{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:00:31Z","timestamp":1785506431465,"version":"3.56.0"},"reference-count":41,"publisher":"FapUNIFESP (SciELO)","issue":"suppl 1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>The article analyzes health policies in Brazil from 2016 to 2022, a period marked by a shift in national politics and the COVID-19 pandemic. The study examines federal health policy management under the administrations of Michel Temer (2016-2018) and Jair Bolsonaro (2019-2022), considering the context, the political process, and policy content, as well as the different phases of the pandemic response. Drawing on historical institutionalism and the concept of critical juncture, the analysis explores continuities, changes, and disputes surrounding the Brazilian Unified National Health System (SUS). The study drew on document research, news articles, and the academic literature. The results indicate that the period was a critical juncture, with immediate and severe effects on policy implementation and the pandemic response. There were constraints on sectoral funding, setbacks in specific policies, institutional weakening, and forms of resistance within the state and society. During the period studied, no radical changes were observed in the direction of the Brazilian health system, due to structural factors, the institutional density of the SUS, competing policy agendas, the interaction of coalitions of actors with varied interests, or even the period\u2019s short duration. However, fully understanding the impact of this critical juncture, which is still recent, requires assessing its medium- and long-term repercussions at the global, regional, and national levels.<\/jats:p>","DOI":"10.1590\/0102-311xen228525","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:03:45Z","timestamp":1785503025000},"source":"Crossref","is-referenced-by-count":0,"title":["Health policies in Brazil (2016-2022): neoliberalism, pandemic, and threats to the Brazilian Unified National Health System"],"prefix":"10.1590","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9577-0301","authenticated-orcid":false,"given":"Cristiani Vieira","family":"Machado","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Fiocruz,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-8387","authenticated-orcid":false,"given":"Luciana Dias de","family":"Lima","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Fiocruz,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","DOI":"10.1590\/0102-311x00129616","article-title":"Pol\u00edticas de sa\u00fade no Brasil em tempos contradit\u00f3rios caminhos e trope\u00e7os na constru\u00e7\u00e3o de um sistema universal","volume":"33","author":"Machado CV","year":"2017","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1080\/10714839.2016.1228166","article-title":"Brazil's Neoconservative Offensive how right-wing forces coopted and redirected popular discontent in Brazil to oust democratically elected president Dilma Rousseff","volume":"48","author":"Fortes A","year":"2016","journal-title":"NACLA Report on the Americas"},{"key":"ref3","series-title":"Governo Bolsonaro: retrocesso democr\u00e1tico e degrada\u00e7\u00e3o pol\u00edtica","author":"Avritzer L","year":"2021"},{"key":"ref4","series-title":"O Brasil dobrou \u00e0 direita","author":"Nicolau J","year":"2020"},{"key":"ref5","series-title":"Limites da democracia: de junho de 2013 ao governo Bolsonaro","author":"Nobre M","year":"2022"},{"key":"ref6","series-title":"Cidadania em perigo: desmonte das pol\u00edticas sociais e desdemocratiza\u00e7\u00e3o no Brasil","first-page":"187","volume-title":"Direito Universal \u00e0 Sa\u00fade no Brasil: da expans\u00e3o restringida ao desmonte","author":"Lobato LVC","year":"2024"},{"key":"ref7","series-title":"Curto-circuito","author":"Carvalho L","year":"2020"},{"key":"ref8","series-title":"O grande recuo: a pol\u00edtica p\u00f3s-populismo e p\u00f3s-pandemia","author":"Gerbaudo P","year":"2022"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1590\/1413-81232018237.09192018","article-title":"Direito \u00e0 sa\u00fade e austeridade fiscal o caso brasileiro em perspectiva internacional","volume":"23","author":"Santos IS","year":"2018","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"ref10","series-title":"Evolu\u00e7\u00e3o do piso federal em sa\u00fade: 2013-2020","author":"Ock\u00e9-Reis CO","year":"2023"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.1590\/0102-311xen055023","article-title":"The response to COVID-19 in Argentina, Brazil, and Mexico challenges to national coordination of health policies","volume":"40","author":"Machado CV","year":"2024","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref12","series-title":"Making health policy.","author":"Buse K","year":"2012","edition":"2nd"},{"key":"ref13","series-title":"Explaining institutional change: ambiguity, agency, and power.","author":"Mahoney J","year":"2010"},{"key":"ref14","series-title":"The Oxford handbook of historical institutionalism","first-page":"89","volume-title":"Critical junctures","author":"Capoccia G","year":"2016"},{"key":"ref15","series-title":"Uma Ponte pra o Futuro."},{"key":"ref16","series-title":"Por que gritamos golpe? 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