Federalismo y gobernanza de la salud pública. El papel de la coordinación horizontal a nivel estatal en durante la respuesta a Covid-19 en Brasil
DOI:
https://doi.org/10.59339/de.v64i242.668Keywords:
Federalism, Multi-Level Governance, Brazilian federalism, Covid-19Abstract
El documento describe la pandemia de Covid-19 como un momento definitorio que impulsa una cascada de respuestas institucionales, al principio descoordinadas, pero que alcanzan un equilibrio más tarde para establecer una gobernanza multinivel (MLG) basada en la coordinación horizontal entre unidades subnacionales sobre áreas temáticas específicas. Este momento ofrece una oportunidad especial para observar la confrontación entre el gobierno federal y las unidades subnacionales en Brasil sobre la naturaleza de la respuesta y la prerrogativa de actuar. De especial interés para nuestra comprensión del impacto de Covid-19 en Brasil son dos cuestiones relacionadas. En primer lugar, ¿podemos hablar de las respuestas políticas "nacionales" a la pandemia como una desviación definitiva del patrón de interacción que caracteriza al federalismo democrático brasileño? En segundo lugar, en caso afirmativo, ¿cuáles son las implicaciones de este proceso transformador en términos de gobernanza de la salud pública? Más concretamente, ¿cómo afectan los cambios relevantes en la dinámica política del federalismo brasileño a la provisión de bienes de salud pública y a las perspectivas de gobernanza democrática? Nuestro análisis concluye que, al poner en tensión el patrón de cooperación entre el gobierno federal y las entidades subnacionales, el intento de Bolsonaro de retomar las prerrogativas presidenciales impulsó la mejora de las relaciones intergubernamentales (RIG) de los estados brasileños a nivel horizontal y, en consecuencia, del MLG por dominio político. Este cambio es un aspecto clave de lo que puede describirse a grandes rasgos como el reajuste de las fuerzas políticas y sociales que participan en la respuesta al reto global de la gobernanza de la salud pública en el marco de la Constitución de 1988.
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