THE STRUCTURAL DEVALUATION OF SANITARY SURVEILLANCE IN BRAZIL AND ITS IMPACTS ON PUBLIC HEALTH

Abstract

Health surveillance occupies a strategic position within Brazil’s Unified Health System (SUS), as it brings together regulation, inspection, risk prevention, and the protection of collective health. Despite this central role, its institutional position remains fragile across much of Brazilian territory, especially in municipal contexts marked by political dependence, low technical and operational capacity, and unstable funding. This article aimed to discuss the structural determinants of the devaluation of health surveillance in Brazil and their repercussions for the effectiveness of sanitary control, health equity, and the State’s regulatory capacity. A narrative literature review with an analytical approach was conducted, based on scientific articles and national and international institutional documents. The analysis was organized into four axes: the institutional place of health surveillance within the SUS; the effects of decentralization and federal inequalities; work, human resources, and organizational vulnerability; and public legitimacy, social participation, and communication. The findings indicate that the devaluation of health surveillance does not result solely from budgetary constraints, but from a political-institutional arrangement that reduces its technical autonomy, fragments its material base, and limits its social visibility. It is concluded that strengthening the field depends on combined measures of institutional protection, stable funding, cooperative regionalization, continuous workforce training, and the expansion of the public legitimacy of regulatory action.