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Conversation highlights:
- The Institute of Ethics in Health represents a global reference model, where competing companies from multiple segments come together to promote honest and ethical business practices in the Brazilian health sector.
- The institute operates through a comprehensive ecosystem that identifies corruption, monitors unethical practices, and implements solutions through education, private self-regulation, and public policy influence.
- With 75% of Brazilian patients depending on the public system and 25% on supplementary health, ethical practices directly impact access and complete outcome to medical and hospital treatment for more than 230 million people
- The organization has established strategic partnerships with important government agencies, including the Office of the Comptroller General of the Union, the Federal Court of Accounts, the National Health Surveillance Agency, the National Supplementary Health Agency, and Parliamentary Fronts, as well as entities representing various health segments.
- May has been designated as Health Ethics Month in Brazil, with new legislation and research on perceptions of corruption being released.
- Ethics and transparency are not optional, but essential realities that must be translated into both personal and professional life to save patients' lives.
EF: Can you tell us about the mission and strategic positioning of the Institute of Ethics in Health in the health sector in Brazil?
FVS: The Institute of Ethics in Health promotes health and integrity in our country with a technical, proactive, and decisive voice, which has become increasingly indispensable in the ethics and integrity agenda for our health sector and for all Brazilians. Our core values include dialogue, transparency, legal certainty, and legitimate trust. These principles have been our foundation since their foundation and constitute the basis for strengthening the real stability and sustainability of our sector, reflected in solid governance throughout the value chain. We operate with a strategic positioning focused on expansion, working with national and international representative entities, as well as state inspection and control bodies and parliamentary fronts in structural deliverables, strengthening alliances, and maintaining a qualified presence in major public and private debates. Our work covers the public, private, and third sectors, always affirming ethical practices. We constantly talk about transparency and trust as a fundamental point for the realization of ethics in health. Trust is the starting point for relationships to be truly honest in all actions. This is challenging in a context of regulation and public-private transactions, but when we manage to reach everyone with whom we identify in relation to our purpose, showing that unethical practices can be identified, monitored, and that there are viable solutions to mitigate and/or eliminate them, we achieve something that touches me deeply: we can change the model of patient care and save lives.
EF: How is the institute structured in terms of governance and decision-making?
FVS: We have strengthened institutional governance with several key pillars. We maintain a board of directors with representatives of member companies, people truly committed to the cause, an ethics council with people of great knowledge, and an advisory board with a proactive character, aligned with the challenges of our sector. This reinforces all management, governance, transparency, and decision-making practices to ensure effectiveness and efficiency in our actions. The word is always ethics and transparency to restore trust in the health sector. We work with a focus on legacy and with a vision for the future, without losing our public sense or institutional bases since the foundation of the institute, primary values that have permeated our flag since the sectoral agreement on medical devices, today extended to all health segments. The Institute of Ethics in Health has a movement that reinforces its public identity and leadership capacity in issues of ethics and transparency throughout the Brazilian health sector. Today, we can work with hospitals, medical device companies, health operators, private insurance, public health systems, and health professionals.
EF: What are the main areas of action and current initiatives of the institute?
FVS: Today, we seek to act very clearly and firmly in the proposal for training and education of future health professionals. We led the Front for the Promotion of Ethics and Integrity in the Training of Future Health Professionals, with the elaboration of a concrete proposal, endorsed by dozens of representative entities and renowned professionals, in which we delivered to the Ministry of Education and the National Council of Education the change in the curricula of health courses in Brazil in a transversal way, incorporating ethics and integrity in the training of all future health professionals. This project gave rise to EME – Moral and Ethical Education, one of the greatest struggles of our institution. To address the problem of corruption in the cause, to educate future professionals so that, when they arrive in the job market, they can have deep technical knowledge to act in a transparent and honest way, basing their actions on true ethical principles. We are also building responsible self-regulation among private companies operating in our sector, an action that has existed, with concrete effects, since the foundation of the Institute, through normative instructions and the consensus framework for multisectoral collaboration in the health sector. The results observed by the institute, among the companies that have remained firm in their purpose, are incredible. These companies are truly transparent in their relationships. This is important because private companies supply the public sector, so when everything is transparent and ethical in our private sector, it will also be transparent and ethical in the public administration, since the public administration buys from the private sector. We have technical cooperation agreements with control bodies such as the Comptroller General of the Union, the Federal Court of Accounts, with Anvisa, the ANS, we are also part of the Advisory Council of the Parliamentary Front for Inspection, Integrity and Transparency and we are responsible for managing the executive sextaria of the mixed parliamentary health front, where we act as Executive Secretariat, thus seeking to facilitate transit in the Brazilian Parliament, working for proposals for laws and regulations. Our technical capacity for multistorial articulation has created an ecosystem of ethics and integrity in health, called the Ecosystem of Ethics in Health of Business Ethics.
