{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:09:59Z","timestamp":1762528199699,"version":"build-2065373602"},"reference-count":31,"publisher":"FapUNIFESP (SciELO)","issue":"10","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>O objetivo deste estudo foi compreender a participa\u00e7\u00e3o das iniciativas globais de sa\u00fade (IGS) no enfrentamento da epidemia de HIV\/aids em Guin\u00e9-Bissau, a partir de distintos atores sociais e pol\u00edticos, representantes das IGSs, do governo guineense e das organiza\u00e7\u00f5es da sociedade civil. Foi realizado um estudo de caso de abordagem qualitativa, do tipo descritivo explorat\u00f3rio, que utilizou entrevista semiestruturada com 36 participantes. Empregou-se t\u00e9cnica de an\u00e1lise de conte\u00fado tem\u00e1tica. Os relatos dos participantes foram organizados e apresentados a partir de quatro categorias tem\u00e1ticas. Os resultados indicam que, na resposta ao HIV\/aids, al\u00e9m do governo, identificou-se pelo menos 15 institui\u00e7\u00f5es n\u00e3o governamentais e uma forte parceria com o Brasil. As limita\u00e7\u00f5es e desafios do governo est\u00e3o relacionados \u00e0 capta\u00e7\u00e3o de financiamento e gerenciamento dos recursos proveniente das IGSs. As contribui\u00e7\u00f5es das IGSs foram descritas como positivas, pois h\u00e1 um desfinanciamento interno e depend\u00eancia externa onde o Fundo Global se confirma como o principal financiador das a\u00e7\u00f5es de resposta ao HIV\/aids. Essa depend\u00eancia interfere na autonomia da gest\u00e3o e afeta a coordena\u00e7\u00e3o. A realidade da Guin\u00e9-Bissau se assemelha a v\u00e1rios pa\u00edses da \u00c1frica Subsaariana onde a atua\u00e7\u00e3o das IGSs \u00e9 caracterizada por um paradoxo: a depend\u00eancia 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 pa\u00eds de adotar as caracter\u00edsticas de um Estado est\u00e1vel, seguro e com medidas que instigam sua autonomia e independ\u00eancia da colonialidade.<\/jats:p>","DOI":"10.1590\/0102-311xpt151324","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:04:34Z","timestamp":1762527874000},"source":"Crossref","is-referenced-by-count":0,"title":["\u201cQuando o pa\u00eds depende inteiramente dos parceiros, as coisas tendem a n\u00e3o dar certo\u201d: iniciativas globais de sa\u00fade e HIV\/aids em Guin\u00e9-Bissau"],"prefix":"10.1590","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4767-0111","authenticated-orcid":false,"given":"Amiry Monteiro","family":"Sanca","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4187-0603","authenticated-orcid":false,"given":"Franciela Delazeri","family":"Carlotto","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3281-2911","authenticated-orcid":false,"given":"Cristianne Maria Famer","family":"Rocha","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-8985","authenticated-orcid":false,"given":"Deise Lisboa","family":"Riquinho","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"key":"ref1","series-title":"Systems thinking for global health: how can systems-thinking contribute to solving key challenges in global health?","first-page":"234","volume-title":"Systems thinking for global health initiatives (GHIs) in Sub-Saharan Africa","author":"Kidane A","year":"2023"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1016\/S0140-6736(09)60919-3","article-title":"An assessment of interactions between global health initiatives and country health systems.","volume":"373","author":"Samb B","year":"2009","journal-title":"Lancet"},{"key":"ref3","series-title":"The global HIV\/AIDS epidemic."},{"key":"ref4","article-title":"As iniciativas globais de sa\u00fade e o combate ao HIV\/Aids no continente africano revis\u00e3o de escopo","volume":"30","author":"Sanca AM","year":"2025","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"ref5","series-title":"UNAIDS data 2023."