Revisiting the construction process of SUS: In search of a decolonial practice

Abstract

This article aims to revisit the process of building the Unified Health System (Sistema Único de Saúde - SUS) and analyze how it has been constructed and established as a decolonial practice, from its implementation to the present day. In this sense, we highlight some concepts presented by Maldonado-Torres (2018) as the basis for the present work, such as colonialism, modern colonialism, coloniality, decolonization, and decoloniality. Thus, analyzing SUS as a decolonial action implies observing a change in attitude throughout its history, a fundamental condition of antagonistic engagement with coloniality and in favor of decoloniality as a project. In this sense, decolonial action is essential to the decolonial project, and vice versa. To this end, the historical antecedents of the creation of SUS were analyzed, as well as its principles as practices of decoloniality. We observe, therefore, that the implementation of SUS can be considered a significant advancement. Even though it may be progressing slowly, it represents a decolonial strategy and action, especially by raising the need for an attitudinal change and listening to the one who has always been considered a secondary element in healthcare: the patient themselves.