Health, class struggle and the ‘ghost’ of the Brazilian Sanitation Reform: notes for history and criticism

Abstract

The political process of the modern Brazilian Sanitation Reform has been haunted by a phantom  since its beginning, in the 1970s: the so-called ‘ghost  of the absent class’, which intends to designate the  little participation of the masses in the fights and  claimings for health. Brazilian sanitarists had the  popular participation experience of the Italian  Sanitation Reform as a reference and it was precisely  from it that emerged a certain strangeness to the  Brazilian case. The history of the phenomenon,  however, is inscribed in the dilemmas experienced by  the Brazilian working class as a whole, which was  under a process of strategic transition then. We conclude that the organizational and  combative retreat of the class is part of the historical  defeat suffered when the socialist block fell, in the  turn of the 1980s. The overcoming of both the defeat  and the phantom will only be accomplished through  the resumption of the struggle from the base,  crossing sectoral boundaries and breaking with the  fetishization of the State as a means to the full  emancipation of the workers; and through the  restoration of the bourgeois ‘democratic’ order as a  rightful locus of political struggle.