Smiling Brazil initiative sets example to other nations to eliminate healthcare disparities

Today, the International and American Associations for Dental Research (IADR/AADR) published a Discovery! article titled "10 Years of a National Oral Health Policy in Brazil: Innovation, Boldness and Numerous Challenges." In it, authors Gilberto Alfredo Pucca, Jr., University of Brasília; and Mariana Gabriel, Maria Ercilia de Araujo and Fernanda Campos Sousa de Almeida, University of São Paulo, discuss Brazil's National Policy of Oral Health, also known as "Smiling Brazil."

Brazil is the only country with more than 200 million inhabitants that has a universal health system, funded by federal, state and municipal budgets. In recent decades, the system has evolved from an exclusionary to a universal model, the unified health system (Sistema Único de Saúde [SUS]), where everyone is entitled to healthcare and the government is required to provide it. Primary healthcare is the backbone of the new system, in keeping with the guidelines set forth by the Primary Healthcare Reform, recommended by the Pan American Health Organization/World Health Organization.

Evidence shows that Brazil is tackling its health inequalities. In a clear demonstration that the country is overcoming this challenge, it was removed from the World Health Organization's hunger map in 2014, after 22 million were lifted out of extreme poverty, meaning that the segment of the population living in extreme poverty fell from 25.5% to 3.5% between 1990 and 2012. For Brazil to take these strides, it had to deploy actions across different sectors and take individuals as well as society as a whole into consideration. Bearing in mind this integral approach, oral healthcare was incorporated into the public healthcare system.

Smiling Brazil was launched in 2004. Under its initiative, oral health was designated one of the four priority areas of the SUS. This policy changed the concept of oral healthcare by pursuing the integral care system envisaged for SUS at its creation. The authors of this paper believe that smiling Brazil is an extraordinary experience that can be emulated and adapted to the conditions of other countries and other healthcare systems, evidently taking into account internal political and budgetary considerations. Positive evidence of the accomplishment of this goal can be attested to by observing: oral health epidemiological indicators; financial investment and professional development; and the building of an oral healthcare network throughout the policy's existence.

"As IADR strives to improve oral health worldwide and eliminate oral health disparities, it's encouraging to know that the Smiling Brazil initiative has been successful and is helping Brazilians have access to oral health care," said IADR Past President Maria Fidela de Lima Navarro. "I hope that Smiling Brazil can serve as an example to other nations that are researching methods to eliminate healthcare disparities and provide all its citizens with access to health care."

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