Brazil's Federal Court of Accounts (TCU) has given the Ministry of Health 60 days to explain why 97% of drug deliveries scheduled under an agreement with the Fiocruz biomedical institute arrived late between June and December 2024. Only 3% arrived on the contracted date. The audit was reported on Wednesday (9) by g1, Globo's news portal, the only outlet carrying the story that this report could reach.
The agreement, Technical Cooperation Agreement (ACT) 02/2023, is managed by the ministry's science and technology secretariat, with shipments made by Farmanguinhos, the drug manufacturing institute of Fiocruz. The medicines belong to a SUS program for diseases that require specialized care. Brazil's public health system distributes them free of charge. The audit covered four medicines in seven formulations: cabergoline, pramipexole, sevelamer and tacrolimus, all of them continuous-use drugs. Tacrolimus prevents organ rejection in transplant patients, pramipexole treats Parkinson's disease, sevelamer controls blood phosphorus in chronic kidney disease and cabergoline lowers excess prolactin.
The percentages measure punctuality, not volume. Delays show up in quantity too: of roughly 248.84 million pharmaceutical units planned for the period, about 106.28 million were delivered, 43% of the total. The TCU itself cautions that the 3% on-time rate applies to this agreement alone and cannot be read as an average for the ministry's purchases.
What the court found
The audit recorded problems in obtaining inputs, in production and in logistics, along with the effects of a cyberattack on Farmanguinhos in August 2023. The failures were not limited to manufacturing. The TCU also pointed to delays by the Ministry of Health itself in formalizing distribution schedules and in transferring budget funds. In some cases, the court says, this led to production based on informal estimates, raising the risk of losses from expired drugs. There were also obstacles to scheduling deliveries with state health departments and customs hurdles.
No confirmed nationwide shortage
The TCU says the data do not allow the conclusion that there was a national shortage. The assessment runs into a limitation acknowledged by the ministry itself: Brazil lacks a computerized system with real-time updates that tracks both consumption and stocks of these medicines nationwide. The ministry told the court it adopted contingency measures and moved stocks between states to preserve treatment continuity. For the TCU, the absence of real-time data keeps the public system exposed to the risk of running out of a critical input. g1 also reported that punctuality indicators existed, but they were to be consolidated mainly at the end of the agreements, which made control reactive. Neither the ministry nor Fiocruz answered the outlet's questions before publication.
For patients, routine steps matter more than alarm. The court found no confirmed national shortage, but drugs such as tacrolimus and pramipexole depend on steady refills, and transplant patients have the narrowest margin: without the immunosuppressant, the body may start rejecting the transplanted organ. Renewing prescriptions early, checking availability at the dispensing unit before personal supplies run out and telling one's doctor about any difficulty picking up medication are the steps that reduce the risk of interruption.