Our permanent tasks: Health, Democracy and Socialism

3 Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (Ensp) – Rio de Janeiro (RJ), Brasil. WHILE THESE LINES ARE BEING WRITTEN, Brazil has reached 18 million cases of Covid-19 and has just broken the barrier of 500,000 deaths from the disease. The President of the Republic makes jokes, encourages crowds, discourages vaccination. The year 2020 ended with the country back on the United Nations’ Hunger Map: 60% of Brazilian households in a situation of food insecurity, 15% in a situation of severe food insecurity – hunger itself1. June 2021, almost 15 million unemployed, of which about 3.5 million for more than two years2. The Minister of Economy declares that the Brazilian middle class wastes food and proposes that the leftovers be collected to feed the population; and those who have no income because the economy has stopped is a bum, the elderly should die, among other atrocities. In addition, vigorously maintains the fiscal austerity policy celebrated by editorials of the big press and by the big capital administered on Avenida Faria Lima, São Paulo’s ‘Wall Street’. Day in, day out, the President insults the institutions of the Republic, insults the press and encourages social conflicts by attacking civil rights; and continues on his bellicose attempt to encourage the distribution of weapons and indiscipline in the Armed Forces and police forces. He organizes motorcycle rallies in the fashion of Mussolini and anticipates that he will not accept the results of the 2022 elections if he is defeated. On the other hand, although the impeachment requests still do not prosper, there is already a growing resistance from conservative segments to the excesses of the government. In May and June, despite the pandemic, the streets were filled with popular demonstrations calling for the President to be ousted, vaccines, and an end to austerity. Political and party alternatives for the 2022 general elections are widely discussed. This resumption requires us to revisit our permanent agenda to better guide our intellectual and militant action in the current situation. In its latest theses (2017-19)3, the Brazilian Center for Health Studies (Cebes) recorded

WHILE THESE LINES ARE BEING WRITTEN, Brazil has reached 18 million cases of Covid-19 and has just broken the barrier of 500,000 deaths from the disease. The President of the Republic makes jokes, encourages crowds, discourages vaccination. The year 2020 ended with the country back on the United Nations' Hunger Map: 60% of Brazilian households in a situation of food insecurity, 15% in a situation of severe food insecurity -hunger itself 1 . June 2021, almost 15 million unemployed, of which about 3.5 million for more than two years 2 . The Minister of Economy declares that the Brazilian middle class wastes food and proposes that the leftovers be collected to feed the population; and those who have no income because the economy has stopped is a bum, the elderly should die, among other atrocities. In addition, vigorously maintains the fiscal austerity policy celebrated by editorials of the big press and by the big capital administered on Avenida Faria Lima, São Paulo's 'Wall Street'.
Day in, day out, the President insults the institutions of the Republic, insults the press and encourages social conflicts by attacking civil rights; and continues on his bellicose attempt to encourage the distribution of weapons and indiscipline in the Armed Forces and police forces. He organizes motorcycle rallies in the fashion of Mussolini and anticipates that he will not accept the results of the 2022 elections if he is defeated.
On the other hand, although the impeachment requests still do not prosper, there is already a growing resistance from conservative segments to the excesses of the government. In May and June, despite the pandemic, the streets were filled with popular demonstrations calling for the President to be ousted, vaccines, and an end to austerity. Political and party alternatives for the 2022 general elections are widely discussed. This resumption requires us to revisit our permanent agenda to better guide our intellectual and militant action in the current situation.
In its latest theses (2017-19) 3 , the Brazilian Center for Health Studies (Cebes) recorded [...] growing tension between capitalism and democracy. At the moment, there is a radicalization of such tension, which appears as the greatest challenge in the context of the democratic deficit expressed by the global process of disorganization of post-war social democracies.
