@article{fdi:010074143,
  title = {{D}ecentralisation of {B}razil's {HIV}/{AIDS} programme : intended and unintended consequences},
  author = {{F}rasca, {T}. and {F}aur{\'e}, {Y}ves-{A}ndr{\'e} and {A}tlani {D}uault, {L}a{\¨e}titia},
  editor = {},
  language = {{ENG}},
  abstract = {{B}razil's response to the {HIV}/{AIDS} epidemic was characterised by an innovative alliance of governmental and non-governmental actors inspired by a strong progressive tradition in public health. {B}razil eventually moved to decentralise {HIV}/{AIDS} programmes to its states and cities, a policy endorsed and supported financially by the {W}orld {B}ank as consistent with the mix of public and private elements central to the country's {HIV}/{AIDS} strategy. {H}owever, decentralisation has not provided the results anticipated. {T}hrough interviews with key informants, government officials and patient advocates as well as observation of treatment sites, we outline how the shift of administration and resources to state and municipal bodies operated in practice. {T}he {B}ank promoted decentralisation as an uncontroversial technical matter, and its programmatic guidelines implied that the nonprofit sector would be strengthened by it. {H}owever, instead of bringing {HIV}/{AIDS} policy closer to the grassroots, decentralisation has undermined the country's early work and opened the door to a rejuvenated epidemic by empowering unsympathetic local elites, marginalising the human rights focus, and removing federal oversight. {I}ts experience holds crucial lessons for developing countries facing similar conditions.},
  keywords = {{HIV}/{AIDS} ; {B}razil ; decentralisation ; health systems ; {W}orld {B}ank ; {BRESIL}},
  booktitle = {},
  journal = {{G}lobal {P}ublic {H}ealth},
  volume = {13},
  numero = {12},
  pages = {1725--1736},
  ISSN = {1744-1692},
  year = {2018},
  DOI = {10.1080/17441692.2018.1455888},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074143},
}