Objective

This article carries out a balance of health promotion during the performance of the health system, starting from the constitutional reform of 1991.

Methods

It is part of a thematic review, in databases, Pubmed, Scielo, google scholar, through boolean terms and operators (health promotion or prevention) and (Colombia), in the last 10 years (2011 - 2021); and the legislation on health promotion of the last 30 years in Colombia, selecting the most relevant.

Discussion

The regulatory trajectory of public health, derived from Law 100 of 1993, is analyzed, highlighting the confusion between promotion and prevention occurred in the system. Various phases of public health development are discussed in this period, with major flaws in the first decade of the reform, improving after 2005 but without achieving its mission, given the contradictions with the market model that governs the system. It was not possible to develop the collective and community levels of health promotion, as well as the strategic perspective of primary health care (PHC).

Conclusion

Health promotion and prevention could not be fully developed in Colombia, despite the international environment prone to its implementation through primary health care. Many of the theoretical postulates of the legislation have remained in rhetoric and pending application, despite the broad regulatory framework that has occurred in these 30 years.