Towards a paradigm of humanity as a tool for producing comprehensive care in Primary Health Care

Abstract

As the main entry point to Brazil’s Unified Health System (SUS), Primary Health Care (PHC) is positioned as a privileged locus for ensuring health as a right for all Brazilians, by operationalizing the principles of universality, comprehensiveness, and equity. In striving to provide care that is truly comprehensive, context-sensitive, and capable of understanding the diverse processes of health and illness, PHC has sought to implement the biopsychosocial paradigm in place of the biomedical model. Forged within modernity/coloniality and the myth of Brazilian racial democracy, both the biomedical and biopsychosocial paradigms fail to recognize race as central to the construction of subjectivity and socialization, and to the role of racism — intersecting with other social markers of difference — in the processes of health, illness, and care. This article presents the paradigm of humanity as a tool capable of producing care that is deuniversalized, contextualized, attentive to health and illness processes, and oriented toward emancipation and well-being. This paradigm, co-produced by Black lesbian women, challenges the notion of humanity fabricated by modernity, which considers the white subject as human while dehumanizing Black and Indigenous peoples. It points toward pathways for a clinical practice that acknowledges the socio-racial diversity of illness and proposes care practices that break with the dehumanizing logic imposed by coloniality.