[Community participation and control of endemic diseases in Brazil: problems and possibilities]

Community participation (CP) is considered one of the most important elements for the control of endemic diseases in poor countries, particularly for prevention and epidemiological surveillance. Mainly affecting the poorest segments of the population, endemic diseases are costly and require specific government action aimed at efficient, egalitarian, universal health system, where CP acts in a guardian, monitoring capacity and entails other specific tasks. Despite its rationality, CP has not been encouraged in countries like Brazil, due to the highly centralized nature of political power and activity. Several examples and situations of CP in Brazilian endemic diseases are described and discussed in the article. CP for endemic disease control should be seen as an ongoing social process, a profound social exercise, and a great challenge for the country as a whole and the new Unified Health System now being implemented in Brazil.