PT  - JOURNAL ARTICLE
AU  - Gómez, Eduardo J
TI  - The international and domestic politics of type 2 diabetes policy reform in Brazil
AID  - 10.1136/bmjgh-2020-002457
DP  - 2020 Sep 01
TA  - BMJ Global Health
PG  - e002457
VI  - 5
IP  - 9
4099  - http://gh.bmj.com/content/5/9/e002457.short
4100  - http://gh.bmj.com/content/5/9/e002457.full
SO  - BMJ Global Health2020 Sep 01; 5
AB  - Introduction Understanding the international and domestic political factors influencing the evolution of type 2 diabetes policies and primary care institutions is a new area of scholarly research. This article contributes to this area of inquiry by illustrating how a government’s shifting foreign policy aspirations, that is, to establish the government’s reputation as an internationally recognised leader in type 2 diabetes policy, and presidential electoral incentives provide alternative insights into the evolution of type 2 diabetes treatment policies and primary care institutional reforms.Methods I conduct a single-case study analysis with the usage of qualitative data; quantitative statistical data on epidemiological trends and government policy spending is also provided as supportive evidence.Results The case of Brazil illustrates how a reduction in foreign policy commitment to international reputation building in health as well as presidential electoral incentives to use diabetes policy as an electoral strategy account for a decline in sustaining policy and primary care institutional innovations in response to type 2 diabetes.Conclusion Future scholars interested in understanding the lack of sustainability and effectiveness in type 2 diabetes programmes should consider investigating the complex international and domestic political factors influencing political interests, incentives and commitment to reform.