[Public-private partnerships (PPPs) in the health sector: global processes and national dynamics].

This essay addresses several dimensions that promote and consolidate the growing participation by private stakeholders in the decision-making process in health, emphasizing international and domestic factors that have facilitated and sustained the persistence of the neoliberal political and ideological perspective over the course of nearly thirty years (since the 1990s). The article emphasizes the role of intergovernmental organizations in this process, highlighting public-private interactions at the global and domestic levels, with a specific focus on so-called public-private partnerships (PPPs). The working premise is that such linkages alter the power relations in policy formulation and implementation, with a predominance of private stakeholders. The article presents an overview of the development of PPPs in Europe, Latin America, and Brazil, identifying their specific origins and the simultaneity of triggering events. The text reiterates the importance of not overlooking the power of these actors in dislodging them from this political position, whether in multilateral organizations or national health systems. The aim is to emphasize the importance of more in-depth reflection on the subject, backing debates within the sector. This entire dynamic requires rethinking strategies of resistance to preserve the rights won through centuries of struggle.

[1]  A. M. Malik,et al.  Desafios na organização de parcerias público-privadas em saúde no Brasil. Análise de projetos estruturados entre janeiro de 2010 e março de 2014 , 2015 .

[2]  A. Calabrò,et al.  Public–Private Partnerships in the Health Care Sector: A systematic review of the literature , 2015 .

[3]  R. Labonté,et al.  Public–private partnerships (ppps) in global health: the good, the bad and the ugly , 2014 .

[4]  A. Bustamante,et al.  Health care privatization in Latin America: comparing divergent privatization approaches in Chile, Colombia, and Mexico. , 2014, Journal of health politics, policy and law.

[5]  Kelley Lee,et al.  The multiple meanings of global health governance: a call for conceptual clarity , 2014, Globalization and Health.

[6]  L. Viegas A reforma da Organização Mundial da Saúde: processo, tendências atuais e desafios (1998-2014) , 2014 .

[7]  C. Almeida Saúde, política externa e cooperação sul-sul em saúde: elementos para a reflexão sobre o caso do Brasil , 2013 .

[8]  F. Yepes Por qué la crisis multisistémica de la salud , 2013 .

[9]  D. Sridhar Who Sets the Global Health Research Agenda? The Challenge of Multi-Bi Financing , 2012, PLoS medicine.

[10]  Mariana Carrera Parceria público-privada na saúde no Brasil: estudo de caso do Hospital do Subúrbio de Salvador - Bahia , 2012 .

[11]  Mínistério da Saúde,et al.  Programa de Desenvolvimento Institucional do Sistema Único de Saúde Institutional Development Program of the Brazilian National Health System , 2011 .

[12]  J. Pereira O Banco Mundial e a construção político-intelectual do "combate à pobreza" , 2010 .

[13]  Christopher Kaan,et al.  Transnational Public-Private Partnerships in International Relations: Making Sense of Concepts, Research Frameworks, and Results , 2009 .

[14]  C. Hermann,et al.  Privatisation and Marketisation of Health Care Systems in Europe , 2009 .

[15]  G. Oliveira Parceria público-privada e direito ao desenvolvimento : uma abordagem necessária , 2005 .

[16]  K. Buse,et al.  Power to the Partners?: The politics of public-private health partnerships , 2004 .

[17]  S. Kamat The privatization of public interest: theorizing NGO discourse in a neoliberal era , 2004 .

[18]  Ó. A. Herrera El difícil camino desde el diseño a la implementación de las reformas de salud , 2004 .

[19]  G. Yamey Have the latest reforms reversed WHO's decline? , 2002, BMJ : British Medical Journal.

[20]  J. Nelson Building partnerships : cooperation between the United Nations system and the private sector , 2002 .

[21]  G. Walt,et al.  Global public-private partnerships: Part I--A new development in health? , 2000, Bulletin of the World Health Organization.

[22]  G. Walt,et al.  Global public-private partnerships: Part II--What are the health issues for global governance? , 2000, Bulletin of the World Health Organization.

[23]  Celia Almeida,et al.  Reforma do Estado e reforma de sistemas de saúde: experiências internacionais e tendências de mudança , 1999 .

[24]  J. Quick,et al.  Partnerships for health in the 21st century. , 1998, World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales.

[25]  Ajay Chhibber,et al.  The state in a changing world , 1997 .

[26]  Juan Luis Londoño Estructurando Pluralismo en los Servicios de Salud. La Experiencia Colombiana , 1996 .

[27]  Celia Almeida,et al.  Os modelos de reforma sanitária dos anos 80: uma análise crítica , 1996 .