Article Text

The potential impact of austerity on attainment of the Sustainable Development Goals in Brazil
1. Luis Eugenio Portela Fernandes de Souza1,
2. Rafael Damasceno de Barros1,
3. Maurício Lima Barreto1,
4. Srinivasa Vittal Katikireddi2,
5. Thomas V Hone3,
6. Rômulo Paes de Sousa4,
7. Alastair Leyland5,
8. Davide Rasella6,
9. Christopher J Millett3,
10. Julia Pescarini6
1. 1Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil
2. 2MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
3. 3School of Public Health, Imperial College London, London, UK
4. 4Fundação Oswaldo Cruz, Centro de Pesquisas René Rachou, Belo Horizonte, Brazil
5. 5University of Glasgow, Glasgow, UK
6. 6Federal University of Bahia, Salvador, Brazil
1. Correspondence to Professor Luis Eugenio Portela Fernandes de Souza; luiseugenio{at}ufba.br

## Abstract

In the recent decades, Brazil has outperformed comparable countries in its progress toward meeting the Millennium Development Goals. Many of these improvements have been driven by investments in health and social policies. In this article, we aim to identify potential impacts of austerity policies in Brazil on the chances of achieving the sustainable development goals (SDGs) and its consequences for population health. Austerity’s anticipated impacts are assessed by analysing the change in federal spending on different budget programmes from 2014 to 2017. We collected budget data made publicly available by the Senate. Among the selected 19 programmes, only 4 had their committed budgets increased, in real terms, between 2014 and 2017. The total amount of extra money committed to these four programmes in 2017, above that committed in 2014, was small (BR$9.7 billion). Of the 15 programmes that had budget cuts in the period from 2014 to 2017, the total decrease amounted to BR$60.2 billion (US\$15.3 billion). In addition to the overall large budget reduction, it is noteworthy that the largest proportional reductions were in programmes targeted at more vulnerable populations. In conclusion, it seems clear that the current austerity policies in Brazil will probably damage the population’s health and increase inequities, and that the possibility of meeting SDG targets is lower in 2018 than it was in 2015.

• Health policies and all other topics
• Health systems

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## Footnotes

• Handling editor Seye Abimbola

• Contributors All coauthors have made substantial contributions to the conception and design of the work, as well as to the analysis and interpretation of data. LEPFdS and RDdB were responsible for the acquisition of data and for drafting the work. All coauthors revised the work critically for important intellectual content and approved the version to be published. Everyone agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None declared.

• Patient consent for publication Not required.

• Provenance and peer review Not commissioned; externally peer reviewed.

• Data availability statement All data relevant to the study are included in the article.

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