Brazil launches e‑SUS AF, national platform to manage medicines across SUS pharmacies

When a patient walks into a public pharmacy in Brazil, whether the shelves are stocked and the right medicine is handed over increasingly depends on one thing: the software running behind the counter.

That software is about to change. Brazil’s Ministry of Health has launched a new national platform, e‑SUS Assistência Farmacêutica (e‑SUS AF), to manage how medicines are bought, stored and dispensed across the public health system, known as SUS. The tool is meant to gradually replace Hórus, the long‑used pharmaceutical management system, and municipal governments can start signing up now.

The shift goes far beyond a name change. Hórus has been the backbone for tracking medicine stocks and dispensations in many SUS pharmacies for years. Health officials describe e‑SUS AF as a modernization effort to overcome what they call the “technological limitations” of Hórus. But the transition will be slow and complex: existing Hórus records will not be automatically migrated, and local managers will need to keep consulting the old system for up to five years while building new histories in e‑SUS AF.

The ministry presented the platform in a national webinar on April 9 and detailed the rollout in a news release the following day. The new system is designed to cover day‑to‑day pharmaceutical assistance — from inventory control in storerooms to recording every time a patient receives a medicine — and to feed those data into national health databases used for planning and oversight.

Technically, e‑SUS AF is built on free software and a more flexible, scalable architecture than its predecessor, the ministry said. It is designed for integration through application programming interfaces, or APIs, which allow different systems to exchange data in standardized formats. Officials say the platform will connect to three key federal databases: BNAFAR, the national base that consolidates pharmaceutical services data; the National Health Data Network (RNDS), which links digital health records; and CADSUS, the national registry of SUS users.

“Vamos migrar para um sistema aderente a padrões com gestão de dados adequada e integração via API … Isso permitirá maior agilidade no campo, descentralização e autonomia para os gestores locais,” said Nélio Cezar de Aquino, director of the Department of Pharmaceutical Assistance and Strategic Inputs at the Ministry of Health. In the same announcement, he described the change as “uma transformação necessária” and acknowledged that the current system “possui limitações tecnológicas.”

The ministry developed e‑SUS AF in partnership with the Instituto Federal da Paraíba, a federal education institution, and says ongoing maintenance will follow a collaborative model involving federal, state and municipal health authorities through a structure called Hub InovaAF. The hub is already offering an online, self‑paced course on how to use the system, which was updated on the same day as the webinar.

Enrollment for municipalities — known as “adesão” — is now open. The ministry also plans to deploy e‑SUS AF in the Distritos Sanitários Especiais Indígenas, or Indigenous Health Districts, still in April, extending the platform to services that manage medicine supply in some of the country’s most remote areas.

The national rollout follows pilots in states such as Pernambuco, which began testing the system in 2025, and Sergipe, which announced a pilot for its specialized pharmaceutical services earlier this year. Those early implementations suggest the platform has already been used in real‑world settings, though detailed evaluations of results have not yet been made public.

Under the ministry’s plan, e‑SUS AF is offered as a public alternative that will “gradually” take the place of Hórus. Once a municipality has fully implemented the new tool, it will still be able to access Hórus in read‑only mode for consultation for up to five years. However, there will be no automatic transfer of historical data from one system to the other.

In practice, that means pharmacy and IT teams will start with a clean slate in e‑SUS AF, while older dispensing and stock records remain locked in Hórus. During the transition, staff may need to consult and, in some cases, manually reconcile information between the two platforms — potentially increasing workload and creating room for inconsistencies if local planning is not careful. At the same time, the move offers a chance to standardize and “clean” data to match the information models required by BNAFAR, which were updated by Health Ministry ordinance GM/MS No. 5.713/2024.

The ministry argues that the gains outweigh the friction. “Temos hoje um sistema que foi importante, mas que possui limitações tecnológicas,” Aquino said, framing the shift as overdue modernization rather than a simple system swap.

National councils representing state and municipal health secretaries have publicly endorsed the launch. Elton Chaves, technical adviser at the National Council of Municipal Health Secretaries (Conasems), called it “uma entrega histórica do Ministério da Saúde, resultado de um processo colaborativo, que atende a um pleito dos 5.571 municípios brasileiros.” Henrique Vogado, a technical adviser at the National Council of Health Secretaries (Conass), said the change “vai fortalecer tanto o planejamento dos profissionais quanto a capacidade dos gestores de dar as respostas necessárias para uma sociedade que tanto precisa.”

Despite that support, the pace and quality of implementation are likely to vary. Adoption is voluntary, and many municipalities still face gaps in IT infrastructure, internet connectivity and staff training. Smaller towns and remote Indigenous districts may depend heavily on federal support, both technical and financial, to make full use of the platform’s more advanced features, including integration with national databases.

The ministry presents e‑SUS AF as part of a broader push to digitize and standardize pharmaceutical assistance in the SUS, aligning medicine data with national reporting rules and Brazil’s data‑protection law. Over the next five years, key questions will be how quickly municipalities migrate, what resources they receive to manage parallel systems, and how securely and transparently the government handles more detailed medication records as they flow into the country’s central health data infrastructure.