Name: Welington Serra Lazarini
Type: PhD thesis
Publication date: 27/11/2018

Namesort descending Role
Francis Sodré Advisor *

Examining board:

Namesort descending Role
Francis Sodré Advisor *

Summary: This thesis analyzed the relationship between the World Bank and Brazil and its developments in health policies between 2003 and 2014, during which the country was governed by three consecutive administrations led by the Partido dos Trabalhadores. The theoretical premise starts from the imposition context made by the current stage of capitalism to poor countries, among them Brazil, which aims to make the structuring of social policies more flexible, threatening important achievements, such as the Unified Health System. The study is articulated under three axes of analysis: partnership strategies between the World Bank and Brazil and their influence on health policies, projects funded by the World Bank for the Brazilian health sector, and the relationship between health policy formation in the Brazil and its relationship with the World Bank's poverty coping agenda. We proceeded with the documentary research to obtain the results. The analysis material is from the vast output of the World Bank, such as books, partnership contracts, recommendations, reports and project contracts. The documents highlighted the objectives of the contracts, the bank's contribution, the main challenges to be faced by the country in each period, as well as the risks presented. With regard to health, the main proposals for the sector have focused on directing health services to the poorest populations, strengthening attention to chronic diseases, reducing costs and developing the private sector. Their partnership, however, has never been aimed at contributing to overcoming the inequalities that afflict a large part of the population. Of the 174 projects financed in the country, 31 contemplated the health sector in its composition, being 64.53% of these signed with the state governments. Most of the health projects were signed in the second Lula government and the main structuring themes were: Human Development and Gender, Public Sector Management and Private Sector Development. It was found that there was a centrality of projects around the fight against poverty, while social policies occupied a secondary place in this agenda. In this process, the World Bank approached states and municipalities, expanding the spread of its state reform agenda, and reinterpreting structuring concepts of the Brazilian health system. This movement denoted the World Bank's ability to identify global changes in progress, particularly those stemming from the realignment of geopolitical and economic forces in the world. Thus, it is possible to affirm that the World Bank not only maintained but broadened its interest and influence in Brazil at the beginning of the 21st century

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