Challenges of Artificial Intelligence in the Management of Public and Private Health Services in Brazil: Between Innovation and Anticipatory Governance

Artificial Intelligence (AI) is rapidly transforming healthcare systems worldwide, offering unprecedented opportunities for efficiency, precision, and innovation. In Brazil, both the public sector - represented by the Unified Health System (SUS) and the private sector face unique challenges in adopting AI responsibly. This article critically examines the regulatory, ethical, and organizational dilemmas associated with AI in Brazilian healthcare, drawing on official reports from the World Health Organization (WHO), the Organization for Economic Co-operation and Development (OECD), FIOCRUZ, and the Brazilian Ministry of Health. Building on this author’s anticipatory governance framework, we propose a multi-level governance model that integrates foresight, participation, adaptability, and distributed accountability. The analysis demonstrates that while AI can enhance diagnostics, epidemiological surveillance, and patient management, its implementation risks amplifying inequalities unless robust governance mechanisms are established. Brazil’s recent entry into the Health AI international consortium and its leadership role in BRICS debates highlight a strategic opportunity to shape global standards. Ultimately, AI governance in healthcare must reconcile technological efficiency with democratic values, ensuring inclusivity, transparency, and equity.