Contribution short abstract:

This research explores tensions between epidemiological surveillance and primary care in syphilis control in Brazil, based on a study with health professionals. It examine how integrality—a constitutional principle framing health as a common good—is applied in syphilis care work processes.

Contribution long abstract:

Syphilis has been classified as an epidemic in Brazil since 2015, representing a significant public health challenge. This persistence is particularly striking given the availability of diagnostic tests, and the accessibility of its effective treatment—penicillin, a low-cost and easy-to-administer drug. In Brazil, the response to syphilis is guided by the constitutional principle of integrality, which frames health as a Common Good. This principle emphasizes holistic care and fosters intersectoral articulation within the healthcare network.

This study explores the concept of integrality in syphilis control strategies in Brazil, focusing on the tensions between epidemiological surveillance and primary health care. This is post-doctoral research carried out in the field of public and collective health. Qualitative fieldwork was conducted using observations, semi-structured interviews, and focus groups with health professionals from a city in the metropolitan region of Porto Alegre, the capital of Rio Grande do Sul, Brazil’s southernmost state.

The research aims to understand the dynamics between these two sectors of the Brazilian health system, exploring their cooperation, conflicts and frictions. It investigates how integrality is understood and practiced in the work processes of syphilis care. The data produced reveals that while primary health care focuses on immediate individual cases under an emergency logic, epidemiological surveillance adopts a collective monitoring perspective. These differing temporalities make integrality a fragile and transient process in the health system's daily practices. Health as a Common Good depends not only on a public and universal system, but also on a coordinated one.