Living with HIV in Brazil

The word on the street (or at least at social work student potlucks) is that Brazil is ahead of the curve when it comes to taking care of their citizens with HIV/AIDS. In the midst of the US’s raging health care debate, this is an amazing thought to ponder: if you are infected with HIV/AIDS in Brazil, you will be treated…free of charge.

As of this year, approximately 730,000 people are living with HIV/AIDS in Brazil with a prevalence rate of 0.6 according to the Joint United Nations Programme on HIV/AIDS [3] (although other sources describe this number as low as 630,000 [4]). The Joint United Nations Programme estimates the same prevalence rate in the United States as in Brazil [3]. It’s amazing that these two countries have the same prevalence rate, especially considering that the 1990s found Brazil confronting a potential AIDS epidemic with the World Bank estimating that 1.2 million Brazilians would be living with HIV/AIDS by the year 2000 [1]. Instead of letting this happen, Brazil took action.

In the 1990s developing countries were encouraged to focus on prevention programs for their citizens because AIDS drugs were prohibitively expensive [4]. But Brazil saw the situation differently and challenged the conventional wisdom of the World Bank. Starting in 1996, under a law passed by the Brazilian Congress, the country has provided free universal access to these life-saving drugs, made possible especially due to the production of generic versions of these drugs (drawing some ire from other countries, such as the US of A) [4] and negotiating for lower drug prices [2]. Essentially, this is described as an, “…exercise of corporate social responsibility” that “…highlights the importance of a strong role for national governments and international organizations, pressuring companies to perform better” [2, p. 72].

On the prevention side, Brazil has been educating its citizens about HIV and distributing condoms, especially to its vulnerable populations, since the 1980s [4].The early education has been described “stigmatizing, threatening, and ineffective” [1, p. 63], but it has improved considerably, and with the help of the media, is now reaching most of the population [1].

Brazil’s success has been attributed to a strong response in public policy, a strong civil society with well-organized AIDS movements and thinking outside the conventional box when it comes to affordable drugs for treatment, changing the global norms for how we treat AIDS [4].

HIV/AIDS is still a national and global crisis, no doubt about that. While HIV/AIDS affects everyone in Brazil, it is unsurprising that the poor and most socially vulnerable are the hardest hit by the disease [1]. The world has a long way to go in terms of fighting HIV/AIDS, but it makes me hopeful to see the viable fight that Brazil has been waging against the disease on behalf of its people.

I’ll be curious to see how this fight transcends (or doesn’t) to the youth I’ll be working with in Porto Alegre.

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References

1. De Arimateia da Cruz, J., da Cruz, B. K., Hammers, C. (2007). HIV/AIDS: The pandemic hits the ‘Sleeping Giant.’ International Social Science Review, 83(1&2), 55-67.

2. Flanagan, W. & Whiteman, G. (2007). “AIDS is not a business;” A study in global corporate responsibility – securing access to low-cost HIV medications. Journal of Business Ethics, 73, 65-75.

3. Joint United Nations Programme on HIV/AIDS

4. Nunn, A. S., da Fonseca, E. M., Bastos, F. I. & Gruskin, S. (2009). AIDS treatment in Brazil: impacts and challenges. Health Affairs, 28(4), 1103-1113.