Special Secretariat for the Attention of Indigenous Health: challenges

Abstract

The implementation of the so-called Special Indigenous Sanitary Districts (DSEIs) of the National Health Foundation (Fundação Nacional de Saúde
- FUNASA) is not accompanied by reengineering of the mechanisms of decision making, structures and professional teams of the institution, as is shown in the literature of reference regarding the introduction of sanitary districts and the “Local Health Systems”. Far from conferring to administration the necessary supremacy faced with the regional oligarchs (frequently anti-indigenous), this process reinforces the authoritarian and corporative culture of FUNASA as well as the power of the oligarchs. The DSEIs of the whole country are facing permanent crises since implementation. The public statement by the Minister of Health that the Foundation has become a “den of corruption” announces his intention of transferring these responsibilities to the Secretary for Primary Health Attention and Promotion and, later on, to the Special Secretary for the Attention of Indigenous Health, tied to the Cabinet of the Minister – according to deliberations of the II and III National Conferences of Indigenous Health. I hereby discuss the main challenges for this Secretariat.