RESUMO Este artigo analisa a relação entre diferentes formas de accountability no contexto do Subsistema de Atenção à Saúde Indígena do Sistema Único de Saúde (SASI-SUS), por meio de um estudo de caso do Distrito Sanitário Especial Indígena (DSEI) do rio Negro, localizado no estado do Amazonas. A partir de um episódio de mobilização indígena iniciado após um surto de malária no DSEI, o estudo aponta alguns dilemas fundamentais decorrentes da incorporação de lógicas conflitantes de accountability ao desenho do SASI-SUS.

ABSTRACT This article discusses the interplay of different forms of accountability in the context of the Indigenous Health Subsystem of Brazil’s Unified Health System (SASI-SUS), via a case study of the Rio Negro Special Indigenous Health District (DSEI-ARN) in the State of Amazonas. Focusing on a case of indigenous mobilisation triggered by a malaria outbreak it highlights some of the underlying dilemmas that derive from the embedding of conflicting accountability logics within the architecture of the SASI-SUS.

RESUMO Mudanças econômicas e geopolíticas recentes obrigaram os países membros da OECD-DAC a reconhecer mais claramente as atividades de cooperação dos BRICS e de outros poderes emergentes que alegam seguir uma lógica diferente daquela dos modelos de transferência coercitiva de políticas públicas associados à cooperação Norte-Sul para o desenvolvimento. Também tem havido um rápido crescimento do “aprendizado recíproco” fora do arcabouço formal da cooperação para o desenvolvimento. Este artigo explora as implicações deste processo para a difusão internacional de políticas públicas na era do desenvolvimento “universal” imaginado pela Agenda 2030 da ONU.

ABSTRACT The economic and geopolitical shifts of recent years have forced the oecd-dac member countries to offer greater recognition to the development cooperation activities of the BRICS and other rising powers, who claim to follow a different logic from the coercive policy transfer models associ ated with North-South development cooperation. At the same time, there has been rapid growth in international “mutual learning” outside the formal framework of development cooperation. This paper explores the implications of this for international policy diffusion in the age of “universal” development envisaged by the UN’s Agenda 2030.

This article provides an overview of governance arrangements and changes in the Brazilian public health system since 1988, when the "Citizen's Constitution" declared health to be a universal right. Since then, population coverage has grown substantially and health indicators have improved. Despite these achievements, inequities in access remain an important barrier to universal coverage, in particular for marginalized groups such as indigenous peoples. This article discusses the innovation cycle that produced the gains and recent efforts to guarantee more equitable access to health services for the indigenous population in a continent-sized country historically plagued by great inequalities.