["When the country depends entirely on partners, things tend to go wrong": global health and HIV/AIDS initiatives in Guinea-Bissau].

The aim of the present study was to understand the participation of global health initiatives (GHIs) in addressing the HIV/AIDS epidemic in Guinea-Bissau based on the insights of different social and political actors, representatives of GHIs, the Guinean government, and civil society organizations. A qualitative, descriptive, exploratory case study was conducted involving interviews with 36 participants. Thematic content analysis was employed. The discourses of the participants were organized into four main topics. The results indicate that, besides the government, at least 15 nongovernmental organizations and a strong partnership with Brazil were identified in the response to HIV/AIDS. The limitations and challenges of the government are related to the acquisition of funding and the management of the resources provided by GHIs. The contributions of GHIs were described as positive, considering the internal lack of funding and external dependence, with the Global Fund as the primary funder of HIV/AIDS response actions. This dependence interferes with the autonomy of management and affects coordination. The situation in Guinea-Bissau resembles that of several countries in Sub-Saharan Africa, in which the work of GHIs is characterized by a paradox: dependence on financial resources and the need to decolonize from external aid, which, to some extent, serves as a disciplinary device. The findings underscore the need for the country to adopt characteristics of a stable government, with measures that ensure its autonomy and independence from colonialism.