A política de emprego no Brasil e no Chile: a permanência da pobreza e do desemprego / An employment policy in Brazil and Chile: an end to poverty and unemployment

Este artigo é resultado de uma pesquisa documental sobre as políticas de emprego no Brasil e no Chile no período de 2013-2018. Trata-se de uma análise comparativa sobre as políticas supramencionadas e, embora algumas particularidades do desenvolvimento do capitalismo em ambos os países, os resultados nos permitem considerar que a política de emprego está submetida a uma lógica comum, pois seguem parâmetros propostos pelas agências multilaterais e estão subordinadas à dinâmica de crescimento econômico fundomonetarista. Portanto, configuram-se como medidas paliativas, mantendo a pobreza e a desigualdade social como traço marcante na formação social dos países em tela

This article is the result of a documentary survey conducted about on employment policies in Brazil and Chile in the period 2005-2017. The result of this research is that the employment and income policy is subject to a common logic, since they follow parameters proposed by the multilateral agencies and are subordinated to the dynamics of economic growth. Therefore, they are seen as palliative measures, maintaining poverty and social inequality as a striking feature of our social formation

The global HIV response at 40

It is helpful to divide the global HIV response into three phases: The first, from about 1980 to 2000, represents "Calamity". The second, from roughly 2000 to 2015 represents "Hope." The third, from 2015, is unfolding and may be termed "Choices" ­ and these choices may be severely constrained by COVID, so "Constrained Choices in an era of COVID" may prove more apt. As we take stock of HIV at 40, there are positive lessons for the wider health response ­ and challenging reflections for the wider impact of the global HIV response. The positive lessons include: (1) the importance of activism; (2) the role of scientific progress and innovation; (3) the impact of evidence in concentrating resources on proven approaches; (4) the importance of surveillance to understanding transmission dynamics; (5) the use of epidemic intelligence to guide precision implementation; (6) the focus on implementation cascades (diagnosis, linkage, adherence, disease suppression); and finally (7) an overarching execution and results focus. Given this remarkable legacy, it seems churlish to ask whether the HIV response could have achieved more. yet, consider these approximate figures. Development assistance for HIV totals about 100 billion dollars, 70 billion from the USA matched by roughly 100 billion in domestic resources. For 200 billion dollars, should we not have achieved more than 23 million people initiating treatment (very crudely, 10 000 dollars per person on treatment)? Much of the hundred billion dollars of development assistance (roughly half) focused on about a dozen priority countries in eastern and southern African. The larger PEPFAR recipients, with populations of roughly 50 million, each received 5 billion dollars or more cumulatively. And there are further Global Fund contributions of an additional billion dollars in many of these countries. For 6 billion dollars per country, should we have expected more? The World Bank Human Capital Project posits that to maximize human capital formation, countries must ensure that their children survive, are well nourished and stimulated, learn skills and live long, productive lives. Using the Human Capital Index (a composite index based on these factors), South Africa ­ the largest HIV financing recipient ­ ranks 126th of 157 countries, below Haiti, Ghana, the Congo Republic, Senegal and Benin. Consider how many recipients of major HIV development finance fall into the bottom fifth: Namibia, Botswana, Eswatini (formerly Swaziland), Malawi, South Africa, Tanzania, Zambia, Uganda, Lesotho, Ethiopia, Mozambique, Cote D'Ivoire and Nigeria. Of course, causality is unresolved and there are several possible explanations: (1) low human capital formation may increase HIV transmission; (2) the HIV epidemic may have intergenerational impacts; (3) the all-consuming focus on HIV may have displaced other health, education and development priorities. yet, it remains hard to see these data and to argue that successful HIV responses among the largest HIV financing recipients strengthened their wider health sector and human development outcomes. A plausible principle emerges. Narrowly targeted disease-specific emergency responses may lead to disease-specific gains but do not improve governance or national systems capacity or wider disease or development outcomes. This is not to undermine the emergency origins of the HIV response; 2021 is not 2000 and it is unlikely that we would have 23 million people initiating treatment without an emergency response. yet, there are reasons (intensified by COVID), to suggest that we must pivot towards long-term, integrated, developmental, nationally owned and financed, systems-orientated responses ­ particularly when both development assistance and national budgets are likely to be constrained in an era of COVID.

