HEALTH IN BRAZIL: CHALLENGES FOR STRENGTHENING THE UNIFIED HEALTH SYSTEM (SUS)

Abstract

The interactions between democracy, citizenship, and health have profoundly influenced the formation and development of Brazil's Unified Health System (SUS) over the last forty years. Until 2016, despite structural difficulties, conflicts between political projects, and temporal variations, there was a strengthening of democracy and an expansion of social rights. The SUS enabled significant progress in access to and improvements in health conditions. From 2016 to 2022, significant regressions in economic, social, and health policies were observed. This situation was severely exacerbated by the multidimensional crisis resulting from the COVID-19 pandemic starting in 2020. The actions of the SUS, universities, and public scientific institutions were crucial in confronting the crisis. From 2023 onward, the obstacles to recovering a democratic national project oriented toward social well-being are considerable. Strengthening the SUS depends on the nature of social policies and democracy, and requires profound transformations in the interactions between the State, markets, and society. It is necessary to transcend limitations that have persisted, even under progressive administrations. The SUS, as a universal policy based on a comprehensive concept of health and democratic values, is an essential pillar for consolidating a development model aimed at reducing inequalities and building a more equitable society.