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The Lancet published in May a few papers about the Brazilian health system, none of them on primary care, or with a focus on health policy. Therefore, important questions were kept out of the debate. This letter highlights some of the critical questions as maldistribution of doctors.

• Brazilian health service organization: problems at a glance. Gusso G, Pérez Fernández M, Gérvas J. Lancet. 2011; 378: 316-7. Download English version here.

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Brazil, with almost 200 millions inhabitants, has a public primary health system that covers 60% of the population. Health centers are public, with professionals working as public employees, and organized in health teams (one per 4.000 inhabitans, with a family physician, a nurse, an auxiliar and six agents of communiyt health). The Strategy of Family Medicine is supporting the work in the health centers. In this text, the authors present a summary of their recommendations to improve primary care in Brazil, after a field trial (visiting 19 States, 32 towns and 70 health centers).

• ¿Cómo construir una Atención Primaria fuerte en Brasil?. Gérvas, J., Pérez Fernández, M. Agosto 2011. Download English version here.

See comentary published in the Canadian Journal Medical Association: Brazilian health care faces harsh choices. Download pdf version of the article here.

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Barbara Starfield died 10th June 2011. She was a giant of primary health care. Her publications have being critical for building up a framework for health services researh, and for health policy. This obituary remember her work and life.

• Quando um gigante cai, os añoes ficam sem sombra. Gérvas, J., Peréz Fernández, M. Rev Soc Bras Med Fam Comunit. 2011; 6 (9). Download English version here.

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Seminars of Innovation in Primary Care started in 2005 and they are still on in 2011. This text explains how the Seminars are organized, the methodology and how they finish with formal publications. Key points are the on-line debate before and after the face-to-face workshop, the themes selected, the difussion of practical and theoretical questions and a mix of participants with very different backgrounds.

• Primary Care Innovation Seminars: An experience in dissemination of knowledge on network. Minué, S., Gérvas, J., Violán, C. Madrid. 2009. Download complete text here.

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Iodine supplements during pregnancy could be a dangerous practice in places with normal and medium level de iodine food content. Spanish data show that iodine supplements are associate with problems of the thyroid gland (in the female) and problems in the psychological-motor development of the offspring (girls).

• Iodine supplements to pregnant women. Gérvas J. Marzo de 2011. Note for Tiago Villanueva’s blog. Download text here and longer text in Villanueva’s blog at the BMJ.

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Flu H2N2 is presented as a terrible epidemic in the XX century, with one and half million deads from 1957 to 1968. But this data only give an impression of severity as we can expect around five millions with a “normal” seasonal flu in this period of time.

• Flu H2N2, mortality and vaccination. Gérvas J. March 2011. Download English version here.

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Swine flu was managed is such a way by World Health Organization and national authorities that created panic. At the end of the epidemic WHO and national authorities did not do an analytical exercise to examinate their errors. So they were not errors but a world campaign of “disease mongering”. The Spanish case of the successfull counter-campaign swine flu can help in resisting disease mongering campaign; it is described in six step in the power-point presentation.

• Can we resist disease mongering campaigns? Yes, we can. Gérvas, J. September, 2010. Download English version here.
• Download presentation in English here.

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