Dialogando com os autores: concordâncias e controvérsias sobre atenção primária à saúde no Brasil

Abstract

The instigating article by Arthur Chioro and Luiz Cecilio, researchers that circulate comfortably and skillfully between training, administration, and research in the field of Collective Health, highlights several key issues in the debate on basic care/primary health care in Brazil. Without overlooking that the political struggle in the defense of the Brazilian Unified National Health System (SUS in portuguse), the right to health, and democracy is at the center of current concerns and that it precedes any debate in this restrictive political context, with dismantlement of the SUS, I will focus my remarks on reflections produced by the authors, which extend beyond the circumstantial boundaries of the ethical and political constraints we now face in the country.With good reason, I agree that it is necessary to overcome dogmatic and insufficiently (self)critical stances in what I call the space of primary health care in Brazil in order for us to make progress in consolidating an ethical and political project for "basic care" in Brazil. Our task at this juncture is not "to simply reproduce the principles and guidelines of the ambitious and generous basic health care proposal in Brazil (…), a health policy proposal which apparently suffers no outright opposition, at least in terms of its formulation and premises".The recourse to genetic analysis for the production of concepts is certainly an important strategy for an epistemological break to understand the phenomenon, namely, the process of building Brazil's primary care. This involves formulating policies for basic care, but also the movement of actors and disputes in this field, the gains and obstacles, and the set of epistemological and political agreements that were negotiated explicitly and implicitly among researchers and intellectuals constituting the scientific community, administration, and political activism working on various fronts, in institutional and academic spaces and in the sphere of social movements, in the struggles for the right to health and for organizational reforms.Therefore, the use of a genuinely Brazilian term -"basic care" -was justified and is defended by the authors as a function of the necessary distinction between a reductionist view that reproduces international experiences and formulations and basic care that "must not lose sight of comprehensive care, necessarily connected to networks of services with different technological levels".While it is true that in the sphere of the democratic and militant left in Brazil's Health Reform Movement, this debate originally produced a fertile discussion on the best primary care model for the SUS, it is also true that the adoption of such a model does not solve the conceptual and political problems in the dispute between different projects for primary care. Such disputes also prevail in the

Dimensionamento da força de trabalho na Atenção Primária à Saúde: modalidade de Ensino a Distância

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