Leonor Maria Pacheco Santos , professor 1 , Christopher Millett , professor 2 4 , Davide Rasella , collaborating professor 3 , Thomas Hone , research fellow 4 1Departamento de Saúde Coletiva, Universidade de Brasília, Brasilia, Brazil 2Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil 3Instituto de Saúde Coletiva, Universidade Federal da Bahia, Bahia, Brazil 4Public Health Policy Evaluation Unit, Imperial College London, UK Correspondence to: T Hone thomas.hone12{at}imperial.ac.uk

Those in greatest need will be hit hardest

The More Doctors programme (Programa Mais Médicos)—a large Brazilian government initiative to provide doctors in underserved areas—recently suffered a major setback after the Cuban government withdrew its doctors. Brazil has struggled to attract doctors to work in primary care in remote or impoverished areas and indigenous reserves, and a contentious component of the programme has been to use Cuban doctors to fill the gaps. Until recently 52% of the 16 132 extra doctors working in the programme were Cuban.1 But on 14 November the Cuban government terminated their role in the programme, citing critical and aggressive comments by Brazil’s president elect, Jair Bolsonaro.2

More Doctors has been emotive since its inception and was opposed by the Brazilian medical council and some professional associations when it started. In recent months, Bolsonaro has questioned the quality of the Cuban doctors’ training and has repeatedly described them as “slaves” because of the low pay they receive (relative …