Diabetes, a chronic disease which occurs when the body is unable to produce insulin, has become a major health burden in developing countries. If left untreated, or under poor control, diabetic patients will develop severe complications, such as eye disease, kidney failure and amputations, which represent loss in quality of life for the patient and increased costs to healthcare systems. Diabetes is part of a significant change in the epidemiological patterns of developing countries in the last decades: while still unable to curb infectious diseases, such as dengue, malaria and tuberculosis, these countries are facing growing rates of diabetes and other lifestyle diseases. This combination of factors creates a ‘double burden’ for healthcare systems. Brazil and Mexico, the two most populous countries in Latin America, have followed this pattern, and currently present very high prevalence rates of diabetes.
Considering that the care and prevention of diabetes is not only a health issue, but also a political one, in which public policies greatly affect how the disease evolves, it is of interest to ask: how are public health policies in Brazil and Mexico addressing the recent rise of diabetes in these countries? This project aimed at answering this question through a critical and comparative analysis of the public health policies in the two countries for the period of 2000 to 2010; more specifically on two levels: a) policy initiation and the use of Cost-effectiveness analysis (CEA) and b) policy implementation and evaluation. The project drew from a multidisciplinary theoretical background, including historical institutionalism and functionalist approaches, policy stages framework, so that each stage could be properly characterized and addressed.

The research showed that initial efforts towards diabetes in Brazil and Mexico may have been instigated by the influence of intergovernmental organizations, and since then political attention towards the condition has grown gradually over the past decade. The formulation of the policies for diabetes demonstrated a degree of convergence between the two countries. Nonetheless, the actual implementation of these policies was directly affected by the different institutional arrangements and structures of the two healthcare systems. The analysis of the Mexican and Brazilian policies also reveal a parallel effort regarding health promotion as well as the use of CEA, with considerable structural changes done to the countries to promote both. While some landmarks have been achieved, latest assessments indicate that there is still inequality in access and quality of treatment, and the figures related to diabetes are still on the rise. Nevertheless, considering the efforts are recent, more research is needed in the future to assess their effectiveness, and whether or not they were able to curb the expansion of diabetes and foment a healthier population in Brazil and Mexico.