Brazil has succeeded in turning around the bleak forecasts of the past. Hard hit by the spread of HIV/AIDS in the 1980s and 1990s, the country now has several aspects of the epidemic under control and is affording a better quality of life to people living with HIV, thanks to proactive leadership by the government and support from civil society.
Two decades ago, experts predicted that Brazil would have 1.2 million people living with HIV/AIDS by the end of the millennium. The number of people with seropositive status today, however, stands at just over 580,000. This means that HIV infection levels have fallen back to roughly where they stood in 1995.
The success of Brazil’s strategy has sparked interest among other countries facing this plague in hopes of emulating the Brazilian example, namely in Sub-Saharan Africa and in Latin America. The strategy is built around four pillars: prevention, treatment, human rights, and funding.
The country’s prevention programs have focused on marshalling support from civil society (600 participating NGOs), providing widespread access to condoms (70 percent of men use them), including HIV/AIDS-related topics in school curricula, offering care for the most vulnerable and high-risk groups, and promoting women’s rights, including programs to address mother-to-child transmission.
In the area of treatment, Brazil is committed to its policy of free universal coverage for people with HIV/AIDS. The country has made an extraordinary effort to bring care services to the patient, regardless of where he or she lives. The health infrastructure now in place is able to serve patients in even the most remote areas.
An outgrowth of this policy of free, universal treatment is that people are more willing to submit to voluntary, confidential testing, and as a result cases of HIV/AIDS that would normally not be reported are being detected in their initial stages. Furthermore, people who have been infected with the virus remain in close contact with government- and NGO-operated health systems, and thus receive information, guidance, and preventive treatment. The antiviral therapies in use have produced considerable drops in infection levels. At the same time, patients show increased self-esteem because they feel more useful and make an effort not to spread the virus to others. Treatment has a positive and important impact on prevention.
Brazil also produces its own antiretroviral drugs, a move that has drastically reduced prices and set a global precedent. In 2000, the total cost of treatment for a group of 80,000 patients was calculated at roughly $400 million. As the table above shows, the cost per patient is significantly less than that of other countries with serious AIDS treatment programs.
Another Brazilian initiative has been the establishment of a database on the Internet to report on comparative costs of drugs in different countries. The objective is to foster competition and thereby bring down prices.
Brazil’s human rights program has two fronts of action. First, to combat the stigma that regrettably is still associated with HIV/AIDS and eliminate any and all forms of discrimination that contribute to propagating the epidemic. Second, access to medical care has been considered a fundamental element of the basic human right to enjoy the highest possible level of mental and physical health.