O artigo mostra que crise e reforma são temas recorrentes nas últimas três décadas de funcionamento da Organização Mundial da Saúde (OMS). Após breve apresentação da Organização, os principais elementos de sua crise são identificados, graças à revisão da literatura e à pesquisa documental. A seguir, o artigo arrola sinteticamente os resultados de pesquisa empírica sobre as temas relacionados à reforma, incluídos nas pautas da Assembleia Mundial da Saúde, de 1998 a 2014. Adiciona-se uma breve alusão às posições do Brasil e da União Sul-Americana de Nações (Unasul) sobre a crise e a reforma em tela. Na conclusão, questiona-se se tal reforma poderia tornar a OMS uma espécie de "enclave cosmopolítico" na complexa configuração da saúde global.
By early-2016, the international community began to pressure Brazil for a stronger policy response to Zika. In contrast to what was seen in the past, however, these international pressures did not elicit such a response. In this article, we explore why this was the case, reviewing the government’s policy response and the broader political and economic context shaping this response. The authors used single case study analysis and qualitative sources, such as books, journal articles, and government policy reports to support their empirical claims. We found that despite increased international pressures from the WHO, domestic political factors and economic recession hampered the government’s ability to strengthen its health systems response to Zika. Consequently, those states most afflicted by Zika have seen policy initiatives that lack sufficient funding, administrative and human resource capacity. This study revealed that despite a government’s deep foreign policy history of positively responding to international pressures through a stronger policy response to health epidemics, a sudden change in government, rising political instability, and economic recession can motivate governments to abandon this foreign policy tradition and undermine its response to new public health threats.
Recently, health has become a point of interest for International Relations analysts. In terms of economics, security and social justice issues, health is being debated as part of countries' foreign policy formulation. Brazil, for example, recognizes the importance of health as part of its foreign policy, being a signatory of the Oslo Ministerial Declaration (2007) on Foreign Policy and Global Health, and having included the theme across various international negotiation contexts, both bilateral -for instance, in South-South Cooperation with African States -and multilateral -with the Union of South-American Nations or with the India, Brazil and South Africa Dialogue Forum. Moreover, since health is a constitutional right in Brazil, the country already possesses a legal framework which encompasses the development of international health cooperation. By establishing the concept of structured cooperation for health, Brazil emphasizes cooperation that strengthens the sanitary institutions of different countries. The main objective of this study is to analyze whether there is a specific foreign policy on health in Brazil in the period from 2003 to 2014, exploring the components, actors and principles of which it is made. Additionally, there will be an attempt to understand if Brazil's international action in the field of health converges with the principles of the country's own Unified Health System. Actors are mainly institutions part of either the MoH or MoFA. Regarding constituent elements and principles, certainly solidarity, universal health care, knowledge sharing and cooperation with global South countries were the bricks of all Brazilian actions in this Health Foreign Policy. There is also a deep commitment to the idea of structuring cooperation for health
This article analyses changes and continuities in Brazilian international actions in the field of public health, aiming at understanding how the Brazilian foreign policy in health during President Dilma Rousseff's first term (2011-2014) was developed. Available data from President Luiz Inácio Lula da Silva (2003-2010) years and Dilma's first term were used for comparative purposes. Emphasis was given on South-South cooperation projects, more specifically the Union of South American Countries (USAN, Unión de Naciones Suramericanas - Unasur) and to the Community of Portuguese-speaking Countries (CPLP). Brazilian behavior in international fora, such as the World Health Organization, was analyzed as well, with the purpose of understanding how such behavior evolved. In addition, domestic issues were considered. In this case, the coordination among different actors of the Brazilian Executive Power received due attention. Findings suggest that there has been downfall and even decline in the Government's foreign health policy.
Fortes, pela orientação, pelas conversas que acabavam por se tornar aulas magistrais sobre diversos temas relevantes da saúde pública, pelo apoio, pelo incentivo e, principalmente, por me ajudar a perseguir meus sonhos e meus objetivos. À Daniele Sacardo, pelo carinho, pela atenção, pelas conversas e dicas que sempre me ajudaram tanto e foram fundamentais para a construção desta dissertação.
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