Perspective HEALTH INEQUITIES AND THE BUILDING OF THE UNIFIED HEALTH SYSTEM

Brazil’s public health system was created in the 1930s and grew signifi cantly between 1964 and 1986 during the military regime. However, in the 1980s the system became the focus of important criticisms, particularly that it did not provide universal coverage; too many resources were allocated to highly complex procedures instead of primary care; and richer regions had more resources, facilities, and services. In sum, richer citizens living in better-off regions had much better access to the public health system.[1,2] In 1988, with the return to democracy, a new constitution, known as the “Citizen’s Constitution, ” declared health a universal right of citizenship and replaced the old public health system with the Unifi ed Health System (SUS, its Portuguese acronym).[3] The creation of the SUS refl ected the aspirations of a national and international movement for ‘health for all ’ and for a system that integrated local, state and national levels, as well as preventiv