Porto Alegre, Rio Grande do Sul State, Brazil, November 2012: the closing assembly of the 10th Brazilian Congress of Collective Health passed a motion to hold the 11th edition of the congress, better known by the superlative nickname “Abrascão ”, in Goiânia, capital of the Cerrado (or savannah). Brazil's recent municipal election returns had already been announced and suggested an upsurge by the country's political Left. President Dilma Rousseff was halfway through her first term of office.

In the second round of the subsequent national elections, President Rousseff was elected to a second term by a narrow margin, only 3.28%. This was the closest Presidential reelection in Brazil since the end of the dictatorship, although in 1989 Fernando Collor de Mello had been elected to his first and only term by a narrow margin: 7.08%. What followed is still very much alive in the minds of Brazilians and will certainly merit a special chapter in the country's history.

Widespread dissatisfaction and disapproval of the Administration were accompanied by signs of the Brazilian people's growing estrangement from traditional partisan politics. The National Congress also showed its inability to organize, lead, or even catalyze responses to the people's demands.

The huge grassroots demonstrations in 2013 preceded the Presidential elections and laid bare a profound and as yet unresolved crisis in the country's system of political representation, emphasizing the need for new forms of political organization.

The demonstrations expressed the search for new models to reclaim democratic representation and establish some coherence between Congress and the voice of the streets, conditioning action by the Federal, State, and Municipal Executive Branches on the people's needs and putting civil society back into the political arena. The task is daunting in such confusing times, and with such limited resources.

By all accounts, the spirit of 2013 still echoes in the air. The recent 11th Brazilian Congress of Collective Health took place in this scenario. Even though the political discussion was already present during preparations for the congress, any certainty prior to the event would have been nothing more than an exercise in future-telling.

During a first preparatory seminar in Pirenópolis, Goiás, in February 2014, we combined organization of the themes for our 11th Congress with a proposal for strengthening the 15th National Health Conference. This explains why the congress (traditionally held in mid-December) was scheduled earlier than usual, at the end of the midyear school holidays in late July, which also coincided with the season of low hotel occupancy rates in Goiânia.

Inspired by the role of the health reform movement and rallying cries like “health and democracy” in the 1970s and 80s, which were decisive for reclaiming Brazilians' right to democratic choice, Brazilian Association of Collective Health (Abrasco's) Board of Directors and various departments and committees chose the theme for this year's congress as Health, Development, and Democracy: the Challenge for a Universal Health System .

The decisions that oriented the organizational steps were based on a clear proposal: to share with the various working groups and commissions the definition of themes and guest speakers for the 118 round tables and conferences and the organization of oral communications, veritable colloquiums of researchers, health professionals, and students. In a total of 479 sessions, 3,509 papers were presented, in addition to 60 courses and workshops.

We left this congress with renewed strength and energy, decisive for maintaining the founding principles of the Brazilian Unified National Health System (SUS) and strengthening the country's democracy.

The SUS has come under serious attack. The attackers wager on misinformation, the crisis, and the market's siren call in healthcare. They insist on medicalization as the source for new public and private financing.

The forums of the Abrasco have proven their capacity to exert decisive influence on health policies. During edition of our congress, held on the eve of the 15th National Health Conference, we gathered strength for this time of struggle and new democratic victories.

Elias Rassi Neto
Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás.
eliasrassi@gmail.com

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