This papers examines the Brazilian health policy during the 90's with a effective focus in the challenge posed by the implementation of the Sistema Único de Saúde (SUS). Among the main conclusions the work underlines the new role of the local administrations <FONT FACE=Symbol>¾</FONT> effectively managing budgetary resources and instruments<FONT FACE=Symbol>¾</FONT> nevertheless the huge problems emerging from the new rules of the system. The Federal Government, however, was empowered with new regulatory functions and could set up mechanisms to transfers responsibilities and resources to states and local government levels if these programs were linked to social activities. The decentralization program is governed by SUS operational rules, that are carried out in a country which federative model is still being defined and with a very centralized tax system.
State reforms; Health policy; Decentralization
