Physician News · Brazil

Lula wins a fourth term in Brazil: what it means for the SUS

October 26, 2026 · Filipe Santos MD

Luiz Inácio Lula da Silva won Brazil’s presidential runoff on Sunday, October 25, 2026, defeating Senator Flávio Bolsonaro by nearly 4.4 million votes with every ballot counted. His fourth term begins on January 5, 2027. As a physician trained in Brazil’s public system, I read the result through one lens first: what it means for the SUS.

The result

Bolsonaro led the first round on October 4 with 47% to Lula’s 45%, short of the majority needed to win outright. Lula won the runoff three weeks later. Bolsonaro has not conceded: he has called for the vote to be annulled over a two-hour extension of voting ordered by a Supreme Court justice, and legal action may follow (PBS NewsHour; Al Jazeera).

What his plan promises for health

InfoMoney compared the two candidates’ health plans two days before the vote. According to its summary, Lula’s plan for 2027:

  • Waiting lists: expands Agora Tem Especialistas, the program that refers SUS patients for specialist consultations, exams and surgery, including to private providers, with third-shift clinic hours, more Carretas da Saúde mobile units and new mutirões.
  • Primary care: expands Mais Médicos, with incentives for doctors to stay in remote areas and training in family and community medicine.
  • One record for every patient: integrates primary, pharmacy and specialist care in a single citizen medical record, already being built on the Rede Nacional de Dados em Saúde, with results and appointments on the phone.
  • Vaccines: keeps the national immunization campaigns, adds new vaccines and invests in domestic vaccine production.
  • Older adults, women and mental health: expands home care for older adults, the Dignidade Menstrual program and long-acting contraception, targets maternal and infant mortality in rural areas, and expands care for gambling addiction.

“pretende ampliar programas vinculados ao SUS, como o Agora Tem Especialistas, para auxiliar na redução das filas” (he intends to expand SUS programs such as Agora Tem Especialistas to help shorten waiting lists)

InfoMoney, O que prometem Lula e Flávio para a saúde pública em 2027?, October 23, 2026

Five days before the runoff, on October 20, the Ministry of Health also announced a cancer package for the SUS: nine new medicines, R$ 4 billion a year, 400,000 FIT tests for colon cancer screening in 2026, and wider access to DNA-HPV testing for women aged 25 to 64 (TMC).

Why I see this as good news for the SUS

This is my view, not a forecast. Continuity matters in public health. Programs like Mais Médicos and Agora Tem Especialistas take years to recruit doctors, build referral networks and show results, and a change of government often means rebuilding them under a new name. Lula’s win keeps them running and, if his plan is delivered, makes them larger. Its priorities, primary care in the places that have the fewest doctors, shorter queues for specialists and one record that follows the patient, are the weak points anyone who has worked in the SUS will recognise.

A plan is not a result. What reaches patients depends on funding approved by Congress, on the states and municipalities that run most SUS services, and on how the dispute over the vote is settled. Those are the things to watch in 2027.

Why it is on this page

Brazil is one of the countries many internationally trained physicians in Canada come from, me included. Mais Médicos also matters to Brazilian graduates weighing whether to work in Brazil’s public system or to start the road to practice in Canada. If you trained in Brazil and Canada is the plan, Start Here shows the routes.

Sources

This is my reading of news reports and of a published summary of a campaign plan. The final result is certified by Brazil’s electoral court (TSE). See the disclaimer.