Políticas de saúde integral da população negra: necropolítica, tensionamentos e caminhos para a equidade racial em Belém.

Abstract

The National Comprehensive Health Policy for the Black Population (PNSIPN) has been in force since 2009 by the Ministry of Health and is a SUS policy. However, there are still few Brazilian municipalities that have implemented it in their territories, which ratifies the relevance of institutional and structural racism in the country. In this context, necropolitics as a political project of the State and a philosophical-analytical category, helped to understand how a healthdirective was structuring the Brazilian nation-state and the technique of eugenics was at the service of death management. Through colonial practices, the state of exception and the racialized enemy, the conditions were created to manage and make live in worlds of death, updating the notions of humanity, citizenship and instituting ways of being. This research aimed to analyze how necropolitics structured the tensions around the implementation of the Municipal Health Policy for the Black Population in Belém. It started from the Epistemology of Black Feminist Thought and intersectionality was the methodology used to organize the Mixed Method (MM) of qualitative and quantitative research in which the documents were analyzed; Municipal Health Plan (2002-2025) and the Multiannual Plan (2022-2025), analysis of the information present in the MUNIC / IBGE and a statistical survey (individual registration e-SUS / AB, IBGE, DataSUS, SIM / SINASC Monitoring Panel) in dialogue with theoretical references in the field of health of the black population. Thus, it was demonstrated from the e- SUS/AB (2022) registers of the municipality that 475,113 individuals were black (black + brown), 73,509 white, 12,691 yellow and 659 indigenous, and the black population was the one that most claimed to have hypertension and diabetes (prevalent diseases in the race), has the highest rate of maternal and infant mortality from preventable causes and, even so, Belém did not implement the Municipal Health Policy of the Black Population. It was concluded that, even though blacks were the majority of active citizens in the municipal health system, the technique of eugenics forged whitening as an emergency exit to Brazilian mestizaje and, in Belém, it gained an air of "morenity". This process paved the way for the existence of the myth of racial democracy that uses the denial of racism in society and uses the equality of individuals when differences are mobilized in the sense of plurality, respect and power present, for example, in the denunciations and demands of black movements and black women for affirmative policies such as the PNSIPN. The city of Belém experienced progress with the installation of the Intersectoral Working Group on the Health of the Black Population in 2022, but it is necessary to situate the actions within the scope of State public policies in order to promote racial equity in health, reaffirming blackness in the Belenense Amazon.