The National Fund for Health (Fundo Nacional de Saúde) transfers the budget to the federal government (Ministry of Health), states and municipalities, according to the Pluriannual Plan, Law of Budgetary Guidelines and the Annual Budget Law. It is considered a decentralized system in which each level of government can decide how the money will be spent. The amount of money to be transferred to each level is set by law (Brazilian Ministry of Health, 2019m; International Budget Partnership, 2018). In theory, the budget should not be dispersed through geographical areas as there is transfer according to the three levels of governance in Brazil. However, as each level is responsible for managing and setting priorities for spending the budget, it is not rare to find geographical areas with different levels of investment depending on regional or local management.

References:

Brazilian Ministry of Health. (2019m). Sobre o FNS. http://portalfns.saude.gov.br/sobre-o-fns

International Budget Partnership. (2018). Defining and managing budget programs in the Health Sector: The Brazilian Experience. https://www.internationalbudget.org/wp-content/uploads/case-study-health-budget-programs-in-brazil-ibp-2018.pdf