Institutional Clashes Beyond the Judicialization of Health: Overlapping Powers in the Case of the Cancer Pill

Abstract

The 1988 Brazilian Federal Constitution institutes the promotion of “universal and equal access” to health care for Brazilian citizens. In this article, we will focus on the use and distribution of medicines as one of the national health system components. The organization responsible for standardizing and regulating the production and consumption of products and services is ANVISA – National Health Surveillance Agency, which works like the FDA (Federal Drug Administration). A unique episode took place in 2015 when a “popular uprising” began to take shape in Brazil around an issue regulated by ANVISA. Cancer patients had started to file lawsuits calling for access and permission to use a drug not authorized by this agency and which, according to the askers, supposedly would cure their disease. This drug is named phosphoethanolamine (popular name, cancer pill). Apart from the efficacy or otherwise of the drug in question, it might be interesting to organizational studies why a government organization may miss legitimation to exercise its legal role due to popular pressure, which strongly diverges from court decisions, especially involving power and legal interpretation. We approach theoretical possibilities about judicialization of health discussing triggers of institutional and social conflicts (a) by surveying studies that deal with judicialization calling for supply or release of medication (b) possible connections already established in the academy with the so-called cancer pill and, finally, (c) relating such situations to the concept of institutional void.