Brazil’s free health care network is now 35 years old
Brazil’s Unified Health Care System – the SUS – is now 35 years old. According to the Ministry of Health, the network has become the largest free, universal public health care system in the world.
Created on September 19, 1990, the SUS was a historic achievement of the 8th National Health Conference, held back in 1986, and was formalized in the 1988 constitution, which defined health care as a right for all Brazilians and a duty of the state.
“Before the SUS, only formal workers registered with social security had access to care in public hospitals. In practice, only 30 million people benefited.” For the rest of the population, the alternative was charity, philanthropic services, or direct payment. Today, the entire population has the right to medical care.
As it stands today, 76 percent of the Brazilian population – out of a total of 213.4 million people – depend directly on the SUS, as per official data. Consultations total 2.8 billion every year, involving 3.5 million professionals.
Action
Among the ministry’s highlights in the SUS is the Estratégia Saúde da Família (“Family Health Care Strategy”). Launched in 1994 with a focus on primary care, the initiative has teams across all regions of Brazil.
Its efforts include prevention, diagnosis, and treatment in basic care units and remote and riverside areas, as well as street clinics and clinics in indigenous territories.
The ministry further pointed out that Brazil now boasts the world’s largest public transplant network. In 2024, the country set a new record in the SUS, with 30 thousand procedures performed. The network also provides immuno-suppressive drugs for transplant patients.
Furthermore, the SUS has the largest public vaccination program in Latin America – the Programa Nacional de Imunizações (“National Immunization Program”). In it, 48 immuno-biologicals are available, including 31 vaccines, 13 serums, and four immunoglobulins.
“These actions have contributed to milestones such as the eradication of polio in 1994 and more recent achievements, such as the re-certification of the country as measles-free by the Pan American Health Organization,” the ministry stated.
Brazil was also a pioneer in offering a vaccine against dengue fever. Today, children and adolescents aged 10 through 14 receive the vaccine.
“In 2023, the federal government resumed its agenda for the strengthening of the economic and industrial health care complex, with measures to reduce Brazil’s dependence. In ten years, 70 percent of the SUS’ needs for medicines, equipment, and vaccines are expected to be produced domestically,” the ministry added.
Challenges
Among the historical challenges, the ministry noted, is the waiting time for care in the public health network. The government hopes to address this issue through the Agora Tem Especialistas (“Specialists Available Now”) program, which focuses oncology, cardiology, gynecology, orthopedics, ophthalmology, and ENT.
Another goal is the expansion of telehealth, which can reduce waiting times for specialized care in the SUS by up to 30 percent and is one of the program’s pillars. Data show that 2.5 million telehealth consultations were recorded in 2024.
To expand the system, the government plans to deliver new basic health units, teleconsultation rooms, mobile dental units, polyclinics, maternity wards, psycho-social care centers, and ambulances.
