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["When the country depends entirely on partners, things tend to go wrong": global health and HIV/AIDS initiatives in Guinea-Bissau].

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Title: ["When the country depends entirely on partners, things tend to go wrong": global health and HIV/AIDS initiatives in Guinea-Bissau].
Transliterated Title: “Quando o país depende inteiramente dos parceiros, as coisas tendem a não dar certo”: iniciativas globais de saúde e HIV/aids em Guiné-Bissau.
Authors: Sanca AM; Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil., Carlotto FD; Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil., Rocha CMF; Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil., Riquinho DL; Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Source: Cadernos de saude publica [Cad Saude Publica] 2025 Nov 07; Vol. 41 (10), pp. e00151324. Date of Electronic Publication: 2025 Nov 07 (Print Publication: 2025).
Publication Type: English Abstract; Journal Article
Language: Portuguese
Journal Info: Publisher: Escola Nacional De Saúde Pública, Fundação Oswaldo Cruz Country of Publication: Brazil NLM ID: 8901573 Publication Model: eCollection Cited Medium: Internet ISSN: 1678-4464 (Electronic) Linking ISSN: 0102311X NLM ISO Abbreviation: Cad Saude Publica Subsets: MEDLINE
Imprint Name(s): Publication: <2012->: Rio De Janeiro : Escola Nacional De Saúde Pública, Fundação Oswaldo Cruz
Original Publication: Rio de Janeiro : A Escola,
MeSH Terms: HIV Infections*/prevention & control , HIV Infections*/epidemiology , Global Health* , International Cooperation*, Guinea-Bissau/epidemiology ; Humans ; Qualitative Research ; Brazil ; Acquired Immunodeficiency Syndrome/prevention & control ; Interviews as Topic
Abstract: The aim of the present study was to understand the participation of global health initiatives (GHIs) in addressing the HIV/AIDS epidemic in Guinea-Bissau based on the insights of different social and political actors, representatives of GHIs, the Guinean government, and civil society organizations. A qualitative, descriptive, exploratory case study was conducted involving interviews with 36 participants. Thematic content analysis was employed. The discourses of the participants were organized into four main topics. The results indicate that, besides the government, at least 15 nongovernmental organizations and a strong partnership with Brazil were identified in the response to HIV/AIDS. The limitations and challenges of the government are related to the acquisition of funding and the management of the resources provided by GHIs. The contributions of GHIs were described as positive, considering the internal lack of funding and external dependence, with the Global Fund as the primary funder of HIV/AIDS response actions. This dependence interferes with the autonomy of management and affects coordination. The situation in Guinea-Bissau resembles that of several countries in Sub-Saharan Africa, in which the work of GHIs is characterized by a paradox: dependence on financial resources and the need to decolonize from external aid, which, to some extent, serves as a disciplinary device. The findings underscore the need for the country to adopt characteristics of a stable government, with measures that ensure its autonomy and independence from colonialism.
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Contributed Indexing: Local Abstract: [Publisher, Portuguese] O objetivo deste estudo foi compreender a participação das iniciativas globais de saúde (IGS) no enfrentamento da epidemia de HIV/aids em Guiné-Bissau, a partir de distintos atores sociais e políticos, representantes das IGSs, do governo guineense e das organizações da sociedade civil. Foi realizado um estudo de caso de abordagem qualitativa, do tipo descritivo exploratório, que utilizou entrevista semiestruturada com 36 participantes. Empregou-se técnica de análise de conteúdo temática. Os relatos dos participantes foram organizados e apresentados a partir de quatro categorias temáticas. Os resultados indicam que, na resposta ao HIV/aids, além do governo, identificou-se pelo menos 15 instituições não governamentais e uma forte parceria com o Brasil. As limitações e desafios do governo estão relacionados à captação de financiamento e gerenciamento dos recursos proveniente das IGSs. As contribuições das IGSs foram descritas como positivas, pois há um desfinanciamento interno e dependência externa onde o Fundo Global se confirma como o principal financiador das ações de resposta ao HIV/aids. Essa dependência interfere na autonomia da gestão e afeta a coordenação. A realidade da Guiné-Bissau se assemelha a vários países da África Subsaariana onde a atuação das IGSs é caracterizada por um paradoxo: a dependência dos recursos financeiros e a necessidade de se descolonizar da ajuda externa que, de certa forma, atua como um dispositivo disciplinador. Os achados evidenciam a necessidade do país de adotar as características de um Estado estável, seguro e com medidas que instigam sua autonomia e independência da colonialidade. [Publisher, Spanish; Castilian] El objetivo de este estudio fue comprender la participación de las iniciativas globales de salud (IGS) en la lucha contra la epidemia de VIH/sida en Guinea-Bisáu desde diferentes actores sociales y políticos, representantes de IGSs, el Gobierno guineano y las organizaciones de la sociedad civil. Se realizó un estudio de caso con enfoque cualitativo, de naturaleza descriptiva exploratoria, a partir de una entrevista semiestructurada con 36 participantes. La técnica aplicada fue el análisis de contenido temático. Los relatos de los participantes se organizaron y se presentaron con base en cuatro categorías temáticas. Los resultados revelan que las acciones de respuesta al VIH/sida provinieron de, al menos, 15 instituciones no gubernamentales y del Gobierno, y que hay una fuerte colaboración con Brasil. Las limitaciones y desafíos del gobierno se relacionan con la recaudación de fondos y la gestión de los recursos de las IGS. Las contribuciones de las IGSs fueron positivas, pues existe una definición interna y una dependencia externa donde el Fondo Mundial se confirma como el principal financiador de las acciones de respuesta al VIH/sida. Esta dependencia interfiere con la autonomía de gestión y afecta a la coordinación. La realidad de Guinea-Bisáu se asemeja a la de varios países del África subsahariana donde el desempeño de las IGSs se caracteriza por una paradoja: la dependencia de los recursos financieros y la necesidad de descolonizar de la ayuda externa que, en cierto modo, actúa como un dispositivo disciplinario. Los hallazgos destacan que el país debería adoptar características de un Estado estable, seguro y con medidas que promuevan su autonomía e independencia de la colonialidad.
Entry Date(s): Date Created: 20251112 Date Completed: 20251113 Latest Revision: 20251116
Update Code: 20251116
PubMed Central ID: PMC12600017
DOI: 10.1590/0102-311XPT151324
PMID: 41221891
Database: MEDLINE
Description
Abstract:The aim of the present study was to understand the participation of global health initiatives (GHIs) in addressing the HIV/AIDS epidemic in Guinea-Bissau based on the insights of different social and political actors, representatives of GHIs, the Guinean government, and civil society organizations. A qualitative, descriptive, exploratory case study was conducted involving interviews with 36 participants. Thematic content analysis was employed. The discourses of the participants were organized into four main topics. The results indicate that, besides the government, at least 15 nongovernmental organizations and a strong partnership with Brazil were identified in the response to HIV/AIDS. The limitations and challenges of the government are related to the acquisition of funding and the management of the resources provided by GHIs. The contributions of GHIs were described as positive, considering the internal lack of funding and external dependence, with the Global Fund as the primary funder of HIV/AIDS response actions. This dependence interferes with the autonomy of management and affects coordination. The situation in Guinea-Bissau resembles that of several countries in Sub-Saharan Africa, in which the work of GHIs is characterized by a paradox: dependence on financial resources and the need to decolonize from external aid, which, to some extent, serves as a disciplinary device. The findings underscore the need for the country to adopt characteristics of a stable government, with measures that ensure its autonomy and independence from colonialism.
ISSN:1678-4464
DOI:10.1590/0102-311XPT151324