Health reform strategic issues: the development of the third sector

Abstract

There is an extensive literature dedicated to analyzing health reform in Brazil during the last two decades. However, very little has been written on how the intersectorial configuration affects the Brazilian health system. With a very weak non-profit sector (the so-called third sector), governmental institutions and the market are the two significantly recognized sectorial forces driving the country’s social, political, ideological, cultural, and financial
macro-relationships. This paper discusses the intersectorial relationships, configuring health as a social enterprise and contextualizing the third sector in the social economy, particularly in relation to public health. It examines historical aspects of the third sector’s birth and growth, especially in the US, and argues that the development of an independent third sector is
strategic for the continuous development of Brazil’s Unified Health System, recognizing a variety of social, political, and economic challenges for its establishment. A strong third sector, politically independent and inserted as a protagonist and not merely as a supporting actor in the social economic and cultural scene is crucial to the implementation of a new social pact that
can significantly contribute for social progress in Brazil.