Cancer policy and dependency: Analysis of the Brazilian national audit on the 60-day law

Abstract

This article analyses the results of a national audit focused on compliance with Law No. 12,732/2012, which stipulates that cancer treatment must begin within 60 days of diagnosis, pointing out the obstacles to timely access in relation to the organization of the oncology network and the actions developed at the state and municipal levels, based on audits carried out by the State Audit Sections of the National Audit Department of the SUS of the Ministry of Health (Seaud/DenaSUS/MS). The study analyzed 63 reports produced by 25 audits carried out by the State Audit Sections, coordinated by the National Auditing Department of SUS (DenaSUS) between 2017 and 2020, within the scope of a national audit action. The study analyzed the main problems encountered in light of Marxist Dependency Theory, showing how the structural limits imposed on the dependent Brazilian state, in its three spheres of government, prevent it from being able to rely on an administrative machine capable of ensuring an adequate response to the population’s needs in relation to cancer care. The results of the national audit action revealed: very low compliance with the legal deadline; absence of state plans; low use of information systems; fragility of healthcare regional agreements; deficiencies in the regulation of access to healthcare; and inadequacy of service provider units. It was concluded that the reduced effectiveness of public policy prevents timely access to cancer care, rooted in the dependent condition of the Brazilian state.