[Political challenges facing the consolidation of the Sistema Único de Saúde: a historical approach]

This article investigates the circumstances in which Brazil’s sanitation reform was conceived and the Sistema Único de Saúde (SUS) was constructed. A brief analysis is conducted of Brazil’s political transition to democracy, focusing on three political challenges facing the consolidation of SUS: its weak support base amongst workers, competition with the private sector, and the fragmentation of its administration caused by its municipalization. Finally, the changes in the scenario caused by the weakening of neoliberalism since the 2008 crisis, the reemergence of a multipolar political scenario internationally, and the financing conditions of the Brazilian State are described.