Health is democracy: diversity, equity, and social justice

Abstract

This article is published in Open Access under the Creative Commons Attribution license, which allows use, distribution, and reproduction in any medium, without restrictions, as long as the original work is correctly cited."To generate active trust expert knowledge must be democratically validated. Indeed, scientific statements are now treated by the public as contestable propositional truths and this is why expert systems need to become dialogical. (...) What is at stake is the creation of active trust generating social solidarity among individuals and groups" (Chantal Mouffe 1 , p. 43).From November 21th to 24th, 2022, the 13th Brazilian Congress of Public Health ("Abrascão") occurred in Salvador, Bahia. The theme of the Congress was Health Is Democracy: Diversity, Equity, and Social Justice. Our choice of the phrase Health Is democracy was an intentional reference to Professor Sergio Arouca's speech at the opening of the 8th National Health Conference and Health Reform movement 2 . At times, turning to the past is essential to illuminate the future. Democracy is a very relevant subject to the Brazilian society and it properly fits the current moment, a time when the country's democratic forces have come together and elected a new government that will certainly resume the democracy, interrupted since the 2016 coup. The democratic backsliding was coupled with the COVID-19 pandemic, hardly striking the Brazilian society, largely because of the most absolute failure of the Executive branch. In this dramatic context, the reflections and debates initiated at the 8th Conference needed to be updated in last year's Abrascão.The inspiration sought at that remarkable moment in our country's healthcare history served to recall relevant issues for Public Health, among which the following stand out: the social determination of the health-disease process; the need to create and consolidate a health system that allows us to fulfill the idea that health is a right of all citizens to be guaranteed by the State; and the caveat that among the main problems to be faced are inequalities and inequities in exposure to disease risks and access to health services. All this emphasizes the urgency of ensuring respect for diversity and the ongoing struggle for social justice and equity.Horrified -and somewhat perplexed -we can see the timely glaring of the issues proposed in the historic conference. Since 2018, Brazil has experienced a far-right government, which purposely attacked democracy, promoted chaos, deteriorated resources, and denied and distorted science and persecuted its agents in many ways, aggravating these issues. The degree of attacks on rights, science, and life itself led different authors to call this government's actions as necropolitical, due to its ultra-neoliberal, antifeminist, racist,