Movimento da Reforma Sanitária Brasileira na conjuntura 2013-2020: resistência e revitalização.

Abstract

Studies on the Brazilian Health Reform (RSB), as a socio-historical phenomenon, indicate that the adoption of neoliberal economic policies from the 1990s onwards imposed restrictions on the consolidation of social policies based on universalist principles, negatively impacting the construction of the SUS and hindering the advancement of the Brazilian Health Reform Movement (MRSB). In this process that has worsened in recent years, especially after the days of June 2013, and the strengthening of a group of conservative social forces, the issue of the relationship between democracy and health has been placed back at the center of the political debate. Thus, taking the MRSB as its object, the present study started from the following question: what is the composition, positioning and forms of action of the MRSB in the Brazilian sociopolitical scenario in the period 2013-2020? The general objective is to analyze the composition, positioning and forms of action in the political process in Health in the 2013-2020 situation. The specific objectives are: to characterize the Brazilian sociopolitical scenario; describe the process of articulation of the political subjects that make up the MRSB; analyze the MRSB's political project, comparing the original project with the current one; describe and analyze the MRSB's positions and forms of action in the face of the State's action/omission in the conduct of policy and the public health system; and analyze the perception of MRSB leaders regarding the 2013-2020 situation and its repercussions on the political praxis of the health movement. The construction of the theoretical framework started from the understanding of the RSB as an idea, proposal, project, movement and process, highlighting, firstly, the definition of “political project”, to situate the sociopolitical project of the MRSB in terms of the confrontation between different development projects economic and social and, especially, in relation to the projects in dispute in Health in the situation under study. Next, the concept of “social movements” was reviewed according to the theoretical perspective of Maria da Gloria Gohn, seeking to define the specificity of the MRSB in terms of its composition, positioning and forms of action, given the facts and events that marked the situation. in study. Finally, a brief review of the concept of praxis was systematized, central to the analysis of the forms of action of the entities that make up the MRSB in this period. Regarding the methodology, the data sources were documents produced by the entities that make up the MRSB and interviews with 15 key informants linked to it. The processing of the empirical material was carried out on two levels: understanding the MRSB and the space it occupies in the sociopolitical context under study, through seven analytical categories selected based on the methodological proposal for analyzing social movements developed by the aforementioned author, namely: 1. Composition, 2. Sociopolitical project, 3. Organization, 4. Practices, 5. Opponents, 6. Sociopolitical scenario and 7. Achievements and defeats. All ethical requirements contained in National Health Council Resolutions No. 466/12 and 510/16 were met. The analysis of the MRSB's praxis comprised its performance at the interface between the State and civil society, specifically taking into account the advances and setbacks in the implementation of its project and the political practices (praxis) vis-à-vis its various allies and opponents, also identifying, the achievements achieved and defeats suffered. The results highlighted the vitality of the MRSB in the period 2013-2020, even though its activities were characterized by different practices and levels of intensity, given the challenges of the sociopolitical scenario, which also stimulated its revitalization. Furthermore, the MRSB reaffirmed the principles established in its original project, updating its proposals and action strategies, although it did not achieve hegemony, maintained in the hands of forces linked to the neoliberal project.