved problem months ago, which erupted after the corresponding national directorate (the famous DADSE), which must cover patients who require treatments with drugs whose provinces do not have in their drug banks, was transferred from the Ministry of Human Capital to the Ministry of Health.
The Aedes aegypti mosquito, transmitter of dengue.
Photo: Bloomberg
Due to the trauma of the transfer, due to lack of resources or inaction, there have been patients whose treatments have been interrupted for months.
Russo's response seemed reasonable to those who understand that (to put it brutally)
a hot potato
was thrown at Health with that transfer, but it did not satisfy others, since the Minister promised that the DADSE will regularize its operation in 30 days.
COFESA, the Superintendency and the provinces
Another of the issues that some provinces put on the agenda this Monday refers to the decree that the Government published in the Official Gazette a little over a month ago, which established that the Superintendence of Health Services stops covering benefits when a patient with Social work is attended to in a public hospital, and social work delays payment to the hospital, an issue that continues to generate disagreements at this time.
And another example is
dengue
.
What was discussed about dengue at COFESA
The big question these days was whether the Ministry would end up recommending the Qdenga vaccine (from the Japanese company Takeda) to any sector of the population.
That scenario seems distant for now, while
safety studies
(adverse effects) continue and many expect that phase 4 will show better coverage figures than those collected so far against
virus serotypes 3 and 4
(almost non-existent in the current record epidemic).
Two organizations that guide this rather cautious position (while pharmacovigilance is deployed) are the Pan American Health Organization itself and the National Commission on Immunizations (CoNaIn), which recently held one of its quarterly meetings.
The minutes have not yet been published, so what was discussed there is unknown but, from what could be found out, the Commission would not be a promoter of the vaccine, at least for now.
These issues were discussed at COFESA and the Ministry emphasized that the most effective strategy continues to be
to combat the mosquito with the well-known
(but ignored, in part due to lack of solid official communication) household waste disposal strategies.
In this framework, the details of the latest dengue epidemiological report were presented, an issue that was in charge of the person who now leads the area, Carlos Giovacchini.
What was reported about dengue in COFESA
A source who was present at the ministers' meeting explained that several of the jurisdictions emphasized the communication of health issues and statistical notification, two not minor issues when thinking about dengue.
The figures presented by Health, as we have seen, are harsh: from the last week of July 2023 (epidemiological week 31) to epidemiological week 10 of this year, 106 people died.
Of them, 96 were in 2024.
Regarding the registration of cases, there are 151,310, a figure that is the tip of the iceberg of a larger mass of underregistered cases.
Even so, the accumulated incidence is 321 cases per 100,000 inhabitants, in a context with viral circulation in 19 of the 24 jurisdictions.
For now, the Ministry conveyed that it “permanently monitors the national epidemiological situation and surveillance,” and reported that, with the support of PAHO, a Network of Provincial Clinical Referents was launched.
Also, that there is a commitment from the portfolio to “assume a leading role with a focus on data collection and evidence and management for health results.”
Regarding the federal dimension, what should be the responsibility of each governorate, the position is that “provincial health policies must establish priorities according to the needs of their territories.”
P.S.