},{"key":"ref6","series-title":"Estudo de caso: planejamento e m\u00e9todos.","author":"Yin RK","year":"2015","edition":"5\u00aa"},{"key":"ref7","series-title":"O desafio do conhecimento: pesquisa qualitativa em sa\u00fade.","author":"Minayo MCS","year":"2014","edition":"14\u00aa"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies guided by information power","volume":"26","author":"Malterud K","year":"2015","journal-title":"Qual Health Res"},{"key":"ref9","series-title":"O desafio do conhecimento: pesquisa qualitativa em sa\u00fade.","author":"Minayo MCS","year":"2010","edition":"12\u00aa"},{"key":"ref10","article-title":"Tradu\u00e7\u00e3o e valida\u00e7\u00e3o para a l\u00edngua portuguesa e avalia\u00e7\u00e3o do guia COREQ","volume":"34","author":"Souza VRS","year":"2021","journal-title":"Acta Paul Enferm"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/S0140-6736(13)62407-1","article-title":"The political origins of health inequity prospects for change","volume":"383","author":"Ottersen OP","year":"2014","journal-title":"Lancet"},{"key":"ref12","series-title":"A coopera\u00e7\u00e3o sul-sul no contexto da epidemia de aids: tr\u00eas anos do Centro Internacional de Coopera\u00e7\u00e3o T\u00e9cnica em HIV\/Aids."},{"key":"ref13","article-title":"Brasil recebe delega\u00e7\u00e3o de Guin\u00e9-Bissau para fortalecer a resposta ao HIV e \u00e0 aids.","year":"2024","journal-title":"Ag\u00eancia de Not\u00edcias da AIDS"},{"key":"ref14","series-title":"Guin\u00e9-Bissau: da independ\u00eancia colonial \u00e0 depend\u00eancia da coopera\u00e7\u00e3o internacional para o desenvolvimento.","author":"Santos MCR","year":"2021","edition":"2\u00aa"},{"key":"ref15","series-title":"Diagn\u00f3stico situacional sobre a implementa\u00e7\u00e3o da recomenda\u00e7\u00e3o op\u00e7\u00e3o B+, da transmiss\u00e3o vertical do VIH e da s\u00edfilis cong\u00eanita, no \u00e2mbito da Comunidade de Pa\u00edses de L\u00edngua Portuguesa - 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Interactions between global health initiatives and health systems: evidence from countries.","first-page":"168","volume-title":"South Africa: the effects of global health initiative funding for HIV\/AIDS on the health system.","author":"Bisika T","year":"2009"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/09540121003759919","article-title":"The impact of global health initiatives at national and sub-national level a policy analysis of their role in implementation processes of antiretroviral treatment (ART) roll-out in Zambia and South Africa","volume":"22","author":"Hanefeld J","year":"2010","journal-title":"AIDS Care"},{"key":"ref30","article-title":"Filantrocapitalismo e sa\u00fade global o neoliberalismo da vida e da morte","volume":"11","author":"Back C","year":"2020","journal-title":"Mural Internacional"},{"key":"ref31","doi-asserted-by":"crossref","DOI":"10.1590\/1678-49442020v26n1a204","article-title":"Filantrocapitalismo versus filantropia para a justi\u00e7a social um debate norte-americano sobre como lidar com a pobreza","volume":"26","author":"Silva PK","year":"2020","journal-title":"Mana"}],"container-title":["Cadernos de Sa\u00fade P\u00fablica"],"original-title":["\u201cWhen the country depends entirely on partners, things tend to go wrong\u201d: global health and HIV\/AIDS initiatives in Guinea-Bissau"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0102-311X2025001001405&tlng=pt","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:04:38Z","timestamp":1762527878000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-311X2025001001405&tlng=pt"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0102-311X2025001001405"],"URL":"https:\/\/doi.org\/10.1590\/0102-311xpt151324","relation":{},"ISSN":["1678-4464","0102-311X"],"issn-type":[{"value":"1678-4464","type":"electronic"},{"value":"0102-311X","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e00151324"}}