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The Politics and History of AIDS Treatment in Brazil

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Amy Nunn
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Brazil's public policy response to the AIDS epidemic preceded those of many developing countries. During my tenure as President, in 1996, Brazil adopted a law guaranteeing free and universal access to AIDS treatment for all people living with HIV/AIDS. Brazil became the first developing country to provide publicly-financed AIDS treatment for all people living with HIV/AIDS. We now have one of the world's most successful AIDS programs that is considered a model for other dev- oping countries. Today, 185,000 people receive life-saving AIDS cocktails in Brazil, and thousands of lives have been saved. But this was not an easy battle. There were many challenges along the way. Twenty years ago, Brazil's achie- ments today might have seemed impossible. During the 1980s, in Brazil, as elsewhere, there was overwhelming stigma associated with AIDS; people living with HIV often lost their jobs and died quickly before the advent of life-saving antiretroviral drugs. Brazil's AIDS movement was extraordinarily important in promoting progressive AIDS policies; associations of people living with HIV were the first to denounce pervasive AIDS-related discri- nation and called public attention to the importance of AIDS. Activists protested in the streets for over a decade, engaged the media, and framed AIDS as a human rights issue.
"The Politics and History of AIDS Treatment in Brazil
Amy Nunn, Center for AIDS Research, Brown University Medical School, Providence

In 1992, the World Bank warned that Brazil would face enormous challenges confronting the AIDS crisis, and forecast that Brazil would have 1.2 million people living with HIV by the year 2000. Today, AIDS prevalence in Brazil is approximately 660,000, and Brazil is home to the oldest and one of the largest public AIDS treatment programs in the developing world. Challenging the conventional wisdom that AIDS treatment was infeasible in developing countries, Brazil has halved AIDS-related deaths and dramatically reduced AIDS-related morbidity. Today, Brazil's AIDS program is considered a global model.

The first book to narrate Brazil's complex and inspiring history, The Politics and History of AIDS Treatment in Brazil traces development of Brazil's AIDS treatment policies during the country's tumultuous path to democracy as its government redefined access to health care as a basic right. Meticulously researched, and drawing on dozens of interviews with politicians, activists, people living with HIV/AIDS, pharmaceutical executives and health care providers, this profound volume explains the key role of Brazil in raising global AIDS consciousness. The Politics and History of AIDS Treatment in Brazil also explores the global implications of Brazil's program and identifies the challenges ahead for addressing HIV/AIDS in the developing world.

In clear, accessible detail, The Politics and History of AIDS Treatment in Brazil examines:

Brazil's long history of AIDS treatment in the context of progressive social movements.

The coalition-building between politicians, activists and government agencies in developing the country's National AIDS Program.

The role of the executive, legislative and judicial branches of government in promoting access to drugs for AIDS treatment in Brazil.

The government's controversial decisions to produce generic AIDS drugs and challenge multinational pharmaceutical corporations regarding AIDS drug prices.

Brazil's ongoing efforts to promote global access to AIDS treatment and the country's contributions to international health, human rights, and trade law related to access to medicines.

The impact of the Brazilian experience on global AIDS drug prices and global AIDS treatment policy.

The Politics and History of AIDS Treatment in Brazil contains invaluable lessons for readers across disciplines, particularly researchers and practitioners in health policy, global health, HIV/AIDS, political science, and Latin American studies.

"This is an exceptional academic work, one that deserves to be widely read, and that in my opinion will come to be considered the leading historical study on the social and policy response to the HIV/AIDS epidemic in Brazil - and one of the major policy studies on the response to the AIDS epidemic anywhere in the world."

Richard Parker, Mailman School of Public Health, Columbia University

With foreword by former Brazilian President Fernando Cardoso."
The AIDS Crisis and Democratization in Brazil.- Democratization and Institutional Precursors to AIDS Treatment in Brazil.- Development of Brazil's First AIDS Treatment Institutions in a New Democracy.- Legislative Reforms and AIDS Treatment in the 1990s.- Development of Brazil's Contemporary AIDS Treatment Institutions.- Brazil's Contributions to Global Essential Medicines Institutions.- Conclusion.

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