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What explains the lacklustre response to Zika in Brazil? Exploring institutional, economic and health system context
  1. Eduardo J Gómez1,
  2. Fernanda Aguilar Perez2,
  3. Deisy Ventura3
  1. 1 Department of International Development, King’s College London, London, UK
  2. 2 Institute for International Relations, University of Sao Paulo, Sao Paulo, Brazil
  3. 3 School of Public Health, University of Sao Paulo, Brazil
  1. Correspondence to Dr Eduardo J Gómez; eduardo.gomez{at}kcl.ac.uk

Abstract

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.

  • Brazil
  • zika
  • health system
  • policy
  • foreign policy
  • diplomacy

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Footnotes

  • Handling editor Alberto L Garcia-Basteiro

  • Contributors EJ and FAP were the main authors of this study. FAP conducted most of the empirical analysis and data collection in Brazil, while EJ contributed to the political and institutional aspects. DV contributed to the section on Brazil’s relationship with the international community. EJ and FAP were mainly responsible for organising the overall structure of the article and coauthoring the sections.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data statement No additional data are available.