Integrated, participatory, and territorialized health surveillance in contexts of exposure to agrotoxics in Brazil

ABSTRACT The damage caused by agrotoxics to health is underestimated by the National Health Surveillance System, both in terms of registration and investigation, and health care. In particular, there is underreporting of acute cases, rare reports of chronic effects, and virtually no diagnosis of the impact of agrotoxics on reproductive health in urban, rural, Indigenous, Quilombola, and riverine communities, and also population groups living in urban peripheries - areas marked by poor environmental sanitation and severe epidemiological problems linked to arboviruses, that are poorly addressed by an ineffective, chemical-dependent vector combat model. In response to ABRASCO’s Reproductive Health and Agrotoxics project, a workshop was held during the 9th SIMBRAVISA. The methodology brought together 70 participants from diverse disciplinary and institutional backgrounds to discuss how health surveillance should be conducted to tackle the severe public health crisis caused by the high consumption of agrotoxics in Brazil. Building on the evaluation of this process, this essay aims to deepen and update these discussions amid the current health crisis resulting from the ongoing deregulation of Brazil’s agrotoxic legal framework and to propose a new model of health surveillance grounded in participatory, democratic, integrated, and territorialized actions and deliberative processes.