Regionalization and the federative crisis in the context of the Covid-19 pandemic: deadlocks and perspectives

Abstract

Regionalization is a complex process conditioned by several factors, among them stand out inequalities and federative relations. In the context of the COVID-19 pandemic, these weaknesses in the federative and regional organization of SUS were exposed in an acute and accentuated way by a scenario of incoordination and dismantling of the institutional design conceived by the Federal Constitution of 1988. This essay aims to extract reflections about  strategies built at the municipal, regional and state levels to face the pandemic, as a response to the political and institutional crisis scenario, as well highlight as current and future challenges. The syntheses of the discussions held during the preparatory workshop and the debate table of the Fourth Congress of Policies, Planning and Health Management of Abrasco were used  about the theme of federative relations and regionalization in the scenario of the pandemic of COVID-19. Were observed absence of federal protagonism and the construction of delegated autonomy of subnational entities in the pandemic ; the relevance of some experiences of consortia and new partnerships with society; and the challenges and conditions of a new federative pact and of new formats and designs that are partner and supportive for the organization of the SUS.