Health Policy Reform in South America

Marked changes in political regimes have left their imprint on health sector reforms in South American countries. In the 1970s, most of the countries - starting with Brazil in 1964 — were oppressed by authoritarian regimes under military dictatorships. The 1980s and 1990s brought the ‘debt crisis’ and struc- tural adjustment policies imposed by international financial institutions, which fostered fiscal adjustments and cuts in public social spending, causing increases in poverty, inequalities, and violence. By the 2000s, operating at different times and pace, processes of transition to democracy had culminated in left-wing and centre-left governments in many of the countries. These expanded social poli- cies and worked to reduce poverty and social inequalities and to improve access to healthcare services (Fleury, 2011; ISAGS, 2012).