Brazil’s public health system (SUS) has increased its monthly capacity from 600 to 100,000 telehealth consultations for people facing problems related to online gaming and betting. The initiative took effect this Tuesday (Aug. 4).

The service was launched in March and handled an average of 600 calls per month. According to the Ministry of Health, the expansion was necessary due to high demand.

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The service is available through the Meu SUS Digital app and is provided in partnership with the Ministry of Finance and the Brazilian Agency for Support to SUS Management (AgSUS).

The service offers remote, confidential, and supportive care, providing professional guidance and follow-up while connecting users to the Psychosocial Care Network (RAPS).

Data from the Ministry of Health indicate that more than 1 million people have requested the self-exclusion of their Brazilian tax ID numbers (CPF)-required to access gambling websites and apps-through the Centralized Self-Exclusion Platform, a tool operated by the Brazil Health Observatory on Electronic Gambling.

The figures also show that 35 percent of people initiated self-exclusion due to a loss of control over their gambling behavior.

Among the warning signs listed by the ministry are:

• changes in sleep, eating habits, or mood;
• lying to family and friends about gambling;
• feelings of shame and guilt related to gambling;
• anxiety, irritability, and restlessness when not gambling;
• using gambling as a way to cope with stress or frustration;
• difficulty cutting back on or stopping gambling;
• strained personal and professional relationships;
• increased use of alcohol and other drugs; and
• financial problems affecting personal or family finances due to gambling expenses.

The risk factors listed by the ministry include:

• early exposure to gambling;
• easy access to online gambling;
• seeking emotional relief or an escape from problems;
• a history of mental health disorders, such as depression and anxiety;
• impulsivity and the pursuit of immediate rewards;
• social and cultural influences that romanticize gambling;
• loneliness and social isolation; and
• social vulnerability.

The Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said that Brazil’s public health care system, the SUS, serves as a global model by providing universal coverage to more than 200 million people.

The statement was made during a visit to the Andaraí Federal Hospital in Rio de Janeiro’s northern zone on Monday (Jul. 27), alongside President Luiz Inácio Lula da Silva, Health Minister Alexandre Padilha, and state and municipal officials.

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The WHO director-general noted that few countries have a public health care system with such broad coverage.

“Brazil shows the world that it serves as an example. The Brazilian health system is universal and demonstrates that health care should be for everyone, not just for a few,” he said.

Ghebreyesus also praised Brazil’s role in the international health agenda, citing the global agreement on pandemics approved this year and the historic cooperation between the WHO and the Oswaldo Cruz Foundation (Fiocruz).

Hepatitis B

The director participated in the presentation of the dossier launching the international certification process for the elimination of vertical transmission of hepatitis B (from mother to child) as a public health problem in Brazil. The document was presented on World Hepatitis Day.

According to him, this achievement is the result of years of work by health professionals, researchers, and communities across the country.

“Once again, I thank Brazil for demonstrating that elimination requires discipline, not just slogans,” he pointed out.

Visit

Ghebreyesus’s visit to the Andaraí Federal Hospital took place during his trip to Brazil to attend the International Conference on HIV/AIDS and meet with the Ministry of Health to discuss strategies for disease elimination and ways to strengthen cooperation between the WHO and Brazilian institutions.

During the visit, President Luiz Inácio Lula da Silva highlighted that the revitalization of federal hospitals in Rio de Janeiro aims to transform these facilities into centers of excellence.

“There is no country on the planet with more than 100 million inhabitants that has a universal health system like our SUS,” Lula stated.

“The SUS works because the janitors, nurses, doctors, technicians, and all the workers had the courage to care for people. That is why we are strengthening the SUS,” he added.

The prevalence of the main types of HPV fell by nearly half in Brazil following vaccination, according to the largest study ever conducted in Latin America assessing the vaccine’s efficacy.

Data collected in 2016 and 2017 show that 14.98 percent of participants had already been infected with at least one of the four types covered by the vaccine (6, 11, 16, and 18). In samples collected between 2020 and 2023, however, this proportion stood at 7.95 percent.

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The Pop-Brasil study was conducted by Moinhos de Vento Hospital in partnership with the Ministry of Health. In the first phase, samples from 6,388 unvaccinated participants of both sexes were analyzed. The second phase included more than 10,000 participants, both vaccinated and unvaccinated. Samples were collected at healthcare facilities.

In both phases, the study focused on young people aged 16 to 25 years, according to Eliana Wendland, an epidemiologist and the study’s lead researcher:

“This age group has the highest prevalence of HPV because it coincides with the onset of sexual activity. It was also selected because individuals in this group should already have been vaccinated.”

Unfortunately, that was not the case. Among the girls and women included in the study, only 61.8 percent had been vaccinated, and the proportion was even lower among male participants, at 31.1 percent. The ideal vaccination coverage rate is 90 percent.

Even so, the vaccine demonstrated its potential. Among the girls and women, the prevalence of HPV types covered by the vaccine was 15.6 percent in the first phase, when only unvaccinated individuals participated in the study. In the second phase, however, detection of these HPV types among vaccinated participants dropped to 3.1 percent.

“Herd immunity”

According to Wendland, the study also found evidence that the vaccine has already contributed to a “herd immunity” effect:

“We also observed a population-wide effect of vaccination among the girls. Even among those who were not vaccinated, we observed a decrease in HPV prevalence.”

This occurs because high vaccination coverage reduces the circulation of disease-causing agents, indirectly protecting the entire population. Among unvaccinated girls and women, the prevalence of the four HPV types targeted by the vaccine was 10.5 percent in the second phase of the study.

Among men, the prevalence of the HPV types targeted by the vaccine fell from 13.8 percent to 4.6 percent among vaccinated participants, but there was no statistically significant change among unvaccinated participants in the second phase. According to Wendland, the explanation lies in the low vaccination coverage among this group.

“This finding is not unexpected, since boys tend to receive less encouragement to get vaccinated against HPV than girls, in part because the virus is still widely perceived as primarily a cause of cervical cancer,” notes the preview of the article to be published in the journal npj Vaccines, which presents the study’s results.

Effective vaccination

Another piece of data underscoring the vaccine’s power and importance is that, between the two phases of the study, the overall prevalence of HPV in the population - considering all existing subtypes - rose from 46.7 percent to 56.6 percent, in contrast to what was observed for the four subtypes targeted by the vaccine.

The study also found evidence that the current single-dose regimen offered by Brazil’s national public healthcare system, the SUS, is effective, as there was no difference in HPV prevalence among people vaccinated with one, two, or three doses.

HPV vaccination through the SUS began in 2014, initially targeting only girls, but was expanded to include boys in 2017, with some changes to the eligible age range over the years. In 2024, the basic vaccination schedule changed from two doses to one.

Today, the target population includes all children and adolescents aged 9 to 14 years, as well as certain vulnerable adult groups, such as immunocompromised individuals, victims of sexual violence, users of pre-exposure prophylaxis for HPV prevention, and people with a previous history of precancerous cervical lesions.

HPV, short for human papillomavirus, is the leading cause of cervical cancer, but it can also cause cancers in other organs, such as the penis, anus, and throat. Not all HPV subtypes are carcinogenic, but the vaccine available through Brazil’s public health system protects against the four main oncogenic HPV types.