After testing times, Brazil is back

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.”1

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.2

One of the most disturbing examples of the decay is the Brazilian national immunisation programme.3 After nearly half a century of progress, vaccination coverage of the population, including all World Health Organization recommended vaccines, dropped from 73% in 2019 to 67% in 2020 and 59% …