The decline of Brazil in the global health field: Rupture, loss, and reversal of leadership in the international health agenda

Abstract

The implantation of a public system of universal access to care has been the most significant contribution from the health sector to Brazil's democratization, and its diffusion through foreign policy raised the country to a status as a global health leader. Yet, the rise of a far‐right government impinges a fracture upon this dual process, through the renunciation of leading roles in both regional and wider progressive initiatives. Based on documental and literature analysis guided by exploratory interviews with global health agents, this article introduces the actors responsible for the alignment between foreign policy and the Unified Health System principles and demonstrates that a significant retrenchment of diplomatic activity paved the way for the renunciation of protagonism in progressive agendas. The process began with the shutdown of Unasur Health and public opposition to the sexual and reproductive rights agenda and culminated in the felonious emptying of technical cadres from the Ministry of Health and the change of position on intellectual property issues related to public health during the Covid‐19 pandemic.

After testing times, Brazil is back

“…Opposition to women’s sexual and reproductive rights has been a critical element in Brazil’s foreign policy in recent years. It has defended conservative agendas, abandoning its historical role as a leader of progressive causes in global health 11. The new government is expected to rapidly resume the former synergy between the principles of SUS and its foreign policy, defending agendas such as the limitation of intellectual property rights in favour of public health and an emphasis on the social determinants of health.…”

Utopia interditada: APS como antídoto contra a desdemocratização e a necropolítica neoliberal

“…Colocou-se em curso uma necropolítica neoliberal e conservadora na medida quem que se estabeleceu uma teia de ações e omissões sistemáticas e planejadas do Estado no campo da saúde pública 57 que faz "morrer determinados grupos sociais de um modo legalmente justificado e, de certa forma, silencioso" 56(77) , implicando, inclusive, a perda de liderança do Brasil na saúde global 53 .…”