ABSTRACT Objective: To discuss the political and structural conditions for establishing the Unified Health System (UHS – Sistema Único de Saúde, SUS) in coping with the SARS-CoV-2 pandemic. Methods: Theoretical-reflection study. Results: At the first moment named “The global and the local in facing the SARS-CoV-2 pandemic” is presented the health crisis that took place worldwide and the government actions to combat COVID-19. A second moment named “Between dismantling actions and resistance, the UHS is the best way to face the SARS-CoV-2 pandemic”, reflects on the neoliberal attacks on the health system and how it resists, remaining the main pandemic response strategy. Conclusion: The strengthening of democracy and the defense of the UHS are the way out of the crisis. It is believed that this reflection generates - in everyone who deals with caretaking - the political action, the ethical attitude, the desire for valorization and the spirit of struggle in defense of the UHS and human life.