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(p.1) Introduction
Achieving Access
Joseph Harris
Cornell University Press

This chapter focuses our attention on an unexplained puzzle: how parts of the developing world transitioned from a moment characterized by exclusion from healthcare access (“aristocratic healthcare”) to an altogether different moment characterized by “health universalism.” Grounded in a study of Thailand, Brazil, and South Africa, it highlights the surprising role played by elites from esteemed professions who, rationally speaking, aren’t in need of healthcare or medicine themselves and who would otherwise seem to have little to gain from such policies. The chapter points to the relative success of these “professional movements” in expanding access to healthcare and AIDS treatment in Thailand and Brazil and their relative failure in South Africa. And it draws attention to the importance of holding privileged positions in the state and legal expertise in the respective policy domains during moments of heightened political competition.

Keywords:   aristocratic healthcare, health universalism, professional movements, HIV/AIDS, politics, democratic transition, heightened political competition, Thailand, Brazil, South Africa

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