In 2022, Brazil completed 200 years of political independence in the midst of multiple and interconnected crises. Is there anything to celebrate? There is little room for rational optimism. We are currently faced with global health crises, climate emergencies, a decline in trust in science and democratic institutions, and a political and ideological attack against the state’s role in social protection and the production of well-being. The dossier From Independence to Empire: Health and Disease in Nineteenth-century Brazil is an academic and political act of commemoration, that is to say, an act of remembering together, critically, the challenges, continuities, and changes in public health in Brazil as it transformed from its status as a colony of Portugal to a sovereign country in 1822.

The history of healthcare in nineteenth-century Brazil provides some keys to better understanding public health in the twentieth century and its challenges in the twenty-first. It questions established views in Brazilian public health about the history and the “past” - often linear, unidirectional and evolutionary - and their search for “history lessons,” especially in political and public health crises such as epidemics and pandemics. The work of historians can make time and space the constituent elements of debates, processes, ideas, practices, policies, agents and institutions in the field of public health. This dialogue is explicit in this dossier and has been supported by Ciência & Saúde Coletiva¹1 Hochman G. História, ciência & saúde coletiva. Cien Saude Colet 2020; 25(12):4715-4721..

Until recently, the literature on the history of public health in Brazil focused on the twentieth century, especially the First Republic. Over the last decade, the public health history of the Imperial period has advanced in an original way, dialoguing with and renewing long-standing themes in Brazilian historiography. The articles in this dossier reflect this new trend that incorporates intellectual, political, social, and cultural history. Written by historians and social scientists from different institutions and regions, the articles provide a historical perspective on the multiple, decentralized facets of healthcare and public medicine in Imperial Brazil.

In particular, they address local and provincial experiences, the dynamics of medical, care and public health institutions, therapeutic eclecticism and medical pluralism, innovations such as the introduction of the smallpox vaccine, health professions and practitioners of traditional healing methods, physicians, pharmacists and nurses, epidemics and sanitary conditions in cities, medical and political debates about health and diseases, medical journalism, sanitary issues in the press, the etiologies of diseases and, above all, the human tragedy of slavery and the trafficking of enslaved Africans and its long-lasting impact on Brazilian society. The articles address the continuities and changes from the colonial experience in Portuguese America and the post-independence period through to the first decade of Republican Brazil.

In 1922, the year of the first centenary of independence, Brazilian intellectual and political elites celebrated modern Brazil, the civilized country, and a bright future. However, this imagined future required the erasure of a present and past characterized by violence, inequality and exclusion. In 2022, on the bicentenary of Brazil’s achievement of political sovereignty, reflecting on the history of public health in the nineteenth century Brazil is not just the production of more knowledge about the past. It is part of the fight for a better future.

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