In:

The Lancet

Author:

Richard Horton

Brazil is (understandably) upset. At WHO’s Executive Board meeting last month, one Geneva official told me that the country’s delegation was refusing to back resolutions it might otherwise have supported because the Brazilian Ministry of Foreign Aff airs opposed the World Bank’s country rankings. Brazil is classifi ed by the Bank as an upper-middle-income country, along with its near neighbours Colombia, Ecuador, Paraguay, and Peru. Unfortunately for the Bank (and WHO), Brazil doesn’t see itself as a middle-income nation. It has higher aspirations. Adding further insult, in 2015 the Bank promoted Brazil’s rivals, Argentina and Venezuela, to high-income status. A high-income country is defined by a gross national income per person equal to or above US$12 736. Brazil falls just short at $11 530 (2014). Brazil has long been sensitive to the judgment of others. When WHO published its World Health Report in 2000, the government and country’s health leadership were hurt and outraged. WHO ranked Brazil 125th out of 191 nations (Venezuela was placed 54th and Argentina 75th).

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