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The People Are The Builders Of The Brazil’s Unified Health System

Above Photo: National Health Council.

The 17th National Health Conference held debates on four thematic axes on which guests and delegates could address the need to construct a truly equitable Unified Health System.

Social movements were actively involved in the process.

Brazil’s 17th National Health Conference brought a significant portion of the social mobilizations that led to President Lula’s electoral victory to the federal capital Brasilia. It was a rare opportunity to see all, or almost all, the social struggles from different corners of the country in one place. The National Health Conference represented an important gathering point for different activists and generations, highlighting the long-standing challenges in the pursuit of social justice.

The National Health Conferences are spaces for activists and the population at large to conduct dialogue with the government and influence the priorities and working of the Brazil’s famous Unified Health System (SUS).

“We can no longer develop proposals for the SUS that ignore the realities of life. We cannot turn a blind eye to the lack of investment, budget cuts, precariousness, commercialization, and the delegation of management to entities that disregard human rights. We have been subjected to a policy of death, which disrupts the natural cycle of life. We can still feel the presence of this policy in Brazilian society,” said Rachel Gouveia Passos from Fiocruz, who was a speaker on one of the four thematic axes that guided the primary discussions at the event.

The discussions revolved around the thematic axes during the first two days of the conference. Each axis featured three speakers and covered the following topics: ‘The Brazil we have and the Brazil we want’; ‘The role of social control and social movements in saving lives’; ‘Guaranteeing rights and defending SUS, life, and democracy’; ‘Tomorrow will be another day for all people.’ Following each speaker’s presentation, delegates flooded the stage with their demands, showing how complex it is to build a SUS which is effective for everyone.

“The SUS is our health plan and one of the best public policies in the world. We, as poor, Black, peripheral people, have witnessed the vital role of the SUS during the pandemic while we struggled to survive. Now, with the restoration of participatory councils, we are witnessing a revival of the public health system,” said Luiza Batista Pereira from the National Federation of Domestic Workers (Fenatrad).

Health Minister Nísia Trindade stated that the 17th National Health Conference revives the spirit of the Constitution and the democratization of the country, as manifested during the 8th Conference, which marked the establishment of the SUS. The objective of this conference was to further promote social control and participation in the health system. This message resonated among numerous groups and social movements, extending beyond the health sector, who converged in Brasília.

“It is impossible to consider social control and community health without the involvement of social movements. The former government remained inactive during the pandemic, but the social movements stepped up. If it weren’t for them, crucial issues like education, housing, and food would have been neglected,” emphasized Emanuela Nascimento from the Popular Communicators Network of Paulista, a city located in the Recife region.

“We witnessed the absence of public power during the pandemic. Our experiences with solidarity farming, not only throughout the pandemic but also in other situations such as the rains that affected various states, serve as examples of what we can accomplish. Caring, preserving, and nourishing is one of our mottos. That’s why no investigation committee will deter our fight,” added Alexsandra Rodrigues de Lima from the Landless Rural Workers’ Movement (MST), as she shared stories of solidarity from the capital of the Pernambuco State.

The memories of the pandemic remain vivid among the Brazilian people. They seldom attract the attention of the corporate media, which are caught in the gossip about alleged instability within the health ministry, while disregarding the ministry’s work. In contrast, at the conference, echoing the recent announcement that Jair Bolsonaro will not be able to run for office for the next eight years, participants chanted “ineligible” during breaks and at the beginning of discussions. This expressed the collective joy deeply ingrained in the hearts and minds of those who have experienced the practical brutality of Bolsonarism.

“We are talking about people who worked on the frontlines, witnessed people dying. I’m not only talking about health workers but also about other invisible workers who risked their lives to sustain the healthcare system. Cleaners, assistants, elevator operators, security guards… These workers also faced negativity and false information. We must acknowledge the efforts of many people, including those who are no longer with us,” said Ana Lúcia Paduello, who represented SUS users in the National Health Council.

Health policy is no longer limited to the realm of health experts, as it has been throughout history, including during the renowned 8th Conference, as acknowledged by those involved in preparing the National Health Conference. When we discuss social control, we are also discussing a societal project, recognizing that health is inseparable from the very essence of democracy.

“The past years have been marked by the massacre and the escalating process of displacing Indigenous peoples from their territories. In the current economic climate, it is the workers who protect the country. Participation and social control are the foundations of democracy. I live in the marine coastal reserve of Pará. We work with 122 thousand families, addressing health, education, and food. The verbs we employ most frequently are to recognize, determine, and guarantee. Our lives are shaped by three primary production relations: in the fields, in the forests, and in the waters. This is why we hold SUS in high regard in all its dimensions,” explained Célia Nunes das Neves, a popular educator from the vicinity of Oiapoque, which is one of the last frontiers of predatory capitalist development in Brazil.

As Rachel Gouveia Passos succinctly summarized, “The SUS is a result of a historic collective achievement. As repeatedly emphasized during the conference, ‘it is now time to radicalize democracy’”.

The report was written by Gabriel Brito and published in Portuguese on Outra Saúde.

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