Construction of health policy in Brazil: a socio-historical analysis

Abstract

With the aim of recovering the process of formation and organization of the health reform movement in Brazil, this article portrays the construction of health policy in the period between the 1970s and the pre-constitutional movement. It is a historical study, based on a literature review and documentary analysis of the Proceedings of the 8th National Health Conference in 1986. The historiographical perspective adopted in this study seeks to present socio-historical elements that demonstrate which values, principles, institutions and lines of discourse were used when building the theoretical and social bases that mobilized the formulation of universal health policy. Despite the numerous publications on the constitution of the Unified Health System, the study's differential consists in showing that the construction of public policy took place in a down-up system, based on the mobilization of actors and institutions that built a line of debate based on the understanding that political mobilization and social actors should be done through the rational use of reasons, incorporating elements of historical materialism, in an action that broke with a solely sectoral debate and communicated with the demands of society as a whole. The arguments used to defend the construction of the right to health ended up influencing the understanding of democracy and the dimensions of rights that society wanted to build at that historical moment. Faced with the current scenario, in which studies show a distancing of social participation and new challenges for the consolidation of democracy, especially with regard to the damage caused by the spread of false health information, systematizing and revisiting the process followed by the health reform movement can point to some ways in which health can be understood as a social right and an integral part of a development project for the country.