Brazil: A Model Response to AIDS

The United Nations Global AIDS, Tuberculosis and Malaria Fund (UNAIDS) has calculated that 600,000 people, including men and women of all ages, live with HIV in Brazil. Of these, 116,000 need antiretroviral therapy and receive it free of charge through the public health system. The cost of antiretroviral therapy in Brazil is roughly $1,000 per person per year, a tenth of the therapies cost in developed countries.

The results of Brazil's bold policy are readily apparent. Since 1996, the mortality rate due to AIDS has dropped 50%, while AIDS-related hospitalizations in the public health system are down by 80%. With each passing year, the government is spending less money on AIDS-related treatments, despite the fact that 15,000 new patients are incorporated into the public health system every year.

Activists point out that the key to the success of Brazils national AIDS program is its partnership with social movements. While the model would have been impossible without the government's unconditional commitment, the government acted in response to the mobilization of broad sectors of Brazilian society. From the late 1980s through the 1990s, scores of citizens organizations waged a tough battle with the state over access to antiretroviral therapy through the public health system, arguing that it should be provided on a par with drugs for other serious illnesses.

Pascual Ortells is a sociologist with Fundación Nimehuatzin, a Nicaraguan organization that works on the AIDS issue, and editor of the magazine DeSida. A previous version of this article was printed in Revista Envío, in Managua, Nicaragua.

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