ABSTRACT:
Since its establishment, Brazil’s Unified Health System (SUS) has recognized health information as a foundational component of health system governance, planning, surveillance and social accountability. Health information systems have been conceived not merely as technical tools, but as core instruments to support universality and equity. Over more than three decades, Brazil has developed a comprehensive public architecture for health information, digital health and telehealth, coordinated by the Ministry of Health, positioning the country as a relevant reference among Global South nations. This trajectory includes the institutionalization of national health information systems—such as mortality, live births, hospital and outpatient databases—managed under DEMAS/DATASUS and publicly accessible through platforms like TABNET. These tools have strengthened transparency, social control and secondary use of data for research and policymaking. The nationwide digitalization of primary health care through e-SUS APS further enhanced longitudinal care monitoring and supported performance-based financing and evaluation mechanisms. More recently, the Digital Health Strategy for Brazil 2020–2028 and the establishment of the National Health Data Network (RNDS) consolidated national guidelines for interoperability, data governance and information security. Telehealth has been institutionalized as a public policy through the Telehealth Brazil Networks Program and integrated into primary health care to address regional inequalities, support clinical decision-making and strengthen workforce capacity. Evidence from official reports and scientific studies indicates increased primary care resolutiveness and reductions in unnecessary referrals. During the COVID-19 pandemic, the RNDS enabled nationwide integration of data on cases, testing and vaccination, supporting epidemiological surveillance and coordinated response across Brazil’s vast territory. Despite persistent challenges—including digital divides, data quality and workforce training—the Brazilian experience demonstrates that digital transformation can be deliberately aligned with equity, transparency and health system strengthening. These findings provide concrete and transferable lessons for Global South countries seeking to leverage health information and digital public infrastructure within universal health systems.