Acordos de empréstimo para AIDS e a Política de Incentivo no Sistema Único de Saúde: avanços e lacunas / Loan agreements for AIDS and the National Health System Incentive Policy: advances and gaps

Resumo Introdução No Brasil, os acordos de empréstimo e a Política de Incentivo foram fundamentais para a gestão descentralizada da política de aids, entretanto poucos estudos avaliaram os seus efeitos no âmbito do Sistema Único de Saúde (SUS). Objetivo Analisar a implementação das ações programáticas em DST/Aids no país e no estado de São Paulo quanto aos avanços e lacunas dos acordos de empréstimo com o Banco Mundial e a implantação da Política de Incentivo vigente no SUS. Método Estudo de caso, retrospectivo-descritivo, baseado em análise documental e entrevistas em profundidade com seis coordenadores das três esferas governamentais e dois presidentes do Fórum Estadual de ONG/AIDS de São Paulo. Resultados Identificaram-se diferentes graus e distintas formas de operacionalização da política de aids, demarcadas por períodos de centralização das decisões e do financiamento no "Projeto AIDS I", seguida pela desconcentração administrativa no final do "Projeto AIDS II" e, finalmente a descentralização com a Política de Incentivo, transferindo responsabilidades e recursos em consonância aos princípios do SUS. Conclusão Não obstante os avanços da gestão descentralizada, fragilidades constatadas no processo de monitoramento e avaliação das ações podem comprometer a sustentabilidade técnico-financeira da Política de Incentivo no SUS.

Abstract Background In Brazil, loan agreements and the Incentive Policy were fundamental to decentralize the management of the AIDS policy; however, few studies have evaluated their effects within the scope of the National Health System (NHS). Objective To analyze the implementation of programmatic actions related to STD/AIDS in the country and in the state of São Paulo regarding the advances and gaps of the loan agreements with the World Bank and the implementation of the NHS Incentive Policy currently in force. Method A retrospective descriptive case study based on documentary analysis and in-depth interviews with six coordinators from three governmental levels and two presidents of the State Forum for NGO/AIDS in São Paulo. Results Different degrees and forms of operationalization of the AIDS policy were identified; they are marked by periods of centralization of decisions and funding in the "AIDS Project I", followed by administrative decentralization at the end of the "AIDS Project II" and, finally, decentralization brought about by the Incentive Policy, which transfers responsibilities and resources in line with NHS' principles. Conclusion Despite the progress of decentralized management, weaknesses along the process of monitoring and evaluation of actions may compromise the technical and financial sustainability of the NHS Incentive Policy.

Water and the death of ambition in global health, c. 1970-1990 / A água e o fim da ambição na saúde global, c. 1970-1990

Abstract Economic development and good health depended on access to clean water and sanitation. Therefore, because economic development and good health depended on access to clean water and sanitation, beginning in the early 1970s the World Bank, the World Health Organization (WHO), and others began a period of sustained interest in developing both for the billions without either. During the 1980s, two massive and wildly ambitious projects showed what was possible. The International Drinking Water Supply and Sanitation Decade and the Blue Nile Health Project aimed for nothing less than the total overhaul of the way water was developed. This was, according to the WHO, "development in the spirit of social justice."

Resumo Crescimento econômico e boa saúde dependem de acesso a saneamento e água limpa. Assim, o Banco Mundial, a Organização Mundial da Saúde (OMS) e outros órgãos, a partir do início da década de 1970, inauguraram um período de contínuo interesse no desenvolvimento de ambos para bilhões de pessoas desprovidas de tais necessidades. Durante a década de 1980, dois projetos monumentais e extremamente ambiciosos demonstraram o que era viável fazer. A International Drinking Water Supply and Sanitation Decade e o Blue Nile Health Project visavam à total reestruturação do modelo de desenvolvimento da água. Tratava-se, segundo a OMS, do "desenvolvimento do espírito de justiça social".

O Índice de Capital Humano: um desafio para o Brasil / The Human Capital Index: a challenge for Brazil

Resumo O artigo discute o Índice de Capital Humano (ICH) proposto pelo Banco Mundial em 2018 para avaliar o desempenho das áreas de saúde e educação de 157 países. A situação do Brasil é comparada com sociedades com sistemas de proteção social institucionalizados. Demonstra-se que a condição do Brasil no ICH é sofrível em função do baixo desempenho do setor educacional e da falta de controle da violência sobre os jovens.

