SUS 30 anos: Vigilância Sanitária

Abstract

This article presents an overview of the nature, functions and history of health surveillance in the structure of the Brazilian Unified Health System (SUS). Bibliographical sources and official documents were used, with references from the careers of the authors, who have worked in health surveillance. Extremely serious adverse events in the mid-1990s gave political visibility to the fragility of Brazilian health surveillance, and were reflected in serious problems for the SUS. The creation of Anvisa and the SNVS surveillance system, and the support for bodies in individual states and municipalities, resulted in improvement in the structure and functioning of health surveillance, and improved recognition of the area as an emerging theme in research and education in public health. Several problems hamper the effective structuring of the SNVS. A change in the conception/design of health promotion is postulated, in which the large corporations, whose activities have strong connections with risk factors related to the current epidemic of chronic diseases, would be given a social responsibility. A set of challenges for better structuring of health surveillance in the SUS is also put forward.

Sanitary Conditions of Primary Health Care Services from the perspective of Sanitary Surveillance

“…However, the FG contributed to the identification of problems related to the work process of sanitary surveillance professionals in relation to the strategies for risk minimization in the health services studied that presented a difficult articulation of municipal management with sanitary surveillance. This points to the need to make efforts to broaden and discuss the importance of communication about risks in the formation of health conscience that reaches the users of health services, but also sensitize the professionals of the PHC and of sanitary surveillance with consistent scientific arguments to support the technical performance of sanitary surveillance professionals so that they can confront the interests that often weaken health relationships in different contexts of health systems (Silva, Costa, Lucchese, 2018). It is also necessary to take care not to accept actions of sanitary surveillance that disregard the complexity of the actions that occur in PHC services, based on the perspective that the actions have a lower technological density.…”

“…According to the National Primary Health Care Policy, one of the responsibilities common to all spheres of government is: "to guarantee the adequate infrastructure and good conditions for the operation of basic health units (BHU), guaranteeing space, furniture and equipment, as well as the accessibility of persons with disabilities, in accordance with current norms" (Brasil, 2017). In this context, the Health Units as care spaces must be in conditions that guarantee the safety and quality of care, and they are therefore subject to sanitary norms and are included in the scope of Sanitary Surveillance, given their function as the responsible institution for the protection, control and reduction of health risks (Silva, Costa, Lucchese, 2018). Sanitary Surveillance as it is institutionally organized in Brazil has no equivalent systems in other parts of the world, although the regulatory activities are universal practices (Costa, Souto, 2014;Silva, Costa, Lucchese, 2018).…”

“…In this context, the Health Units as care spaces must be in conditions that guarantee the safety and quality of care, and they are therefore subject to sanitary norms and are included in the scope of Sanitary Surveillance, given their function as the responsible institution for the protection, control and reduction of health risks (Silva, Costa, Lucchese, 2018). Sanitary Surveillance as it is institutionally organized in Brazil has no equivalent systems in other parts of the world, although the regulatory activities are universal practices (Costa, Souto, 2014;Silva, Costa, Lucchese, 2018). In what concerns the performance in health services, sanitary surveillance can be considered a specific component of this system, since its action requires a set of knowledge and practices of a diverse, multiprofessional and interinstitutional nature without which the health services could not fulfill their main role of providing comprehensive health care to users (Costa, Souto, 2014;Teixeira, Souza, Paim, 2014).…”

“…As part of SUS, the NSSS operates in an integrated, decentralized manner and with shared responsibilities in the three spheres of government. This agency, therefore, represented an advance in the organization of sanitary surveillance actions; "it can be said that since its creation, the performance of NSSS entities has been greatly improved, with personnel qualification, better physical structure and other resources of control and sanitary surveillance" (Silva, Costa, Lucchese, 2018, p.1956). However, the NSSS faces challenges, as for example the present contradictions between the economic interests and the health interests that are established by the characteristics of the objects under its competence (Teixeira, Souza, Paim, 2014).…”

Os desafios atuais da luta pelo direito universal à saúde no Brasil

“…Concerning health protection, the performance of actions through the National Health Surveillance System has improved, although con-trol problems persist for large corporations, including food, tobacco and agrochemicals, whose activities are linked to risk factors related to the epidemic of chronic diseases 10 .…”