Around the world, billionaires saw their wealth increase, in the middle of the pandemic, by an astonishing $3.9 trillion between March 18 and December 31, 2020. Their total wealth is now $11.95 trillion, which is equivalent to what G20 governments spent in response to the pandemic in 2020. As the world's biggest billionaires continue to accumulate wealth, people living in A utopia do debate democrático na Vigilância em Saúde Our permanent tasks: Health, Democracy and Socialism poverty become poorer as a result of the crisis caused by the pandemic. Recent estimates show that the number of people living on less than $5.50 a day could increase between 200 million and 500 million by 2020.
In Brazil, the number of billionaires leaped 44% -from 45 in 2020 to 65 in 2021. Together, they hold US$ 219.1 billion, approximately R$ 1.2 trillion -almost the Gross Domestic Product (GDP) of the Country. During the pandemic period, this wealth almost doubled; $127.1 billion last year, an increase of 71 percent.
Death merchants also saw their fortunes increase. The net profit of health insurance operators grew 49.5%, to R$ 17.5 billion in 2020, according to data from the National Agency for Supplementary Health (ANS). This market closed the year with 47.6 million users, representing an increase of 650,000 people. The sector's revenue reached R$ 217 billion, an increase of 4.7%. From Forbes magazine's 2021 list of the 10 largest Brazilian billionaires, three are health traders.
What emerges from the health, economic and social crisis in Brazil, devastated by neoliberalism led by a far-right government that sets an authoritarian suicidal state in motion around nothing, is a disturbing reality. The picture, with no chance of being hidden, is that the majority of the population that inspired and is the object of the discourse and struggle for justice and human rights is not their subject. The undeclared civil war that the country has always lived through and naturalized, genocides and massacres and the accumulation of capital, guaranteed by bullets and fear, emphasizes Safatle 4 .
As Noronha et al. 5 put it: [...] it is then necessary to question the future through the bewilderment of Brazil, explicit in this historical moment, ruled by a delirium of surrender to sacrifice and incites the people's applause to their tormentors, who do not care about the death of others. What affections would be capable of mobilizing changes in this context, in which a distant and weakened solidarity is called for, and at the same time, so requested by the dramality of this moment of such disgrace and impotence on the part of everyone?
No economic, social or health measures will be sufficient without reversing the way capitalist society is; economic growth as a linear equation does not do the trick. However, the crisis is not just economic or sanitary, it is energy, food and ecological. These are the morbid symptoms announced by Gramsci of the old man who has not yet perished in the hegemony crisis 5 .
Humanity is at the crossroads of socialism or barbarism, or "barbarism if we're lucky", as updated by Mészáros 5 . The pattern of production, distribution, accumulation and consumption that exists today in European and North American nations is not reproducible for all the people of the world. It is necessary to update and put on our horizon the construction of new economic and social relations that restore the horizons of better health, democracy and socialism, so that we understand the movements and tactical alliances that must be undertaken in the Brazilian situation for the defeat of bolsonarism and its alliances with the retrograde and colonized bourgeoisie.
The Cebes has to increase its militancy in academic, political and street spaces. Since the recomposition of the representation of the so-called 'scientific community' in the National Health Council (CNS), it has solidified its coordinated action with the Brazilian Association of Collective Health (Abrasco), Rede Unida (United Network), the Brazilian Society of Bioethics, and the Brazilian Association of Health Economics (Abres). It had a prominent role, along with those entities, in the elaboration, in 2020, of the National Plan to Combat Covid, delivered to the health authorities and to the National Congress, in addition to wide public dissemination, Corrêa Filho HR Noronha JC, Souto L consolidated in the creation of the Frente pela Vida (Front for Life). It played a relevant role in the CNS in the fight for health financing and for the repeal of Constitutional Amendment 95.
Together with popular movements, it participates in the Frente Brasil Popular (Popular Brazil Front) and the Frente Povo Sem Medo (People Without Fear Front). Since December 2020, it has started a series of virtual debates with political, health, and popular leaders to support the daily struggle for the defeat of the fascist and neoliberal government that haunts the country.
Cebes is always fighting! Health, Democracy and Socialism!