Abstract The article analyzes the Human Capital Index (HCI) proposed by the World Bank in 2018 to evaluate the performance in the health and education sectors of 157 countries. Brazil's situation is compared to societies with institutionalized social protection systems. It reveals that the condition of Brazil in HCI is deficient due to the poor performance of the education sector and the lack of control of violence against young people.

Banco Mundial, reforma dos Estados e ajuste das políticas sociais na América Latina / The World Bank, state reform, and the adjustment of social policies in Latin America

Resumo Este artigo analisa brevemente os pontos centrais da agenda do Banco Mundial para a reforma dos Estados nacionais na América Latina, no período de 1980 a 2017. O texto se baseia em documentos do próprio Banco Mundial e na literatura especializada. Inicialmente, apresenta alguns aspectos relevantes da história do Banco Mundial e de sua configuração como organização multilateral. A seguir, discute o papel da instituição na promoção de programas de ajuste estrutural das economias da região durante a década de 1980, baseado numa agenda hipermercadista. Após, aborda o processo de renovação e ampliação da agenda política do Banco do final dos anos 1990 em diante, calcado na manutenção do ajuste macroeconômico, na promoção de reformas institucionais e no combate à pobreza extrema. Por fim, discute as linhas centrais da agenda do Banco de reforma das políticas sociais, entre as quais a de saúde.

Abstract This article briefly analyses the central points of the World Bank's agenda for the reform of national states in Latin America, between 1980 and 2017. The text is based on World Bank documents and specialized literature. Initially some relevant aspects of the history of the World Bank and its configuration as a multilateral organization are presented. Next, it discusses the role of the institution in the encouragement of structural adjustment programs for the economies of the region during the 1980s, based on a hyper-market oriented agenda. Afterwards, the process of the renewal and expansion process of the Bank's political agenda from the end of the 1990s is looked at, which was based on the maintenance of the macroeconomic adjustment, the encouragement of institutional reforms, and combatting extreme poverty. Finally, the principal lines in the Bank's social policy reform agenda are discussed, including health.

A gestão social sob a ótica do referencial de Michel Foucault / The social management under the optics of Michel Foucault's referential

Gestão social tem se caracterizado como um conceito-chave que abrange uma série de práticas que oscilam desde ações gerencialistas direcionadas para a simples manutenção ou atualização do sistema capitalista até formas de produção qualificadas como anticapitalistas (Fischer, 2002). Entende-se gestão social como enunciado contido em um campo discursivo — que é definido como espaço no qual é possível a análise de um enunciado considerado em sua singularidade, a partir da compreensão das condições de sua existência, da definição de seus limites e de suas correlações com outros enunciados (Foucault, 2000). Sendo assim, este ensaio foi pensado com o propósito de analisar, sob a ótica do referencial de Michel Foucault, algumas das formas de articulação da prática discursiva que valoriza a gestão social como instrumento de manutenção e reforço da lógica capitalista de mercado, qualificada como formação discursiva predominante no contexto em que estamos inseridos. Assim direcionado, este texto inicia com a introdução de alguns dos aspectos do referencial foucaultiano que serão relevantes para a análise ora proposta. Quanto às estratégias verificadas no campo em estudo, serão examinadas: a) a articulação proporcionada pela lógica sistêmica no campo da gestão social, principalmente em aspectos que possibilitam o direcionamento dos esforços para o desenvolvimento; b) estratégias utilizadas pelos organismos financiadores internacionais e, mais especificamente, pelo Banco Mundial para influenciar os processos de cooperação técnica; e c) a forma de incorporação a este campo do conceito de capital social, conforme proposto por Francis Fukuyama (1996; 2006) e por Pierre Bourdieu (1980).

