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After testing times, Brazil is back
BMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p48 (Published 12 January 2023)
Cite this as: BMJ 2023;380:p48
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Deisy Ventura, professor of global health ethics
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deisy.ventura@usp.br
Synergy between public health system principles and foreign policy must be resumed

The return of Luís Inácio Lula da Silva as president represents an opportunity for Brazil to rebuild its public health system (SUS) and resume its leadership in global health, relaunching cooperation with the global south. However, President Lula will face even greater challenges than those in his previous presidency (2002-10), considering that Brazilian public health was recently described by experts as “scorched earth.”

Since 2016, the national health services have experienced relentless cuts in public funding. This has led to substantial decreases in the number of services provided by SUS, an increase in indicators of child malnutrition and maternal deaths, and the downgrading or withdrawal of successful programmes such as people’s pharmacies, community health agents, and the response to HIV/AIDS.