Paper short abstract:

This research focuses on the political economy of national ownership in situations of aid dependence, with particular reference to the case of the reconstruction of the healthcare system in Timor-Leste.

Paper long abstract:

The study demonstrates that, in a range of areas, the Timor-Leste government was able to exercise some autonomous decision-making even though it was heavily aid dependent. The study distinguishes between patronage-based, populist and rationalist approaches to policy making, and argues that generally in the period 2002-2007, the Timorese government used a patronage-based strategy that allocates large proportions of donor funds in favour of elite political networks, increasing corruption. However, the situation was different in the field of healthcare. Creation of a “modern” healthcare system that would benefit future Timorese generations was central to the ruling party, Fretilin’s, ideology and consequently healthcare became subject to populist rather than patronage-based politics. This was demonstrated particularly in the deal for assistance and capacity building from the Cuban government. The deal was based upon socialist principles advocated by veterans groups in Timor. However, this approach alienated health professionals in Timor, who advocated for a liberal approach to the reconstruction of healthcare, but who lacked the political capital necessary to win the debate.