Legal Basis of Brazil’s SUS
Constitution of 1988
Article 196
Health is everyone’s right and a duty of the State, guaranteed through social and economic policies aimed at reducing the risk of diseases and other health problems, and ensuring universal and equal access to programs and services for its promotion, protection, and recovery.
Legal and Regulatory Foundations
- Organic Health Law No. 8080 of 09/19/1990
- Law No. 8142 of 12/28/1990
- Basic Operational Norms (NOB) established in 1991, 1992, 1993, and 1996
- Constitutional Amendment No. 29, 09/13/2000
- Operational Norm of Health Care Noas-SUS 01/2001
- Operational Norm of Health Care Noas-SUS 02/2002
- Pact for Health (2006)
Law 8080
Law 8080, enacted in 1990, known as the Organic Health Law, defined the functions and powers of each level of government.
It provides for the conditions for the promotion, protection, and restoration of health, and addresses State Constitutions, Organic Laws, and Municipal regulations regarding the organization and functioning of relevant services.
Principles of SUS – Law 8080/90
- Universality
- Comprehensiveness
- Equity
- Decentralization
- Regionalization
- Hierarchy
- Community Involvement
Law 8142/90
- Complements Law 8.080/90;
- Defines the role of Health Conferences and Health Councils;
- Establishes community participation in system management and financing;
- Resources from the National Health Fund are transferred regularly and automatically to states and municipalities, provided the municipalities have: the Municipal Health Fund, the Municipal Health Plan, an Annual Management Report, and a Municipal Health Council.
Health Fund
A method for managing resources, created by law to be the sole recipient of all resources allocated to health.
Municipal Health Plan
Basic instrument reflecting intentions and outcomes to be pursued, covering all areas of health to ensure the comprehensiveness provided by SUS.
- Situational analysis;
- Definition of objectives, guidelines, and targets for a four-year period.
Annual Management Report
- GM/MS No. 3.332/06
- Monitoring and evaluation of the Annual Health Plan, based on results obtained compared to the proposed Plan.
- Results of indicator calculations
- Analysis of implementation schedule (physical and budgetary/financial)
- Approval by the Municipal Health Council.
Municipal Health Council
- Deliberative character
- Composition of the Council:
- 50% users of health services,
- 25% service providers,
- 25% health professionals,
- Approval of the Municipal Health Plan; Training and performance; Control strategies for implementing health policy (including financial resource control).
The Role of Health Counselors
- Counselors need to be well-informed, seeking information about the health budget. They need to understand amounts collected, budgeted amounts for health, and how spending is managed and controlled;
- Must also review and deliberate on annual management reports submitted by managers to the health councils;
- It is imperative that councils have budget and/or finance committees tasked with constantly monitoring the evolution of public health budgets. This monitoring involves verifying reports, expenditure documents (commitments, invoices, resource transfers, etc.), and even bank statements of public accounts;
- For any questions regarding the application of public resources, health counselors have an obligation to seek clarification from the manager. If doubts are not resolved or if there is evidence of irregularities, complaints must be submitted to the competent bodies: the Legislature, Audit Courts, Public Prosecution Service, or courts of justice;
- Health councils, through their leaders and members, must always articulate socially and politically as widely as possible. Therefore, it is necessary to foster relationships with media outlets, public institutions, authorities, and various leaders to promote the strengthening of social control spaces.