Ministry of Health, CNJ and AGU: Creation of an e-NatJus for Rare Diseases and Technical Cooperation Agreement on the Judicialization of Medicines
A cooperation agreement has just been announced between the Ministry of Health (“MS”), the National Council of Justice (“CNJ”), and the Federal Attorney General’s Office (“AGU”) to expand consensual resolution of lawsuits involving the provision of medicines within Brazil’s Unified Health System (“SUS”).
The Technical Cooperation Agreement has two main fronts: one focused on public healthcare and the other on private health insurance. In both cases, the institutions will work together to implement practices aimed at reducing litigation over the provision of medicines.
The following points, presented during the signing of the Agreement, deserve particular attention:
- A specific e-NatJus unit dedicated to rare diseases was announced, in partnership with the Ministry of Health. Its purpose is to provide technical information to support the Judiciary with scientific evidence that may assist in judicial decision-making;
- The CNJ will coordinate national guidelines for the consensual resolution of judicial disputes, the AGU will provide technical and legal clarification regarding the responsibilities of the Federal Government, while the Ministry of Health will provide technical and administrative support for the adjustment of policies of the Unified Health System (“SUS”);
- Within the scope of public healthcare, one of the main focuses is the consensual resolution of lawsuits involving medicines that are already provided by the SUS;
- Within the scope of private healthcare, the agreement provides for the active participation of health insurance operators in conciliation hearings and the adoption of their own consensual dispute-resolution mechanisms. Companies will also be expected to provide technical assistance to the Judiciary in order to improve the assessment of judicial claims.
The creation of an e-NatJus dedicated to rare diseases is particularly noteworthy.
Although the Judiciary Technical Support Centers (NatJus) already have more than 440,000 technical opinions to support judicial decisions, as reported by the CNJ itself, we recently addressed, in an article published in March 2026, situations in which a technical opinion was based on content and recommendations that were not the most up-to-date available in medical science. This required specific measures to address the issue in the case at hand.
There is a concern that the same situation could arise with this NatJus dedicated to rare diseases, which calls for careful consideration of the issue and its practical implications for judicial proceedings.
The Agreement also seeks to mitigate the negative impacts of judicialization, such as decisions that disregard clinical protocols, budgetary pressures, and difficulties in planning. By prioritizing technical and coordinated solutions, the agreement seeks, at least in principle, to reinforce the need for decisions aligned with public policies and the scientific evidence that guides the incorporation of health technologies.
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