EF: Can you explain your comprehensive approach to promoting ethical business in healthcare?
FVS: We work through identification, monitoring, and viable solutions. We seek to identify irregularities in our country as much as possible through studies and research, including cooperation agreements with research groups, for example, in public procurement, law, and corruption, linked to the Pontifical Catholic University of São Paulo, and to the Governance, Compliance, and data protection research group, linked to Mackenzie Presbyterian University. We monitor through our ethics radar, which will now be called the health ethics radar, in which we have developed the ITS platform intelligence and transparency in health ethics, which will identify disclosed cases of public and private corruption in real time, to be assertive in social control, making society and health professionals aware of the entire context of investigations and instituted processes. For solutions, we work through education that changes the critical thinking of all future professionals. When students are at university, we can change the way they think about work and business practices. This includes education, private regulation, and public regulation. We are closing a cycle with identification, monitoring, and solutions. We can be the only institution that has this complete proposal to face the problem of corruption in public and private health. Many people consider it for the public sector, but it's actually directly linked to the private sector, because, as we said, the public administration is a client of the private sector. We work with private self-regulation to mitigate this problem. When we treat the problem in both the private and public sectors, we achieve much better and lasting results.
EF: What are some of the most significant achievements of the institute after 11 years of operation?
FVS: The formation of our institute itself is significant. It represents an almost unique case in the world of a group of companies that come together to fundamentally change the way business is done in our country, promoting true and materialized ethics. The training model has been the most important point since its creation. Our institute can analyze its rules and consensus structure in our country, talking about ethical principles and guidelines for the entire sector. Over these 11 years, we can see the rules and laws, how the topic has grown , and the discussions in our country and sector have evolved, leading to the reduction of corrupt practices, both private and public, in the segment in which we operate. Of course, within the scope we have been able to achieve, we seek to advance and strengthen our purposes, so that ethics and transparency are perceived in the most varied sectors. We have a growing strength to show that unethical practices can be eliminated or mitigated through truth, honest work, and the realization of ethics. The materialization of ethics occurs through private regulation, laws, and education that change everyone's thinking, especially students and professionals who work in the health sector. The main impact on our sector is the ethical training of all professionals and their impacts on people's lives, on all Brazilian citizens, and the continuous and effective search for the best results for patients.
EF: Could you elaborate on the importance and impact of your work on patient outcomes?
FVS: When unethical practices are stopped, we can change lives. The impact on people's lives is very clear. For me, there is no other way to talk about our work than expanding people's lives through the quantity and quality of patient care in our country. All of us who work in the health sector have something in common: the patient. We are all patients when we are born and throughout life. In our country, 75% of all patients are in the public system, 25% in supplementary or private health insurance. We are talking about 230 million people. If we have an ethical and transparent treatment in 100% of the system, with transparency in economic and financial relations and commercial practices, this impacts everyone. We need to change our thinking, and our ecosystem of ethics and integrity in health aims to better influence the whole society, all professionals in the public and private sectors.
EF: What advice would you give to other organizations around the world willing to promote ethical business?
FVS: One word: be sincere. Transparency and integrity have no other way. Ethics is ethics, truth is truth, and there is no half-truth. This is what we must say to all other people, companies, and associations. Alliances must be true as the main point that comes from our heart. The word transparency is synonymous with truth, and trust is synonymous with faith. By rescuing trust in our sector, we must have ethics as a tip, not ethics, as we hear today everywhere, at any event, any research that talks about ethics, but ethics must be materialized with the truth. In laws, in responsible self-regulation, in practice with patients, in changing negotiations, the word must be true with the concept of ethics.
EF: What is your final message to health leaders about why ethics is not optional?
FVS: Ethics, integrity, and transparency are not options. They must be facts, reality. We must translate ethics and integrity into our lives, personal and professional, because they are all changing, mixing. Leaders in the health sector must believe in the ethics of truth, because it is a delivery. When we talk about it, we don't need to talk about numbers, spreadsheets, or survival; management is a natural process in institutions, because when economic-financial relationships are truly honest, profits are maximized and costs are effortlessly optimized. The health sector is what talks about life. Corruption in all sectors is harmful to society. And when we talk about health, we are talking about life. These practices can be devastating. Ethics and the word itself are the message, the truth about its practice.
