In 2004, the World Bank's World Development Report stated that "health services fail for poor people not because of a lack of knowledge to prevent and treat illnesses, but because health systems are tied to a network of relationships that is responsive to these people. " Despite substantial efforts in a number of countries to address this situation, the claim remains valid, and the search for solutions remains urgent.
Health inequalities are a fact widely known in developing countries, appearing as the cause and consequence of others problems. Even in countries that have experienced rapid economic growth in recent years and have significantly increased health investments, progress in reducing inequalities remains sluggish. This is especially true in Africa and Asia. To address this situation, the new UN Sustainable Development Goals emphasize the importance of ensuring that good health services reach all citizens without exception.
If there is a great deal of knowledge about social and economic factors that generate and perpetuate health inequalities , the same can not be said about political and institutional factors. We know that just holding elections is not enough to deal with inequality - more regular and direct accountability and accountability mechanisms are also essential, and have been implemented in a number of countries. It is, however, necessary to understand in detail what leads to the success or failure of these mechanisms, in different contexts and for different social groups.
It is precisely this challenge that Cebrap, N'weti and the Institute of Development Studies are preparing to in a new research project to be developed in Brazil and in Mozambique. This project aims to investigate the relationship between the trajectory of health inequalities and electoral dynamics, as well as public administration, as well as social participation, both in urban centers and in rural areas.
The aim is to identify the dynamics that have contributed to the reduction of inequalities in health under different political and institutional conditions. In addition to conceptual and methodological advances, the project will also invest in connections and collaboration spaces between groups that study, formulate and implement public health policies in Brazil and South Africa, promoting constant interactions between specialists and public managers. There are no formulas to address health inequalities. The solutions depend on context. Of course there are, however, lessons that different countries can learn from each other, as well as approaches that are more likely to succeed. In this sense, Brazil and Mozambique, countries that have cooperated with each other and implemented innovative policies in the area of health, certainly have much to teach and learn.