Chapter 1 Section 2

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November 20, 2021

Article 196. Health is a right of all and a duty of the State and shall be guaranteed by means of social and economic policies aimed at reducing the risk of illness and other hazards and at the universal and equal access to actions and services for its promotion, protection and recovery.

Article 197. Health actions and services are of public importance, and it is incumbent upon the Government to provide, in accordance with the law, for their regulation, supervision and control, and they shall be carried out directly or by third parties and also by individuals or private legal entities.

Article 198. Health actions and public services integrate a regionalized and hierarchical network and constitute a single system, organized according to the following directives:

  1. decentralization, with a single management in each sphere of government
  2. full service, priority being given to preventive activities, without prejudice to assistance services
  3. participation of the community.

Paragraph 1. The unified health system shall be financed, as set forth in article 195, with funds from the social welfare budget of the Union, the states, the Federal District and the municipalities, as well as from other sources.

Paragraph 2. The Union, the States, the Federal District, and the Municipalities shall apply each year, to health actions and public services, a minimum amount of funds derived from the application of percentages calculated upon the following:

  1. in the case of the Union, in the manner defined under the terms of the supplementary law provided for in paragraph 3;
  2. in the case of the States and of the Federal District, the proceeds from the collection of the taxes mentioned in article 155 and of the funds mentioned in articles 157 and 159, item I, subitem a, and item II, after deducting the portions remitted to the respective Municipalities;
  3. in the case of the Municipalities and of the Federal District, the proceeds from the collection of the taxes mentioned in article 156 and of the funds mentioned in articles 158 and 159, item I, subitem b, and paragraph 3.

Paragraph 3. A supplementary law to be revised at least every five years shall establish:

  1. the percentages referred to in paragraph 2;
  2. the criteria for the sharing of funds of the Union earmarked for health and assigned to the States, the Federal District, and the Municipalities, and of funds of the States assigned to their respective Municipalities, with a view to a progressive reduction of regional disparities;
  3. the rules for supervision, assessment, and control of expenditures on health at the level of the Union, the States, the Federal District, and the Municipalities;
  4. the rules to calculate the amount to be applied by the Union. Paragraph 4. The local managers of the unified health system may hire community health workers and endemic disease control agents by means of a public selection process, taking into account the nature and complexity of their duties and the specific requirements of their activity.

Paragraph 5. Federal legislation shall provide for the legal regime, a nationwide professional minimum salary, the guidelines for Career Schemes, and the regulation of activities of community health workers and endemic disease control agents, and it shall be incumbent upon the Federal Government, under the terms of the law, to provide supplementary financial support to the States, the Federal District, and Municipalities, to achieve compliance with said minimum salary.

Paragraph 6. In addition to the cases set forth in paragraph 1 of article 41 and in paragraph 4 of article 169 of the Federal Constitution, an employee whose activities are equivalent to those of a community health worker or an endemic disease control agent may be dismissed if he does not comply with the specific requirements stipulated by law for such activities.

Article 199. Health assistance is open to private enterprise.

Paragraph 1. Private institutions may participate in a supplementary manner in the unified health system, in accordance with the directives established by the latter, by means of public law contracts or agreements, preference being given to philanthropic and non-profit entities.

Paragraph 2. The allocation of public funds to aid or subsidize profit-oriented private institutions is forbidden.

Paragraph 3. Direct or indirect participation of foreign companies or capital in health assistance in the country is forbidden, except in cases provided by law.

Paragraph 4. The law shall provide for the conditions and requirements which facilitate the removal of organs, tissues and human substances for the purpose of transplants, research and treatment, as well as the collection, processing and transfusion of blood and its by-products, all kinds of sale being forbidden.

Article 200. It is incumbent upon the unified health system, in addition to other duties, as set forth by the law:

  1. to supervise and control proceedings, products and substances of interest to health and to participate in the production of drugs, equipments, immunobiological products, blood products and other inputs

  2. to carry out actions of sanitary and epidemiologic vigilance as well as those relating to the health of workers

  3. to organize the training of personnel in the area of health;

  4. to participate in the definition of the policy and in the implementation of basic sanitation actions;

  5. to foster, within its scope of action, scientific and technological development;

  6. to supervise and control foodstuffs, including their nutritional contents, as well as drinks and water for human consumption;

  7. to participate in the supervision and control of the production, transportation, storage and use of pschycoactive, toxic and radioactive substances and products;

  8. to cooperate in the preservation of the environment, including that of the workplace.


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