Making National Participatory Institutions Work: Bureaucrats, Activists, and AIDS Policy in Brazil Jessica A. J. Rich ABSTRACT What are the conditions under which participatory institutions increase the voice of marginalized groups in policymaking? Existing studies of local participatory institutions highlight the role of leftist politicians and a strong civil society in deter- mining outcomes, yet they fail to explain significant variation among participatory institutions at the national level. Examining the case of Brazil’s AIDS policy sector, this article argues that to fully understand the dynamics of national participatory governance, we must consider the role of bureaucrats. As studies of state-society synergy have shown, bureaucrats may seek outside political support from civil soci- ety when other actors inside the state prevent them from advancing their policy preferences. National bureaucrats may create new participatory institutions, and even help civil society delegates coordinate their engagement in such institutions, as strategies to strengthen their policy alliances with civil society. Keywords: Brazil, bureaucracy, civil society, HIV/AIDS, participatory governance, state capacity P articipatory governance has been a core component of efforts to make democ- racy more inclusive in posttransition Brazil. Advocates have presented these institutions as opening access to government for historically marginalized groups. By the same token, politicians who are threatened by the transformative potential of these practices have sought either to block the implementation of these institutions or to reduce their political influence. Tis article explores, broadly, the conditions under which Brazil’s system of participatory governance succeeds in increasing the voice of marginalized groups in policymaking. Existing studies of local participatory institutions claim that these institutions’ implementation and outcomes for policy depend on a combination of partisan pol- itics and civil society strength. Leftist executives implement such institutions as a strategy to empower the historically marginalized groups who support their reformist policies (Abers 2000; Chávez and Goldfrank 2004; Wampler 2007). In cities or states governed by recalcitrant executives, an organized and combative civil © 2019 University of Miami DOI 10.1017/lap.2018.80 Jessica A. J. Rich is an assistant professor of political science at Marquette University. jessica.rich@marquette.edu