Brazil’s creative efforts in tackling the HIV/AIDS epidemic.

One of the Millennium Development Goals is to combat HIV/AIDS, malaria and other infectious diseases. Specifically for HIV/AIDS the goals are (1) to reduce sexual and parenteral HIV transmission by 50%, (2) eliminate vertical HIV transmission, (3) reduce tuberculosis deaths among people with HIV by 50% and (4) deliver antiretroviral therapy (ART) to 15million people. Brazil is a country that took quite an aggressive approach in its response to the HIV/AIDS epidemic and has become an international leading example on this subject. In 1983, before Brazil even had a democratically elected civilian government, the first AIDS program was set up Sao Paulo. In 1988, under the new federal constitution, a Public Health system was born which included a National Health system that was based on: universality, comprehensiveness, equity and social participation. It also formed the Brazilian National AIDS Department as a response to the HIV/AIDS epidemic.[1]

Through this program, the Brazilian government showed that “a developing country is capable of treating people with equity, independently of race, gender and economic power”, and in putting complicated issues like HIV/AIDS high on the political priority list.[2] Brazil’s extensive BRA program sustained NAP choices controlled the growth of the epidemics and gave Brazil an international leading role. Of course, the program isn’t perfect; it hasn’t eradicated HIV/AIDS in Brazil and there are many challenges for the future of this program, but I think it has proven how important political will and priorities are when it comes to tackling complicated problems. 

I attended a guest lecture by Dr. Ines Dourado about this subject. A specific thing from the lecture that I kept in mind was an opportunity she mentioned Brazil is using to expand HIV testing opportunities: the world cup. With its eye on the world cup of 2014 that is being held in Brazil, the government has organized a Special Mobile Program: “I want to do the test.”[3] The program provides information, counseling, rapid tests and condom distribution and is a joint activity of the federal, state and municipal government with civil society. I think this is an extremely clever idea! The government uses a cultural event as a tool to push its political agenda to the front. Not only will they be able to reach a high concentration of people and get them tested – which will allow them to update their health statistics – it will also help diminish the stigma associated with HIV/AIDS. Reducing the stigma of HIV/AIDS and with that, getting more people to get tested is in my opinion a crucial step in battling HIV. It also shows the extend of the National Health system and how approaching issues like HIV/AIDS is not just top-down politics but a combined effort on every level.

Of course, this is only one of the actions Brazil is taking in combatting HIV/AIDS. Yet it shows, in my opinion, that when a government sets a priority and is consistent and determent in investing in it, it can accomplish quite a lot and it will find innovative and creative ways to push its political agenda to reach its goal.

[1] Lecture notes from 09/30/2013 Ines Dourado guest lecture

[2] Greco, B. & Simao, N. (2007). Brazilian policy of universal access to AIDS treatment: sustainability challenges and perspectives. Lippincott Williams & Wilkins.

[3] Lecture notes from 09/30/2013 Ines Dourado guest lecture


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