Social Management has been characterized as key concept that includes a series of practices ranging from generalist actions directed to the simple maintenance or use of the Capitalism to forms of production described as anti-capitalist (Fischer, 2002). Social management is understood as an enouncement comprised in a discursive field — defined as an space where it is possible to analyze an enouncement considered in its singularity, from the understanding of the conditions of its existence, of the definition of its limits and of its correlations with other enouncements (Foucault, 2000). So, this essay was conceived in order to analyze, under the optics of Michel Foulcault’s referential, some of the articulation forms of the discursive practice that value the social management as instrument of maintenance and reinforcement of the market capitalist logic, described as a prevailing discursive formation in the context. In this way, some aspects of the Foucault’s referential, which will be relevant for the analysis proposed now, are mentioned in the beginning of this text. In relation to the study field, the following strategies will be analyzed: a) the articulation provided by the systemic logic in the social management field, mainly in aspects that enable to direct these efforts to development; b) strategies used by the international financial organisms and, more specifically, by the World Bank, in order to influence the technical cooperation processes; and c) the form of incorporation of the social capital concept to this field,as proposed by Francis Fukuyama (1996; 2006) and Pierre Bourdieu (1980).

O conceito de pobreza: uma reflexão sobre os interesses do conhecimento / The concept of poverty: a reflection on the interests of knowledge

Este trabalho busca problematizar o papel do conhecimento no campo social por meio de uma reflexão sobre o uso do conceito de pobreza presente nos relatórios do Banco Mundial em uma perspectiva histórico-crítica. Levanta possíveis interpretações sobre quais são os interesses dessa instituição ao utilizar o conceito pobreza e ao divulgar as receitas direcionadas especialmente para os países em desenvolvimento no que se refere a como combatê-la. A partir dessa discussão ilustrativa, o artigo analisa o que pode estar por detrás da criação de um conceito e questiona-se sobre quais são os interesses do sujeito/pesquisador/instituição que articula as teorias.

This study raises questions about the role of knowledge in the social field through a reflection on the use of the concept of “poverty” in the reports of World Bank in a historical-critical perspective. It also raises possible interpretations upon what are the interests of this institution when using the term poverty and disclosing revenue especially directed to developing countries with regards to the fight against this situation. Based on this illustrative discussion, this article analyses what there might be behind the creation of a concept and raises questions about what are the interests of the subject/researcher/institution that articulates those theories.

Ciudadanía juvenil, juventud y estado: discursos de gobierno sobre sus significados / Cidadania juvenil, juventude e estado: discursos do governo sobre seus significados / Youth, youth citizenship, and state: government discourses over its meanings

En el marco de un proyecto de investigación doctoral que problematiza los procesos políticos de configuración del estado y la participación de los y las jóvenes en ellos, el artículo presenta la síntesis de los resultados de un estudio piloto cuyo objetivo fue explorar los significados atribuidos a las nociones de ciudadanía juvenil, juventud y estado en los discursos del Banco Mundial sobre el tema. Empleando como metodología algunas modalidades de Análisis Crítico del Discurso, los resultados muestran las estrategias argumentativas a través de las cuales la ciudadanía juvenil opera, dentro de un complejo dispositivo de las economías políticas, como un instrumento de gobierno sobre las identidades políticas de los jóvenes, y sobre los significados del estado y de la juventud.

No marco de um projeto de pesquisa doutoral que problematiza os processos políticos de configuração do estado e a participação dos e das jovens nestes processos, este artigo apresenta a síntese dos resultados de um estudo piloto cujo objetivo consistiu em explorar os significados atribuídos às noções de cidadania juvenil, juventude e estado nos discursos do Banco Mundial sobre este assunto. Empregando como metodologia algumas modalidades de Analise Critica do Discurso, os resultados amostram as estratégias argumentativas através das quais a cidadania opera, dentro de um dispositivo complexo das economias políticas, como um instrumento do governo sobre as identidades políticas dos jovens e sobre os significados do estado e da juventude.

Within the framework of a doctoral research project which problematizes the political process of state configuration and the participation of young men and women in them, the article presents the resultsynthesis of a pilot study whose main objective was to explore the meanings assigned to youth citizenship, youth and state in the World Bank’s discourses regarding this topic. Using as method some modalities of Critical Discourse Analysis, the results show the argumentative strategies through which citizenship operates, within a political economies’ complex dispositive, as instrument of government over state’s and youth’s identities.

