Pharmaceutical services in the context of Indigenous health: barriers to access to medicines in two states in southeastern Brazi

Abstract

The National Medicines Policy, the National Pharmaceutical Services Policy, and the National Health Care Policy for Indigenous Peoples share, as central guidelines, the guarantee of access to essential medicines and the promotion of their safe, appropriate, and rational use. This article aims to discuss the main challenges related to the applicability of these policies, especially regarding the effective access to medicines in Indigenous communities. This is an opinion article based on the analysis of public health and pharmaceutical services policies within the context of the Indigenous Health Care Subsystem (SasiSUS), as well as on the authors’ professional experience working with health services intended for Indigenous populations in the states of Minas Gerais and Espírito Santo. The challenges identified involve structural, territorial, logistical, cultural, and intercultural aspects, requiring continuous institutional and political efforts, as well as coordinated action among health professionals, managers, and Indigenous communities. In this context, medicines should be understood as an essential component of health care, and guaranteeing access goes beyond their physical availability, also involving planning, supply, therapeutic guidance, comprehensive care, and respect for the sociocultural specificities of Indigenous peoples. Furthermore, the importance of coordination among the different responsible actors is highlighted as a fundamental strategy for overcoming the barriers that limit access to and the appropriate use of medicines by Indigenous populations, in to ensure comprehensive, equitable health care grounded in respect for the ethnocultural diversity of Indigenous peoples.