Foreign loans for the health sector in Brazil: solutions or problems

Abstract

The present study discusses the relationship, the alignment and the connection of the Brazilian government's health policies with the policy of the agreements with the multilateral financing agencies - World Bank and the Inter-American Development Bank (IDB) -, based on the analysis of the foreign debt payment of the loans contracted by the federal government for the health sector, which were included in the budget of the Ministry of Health. This study refers to the period from 1995 to 2004 and was developed through an exploratory study, using mainly documental research. The health expenditures of the Ministry of Health in the period from 1995 to 2004 are described, bringing into focus the instability and the difficulties in budget evolution, the health expenditures in certain selected countries, and the federal government's payment behavior regarding the total foreign debt, the health sector debts and the World Bank and IDB projects debts. Finally, we come to the conclusion that the percentage of public expenditures in the health sector in Brazil is low, when compared to public health expenditures in a group of countries of high income. We also conclude that the policies of the governments of FHC and Lula for the health sector followed the suitable orientations for economic policy given by multilateral financing agencies - including the promise of debt payment -, materialized in the documents of conditioned loans agreements, when the behavior of foreign debt payment of the contracted loans by the federal government for investments in the health sector was observed.