Avaliação ambiental estratégica no Brasil: considerações a respeito do papel das agências multilaterais de desenvolvimento / Strategic environmental assessment in Brazil: debates regarding the role of multilateral development agencies

A Avaliação Ambiental Estratégica (AAE) surge como uma ferramenta que fornece oportunidades para a formulação de políticas, planos e programas mais sensíveis às questões ambientais; facilita a integração e coordenação entre vários atores institucionais; e aumenta e fortalece a participação pública. As agências multilaterais de desenvolvimento, como o Banco Interamericano de Desenvolvimento e o Banco Mundial, vêm estimulando a adoção da AAE nos países em desenvolvimento como recomendação ou requisito para aprovação de investimentos e, ainda, por meio de eventos e atividades de capacitação. O presente trabalho discutiu a situação atual da AAE no Brasil, e o papel que essas agências estão desempenhando na sua implementação, a fim de identificar possíveis melhoras práticas e limitações. Defende-se que a prática da AAE no Brasil seja resultado de um modelo autônomo, baseado nas características e demandas internas.

Strategic Environmental Assessment (SEA) has emerged as a tool that provides opportunities for making policies, plans and programs more sensitive to environmental issues. It can also assist integration and coordination between various institutional actors, and the increasing and strengthening of public participation. Multilateral development agencies such as the Interamerican Development Bank and the World Bank have been encouraging the adoption of SEA in developing countries as a recommendation or requirement for investments approval. This paper presents and discusses the role Multilateral Agencies are actually playing in SEA application in Brazil in order to identify possible best practices and constraints. It is argued that SEA in Brazil should be developed as an autonomous instrument, based on Brazilian institutional context, specific characteristics and internal demands.

Influence of world politics and economics on global health: Analysis of five major cases / 国際保健医療

Until recently, many global health policies and programs were developed and transformed under the influence of world politics and economics. One example is the primary health care strategy established in a political and social context to enhance the sovereignty and human rights of developing countries. However, the initial ideal had to be abandoned after implementation of the structural adjustment policy derived from the context of growing neoclassical economics. The Integrated Management of Childhood Illness (IMCI) policy was developed entirely based on economical reviews the World Bank initiated. Childhood malnutrition in developing countries remains unresolved due to the politically unequal distribution of food and the strategic selling pressures of multinational food companies. The universal access policy of anti-retrovirus drugs for HIV infection has been impeded by the economical battle for intellectual property rights for the manufacturing and purchasing of these drugs. The World Health Organization's Framework Convention on Tobacco Control was enacted against the marketing strategies of multinational tobacco companies. This paper aims to measure the effects of the intentions of international financing organizations and multinational businesses on the development of global health policies and to discuss the challenges for global health under them.

Influencia del banco mundial en las políticas públicas de salud en Colombia entre 1980 y el 2005: [revisión] / World bank influence on public health policies in Colombia between 1980 and 2005: [review]

Objetivo: examinar la historia del Banco Mundial y sus políticas, así como de su relación con la formulación de políticas de salud en Colombia, partiendo del supuesto inicial de la influencia de la entidad en este país. Metodología: se presenta una revisión, estudio y descripción académica de algunos informes publicados por el Banco Mundial entre 1980 y el 2005, enfatizando en los argumentos e ideales que dieron pie a la influencia de este organismo en Colombia.Se concluye argumentando que la relación del Banco Mundial con Colombia se ha venido formando a través del tiempo por razones económicas y políticas, con el aspecto económico como el más fuerte organismo. Es importante, por lo tanto, pensar en el concepto del Estado y la habilidad de este para gestionar proyectos de alcance social que con restricciones y adecuaciones propuestas por fuerzas externas que no pueden dejarse de lado debido a su poder económico y político. Resultados: se realizó una recopilación de la historia de esta entidad, su estructura y la influencia que ejerce en las políticas de salud en Colombia, desde un punto analítico y crítico referenciado.

Objective: to examine the World Bank history, its policies and its relation to health policies outlined in Colombia. Methodology: an academic revision, analysis and description of the most relevant reports published by the World Bank between 1980 and 2005 is presented, as well as the agenda established since the post war time until now, emphasizing the arguments and ideas supporting the influence of this organization in Colombia. Thus it is important to think about the concept of State and its ability to promote projects in order to impact on social conditions supported on a governmental basis with some restrictions and adjustments proposed by external forces that should be taken in account due to its economical and political influence. Results: the compilation of the World Bank historyand its structure was accomplished as well as its influence on health policies in Colombia from an analytical and critically referenced point of view.

