Social participation and community-led responses to public health emergencies in Brazil, 2015–2025
1
Public Health Faculty, Universidade de São Paulo, Sao Paulo, Brazil
2
International Relations Institute, Universidade de São Paulo, Sao Paulo, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A3399
ABSTRACT
BACKGROUND:
Successive public health emergencies in Brazil, especially Zika virus disease and coronavirus disease 2019, exposed deep inequalities and institutional fragilities and catalyzed civil-society mobilization. This study maps and synthesizes the diversity, complexity and reported impacts of social and community responses to health emergencies in Brazil during 2015–2025.
METHODS:
We conducted an expanded systematic literature review in SciELO, Web of Science, and Dedalus/Universidade de São Paulo. Searches covered 2015–2025 (Portuguese, English, Spanish) and applied 24 descriptors related to social and community participation, civil society, and popular/community-based surveillance in emergencies. The search retrieved 1,721 records; 995 remained after deduplication. After blinded peer screening and full-text assessment, 85 documents composed the analytic corpus.
RESULTS:
The corpus was organized by the level of community protagonism into autonomous community responses, social responses involving public-authority institutions, and techno-scientific inspired responses. Across studies, community agency frequently substituted for or complemented insufficient state action and uneven access to the Brazilian Unified Health System, while collaboration between health-system and community structures enabled adaptation or design of responses in some contexts. Reported initiatives included solidarity kitchens and community gardens; community interventions in the Complexo da Maré were associated with a reported 46% weekly reduction in deaths; and rights-based advocacy, including strategic litigation in the Supreme Federal Court by the Articulation of Indigenous Peoples of Brazil and the Black Coalition for Rights, pressured recognition of state omission as a driver of racial and territorial inequities. Women were prominent across initiatives, while chronic reliance on philanthropy and leadership overload constrained sustainability.
CONCLUSIONS:
Community participation has been indispensable in Brazilian health emergencies, but resilience alone cannot ensure durable rights. Strengthening and legitimizing institutional, financial and normative linkages between the state and communities is essential for more equitable and sustainable preparedness and response to public health emergencies.
Successive public health emergencies in Brazil, especially Zika virus disease and coronavirus disease 2019, exposed deep inequalities and institutional fragilities and catalyzed civil-society mobilization. This study maps and synthesizes the diversity, complexity and reported impacts of social and community responses to health emergencies in Brazil during 2015–2025.
METHODS:
We conducted an expanded systematic literature review in SciELO, Web of Science, and Dedalus/Universidade de São Paulo. Searches covered 2015–2025 (Portuguese, English, Spanish) and applied 24 descriptors related to social and community participation, civil society, and popular/community-based surveillance in emergencies. The search retrieved 1,721 records; 995 remained after deduplication. After blinded peer screening and full-text assessment, 85 documents composed the analytic corpus.
RESULTS:
The corpus was organized by the level of community protagonism into autonomous community responses, social responses involving public-authority institutions, and techno-scientific inspired responses. Across studies, community agency frequently substituted for or complemented insufficient state action and uneven access to the Brazilian Unified Health System, while collaboration between health-system and community structures enabled adaptation or design of responses in some contexts. Reported initiatives included solidarity kitchens and community gardens; community interventions in the Complexo da Maré were associated with a reported 46% weekly reduction in deaths; and rights-based advocacy, including strategic litigation in the Supreme Federal Court by the Articulation of Indigenous Peoples of Brazil and the Black Coalition for Rights, pressured recognition of state omission as a driver of racial and territorial inequities. Women were prominent across initiatives, while chronic reliance on philanthropy and leadership overload constrained sustainability.
CONCLUSIONS:
Community participation has been indispensable in Brazilian health emergencies, but resilience alone cannot ensure durable rights. Strengthening and legitimizing institutional, financial and normative linkages between the state and communities is essential for more equitable and sustainable preparedness and response to public health emergencies.
| eISSN: | 2654-1459 |
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