PHC funding over time: inducement, expansion, and qualification of the family Health Strategy Model

Primary Health Care (PHC) is a foundational pillar of Brazil's Unified Health System (SUS) and is crucial for ensuring the constitutional principle of access to universal health. The historical trajectory of federal funding for the implementation of the different allocation models reflects a movement of both convergence and divergence from the original conception of PHC. In 2020, the implementation of the Previne Brasil Program brought this debate to the forefront, as its detrimental effects on the priority model of the National Primary Care Policy, the Family Health Strategy (FHS), became evident. However, starting in 2023, with a new federal government, the parameters for federal co-funding of PHC were reformulated. This momentum of change materialized in 2024 with the publication of a new budgetary allocation arrangement for PHC, through the Ministry of Health Ordinance No. 3,493/2024. Therefore, this article aims to discuss the historical evolution of how the concept of PHC has been implemented within SUS through different allocation models in order to debate the recent impacts of the Previne Brasil Program, and to analyze the proposed changes in the new 2024 model. The ultimate goal is to highlight the current challenges in funding PHC to strengthen the priority model of the National Primary Care Policy, the FHS.