Uma crítica da concepção de política social do Banco Mundial na cena contemporânea / A criticism of the World Bank´s concept of social policy in the contemporary scenery

O presente artigo reúne os principais elementos que compõem a concepção de política social do Banco Mundial a partir de recentes relatórios publicados sobre o tema pobreza e sociedade na página oficial deste organismo. A ideia central é de que se trata de uma descrição crítica da concepção de política social do Banco, problematizando cada um de seus argumentos mais explícitos com o intuito de desvelar uma intencionalidade organicamente vinculada à classe burguesa. Perspectiva esta que está pautada nos interesses dos segmentos da burguesia articulados em torno de um projeto societário direcionado para a reestruturação capitalista em uma conjuntura de crise estrutural. A concepção de política social do Banco Mundial segue, portanto, uma dimensão profundamente ideológica e política. A utilização, pelo Banco, de instrumentos, como os documentos analisados, para afirmar a hegemonia burguesa na cena contemporânea, atestam que o embate político e ideológico continua presente, explicitando a atualidade da luta de classes.

This article gathers together the main elements that make up the concept of the World Bank´s social policy from recent reportings published about poverty and society in the official page of this organism. The main idea is that it is a critical description of the Bank´s concept of social policy, contesting each one of its more explicit arguments to show a perspective organically linked to the middle class. That perspective is based on the interests of those middle class segments tied up to a project for society towards capitalist reorganization in a conjuncture of structural crisis. Therefore, the World Bank´s concept of social policy follows a deeply ideological and political dimension. The way the Bank uses instruments such as the analyzed documents to assure middle class hegemony in the contemporary scenery certifies that the ideological and political chock is present, which shows that the fight among social classes is still up-to-date.

COST-EFFECTIVENESS AND-BENEFIT ANALYSIS OF WORLD BANK LOAN PROJECT ON SCHISTOSOMIASIS CONTROL IN QIANJIANG CITY / 中国血吸虫病防治杂志

Objective To evaluate the cost-effectiveness and -benefit of the World Bank Loan Project on Schistosomiasis Control in Qianjiang City. Methods According to the national scheme the cost-effectiveness and cost-benefit of the project were analysed. Results After the project was carried out for 9 years, poputation schistosome infections rate decreased by 56.48%; cattle infections rate decreased by 48.08%; snail areas reduced 1224 hm 2(42.76%). Infected snail areas reduced 273 hm 2(17.13%). Snail infections rate decreased by 97.04%. The investment for infections rate decreased by 1% in 100 people was 1384.47 yuan. The investment for infections rate decreased by 1% in 100 head of cattle was 3386.96 yuan. The investment to reduce 1 hm 2 snail ares was 8935.63 yuan. Conclusion For one yuan investment, the benefit was 7.96 yuan and the total of the net benefit was 106784700 yuan in 9 years.

EFFECTIVENESS OF WORLD BANK LOAN SCHISTOSOMIASIS CONTROL PROJECT IN 9 YEARS, IN HUNAN PROVINCE / 中国血吸虫病防治杂志

Objective To analyse the effects of Word Bank Loan Schistosomiasis Control Project in Hunan Province from 1992 to 2000. Methods The administrative villages in Hunan endemic areas were divided into heavy, moderate and low zones respectively, based on human infection rates. Control strategies including a major approach of chemotherapy to inhabitants and bovines with praziquantel, complemented with health education as well as snail control by environment modification, were adopted in each endemic zone. Schistosomiasis prevalence surveillance was carried out in 50 moving pilots selected from endemic villages in each zone every year. Results At the beginning of the programm, there were total of 35 endemic counties (cities, districts, farms) and 471 endemic towns in Hunan Province. Up to 2000, 8 endemic counties (farms) reach the transmission interruption criteria, and 25 counties and 300 towns reach the transmission control criteria. Heavy endemic villages decreased from 762 to 271, while moderate endemic villages from 1728 to 1053, and low endemic villages increased from 1447 to 2716. Human infection rates dropped from 11.59% to 5.64%. Conclusion The schistosomiasis epidemic situation decreased obviously after implementing the project in Hunan Province.