The Brazilian Model for HIV/AIDS Prevention and Control:
Analyzing its Components and Assessing its Transferability
Grant Supported by Ford Foundation
Executive Summary
Background
Over the course of recent years, international attention has increasingly focused on the multi-dimensional range of HIV and AIDS prevention and control activities developed in Brazil by governmental AIDS programs and non-governmental AIDS-service organizations and other sectors of civil society. Funded both through a series of major loans by the World Bank to the Government of Brazil, as well as by a significant commitment of resources from the Brazilian National Treasury, and supported through a broad-based and apparently far-reaching process of social and political mobilization, what has come to be described by some as a “Brazilian model” for the response to AIDS has been suggested not only as perhaps the most successful experience yet realized in any developing country, but perhaps anywhere. It has increasingly been identified as a model that other middle and low-income countries might seek to emulate or replicate in their own national efforts. While the Brazilian model has thus played a crucially important role in many recent debates (offering hope and optimism concerning the possibility of successful responses to the epidemic in a context otherwise characterized by few success stories), the actual content of this model has often been characterized only superficially, and the extent to which it might actually be transferred to other social, cultural and political settings has never been specified. The proposed project seeks to advance the international policy debate concerning the response to HIV and AIDS in the developing world through a detailed examination of the so-called Brazilian model for HIV and AIDS prevention and control, together with a more profound debate about the possibilities and limitations for applying this model (or elements of it) in other countries in the developing world.
Goals
To review the development of HIV and AIDS prevention and control activities in Brazil, and to evaluate the degree to which it is possible to speak of a “Brazilian model” of programmatic activities in response to the epidemic.
To define the key components or principles that underlie the so-called “Brazilian model”, and to outline their historical development over the first two decades of the epidemic.
To assess the extent to which some or all of these components might be transferable to other developing country settings (or even to developed country settings).
To provide an opportunity for interaction and exchange between program staff, researchers, and advocates working on HIV and AIDS in Brazil, the United States and internationally, in order to assess lessons learned in responding to the first two decades of the epidemic.
To disseminate findings through strategic publications aimed at reaching policy makers, advocates and researchers working on HIV and AIDS internationally.
Activities
1) Development of a detailed set of background papers detailing the key components of the Brazilian response to HIV and AIDS in relation to prevention, care and treatment, and human rights. The background papers will be written primarily by Brazilian specialists on HIV/AIDS and will circulate prior to the conference. These papers will be used as the point of departure for discussions at the conference and will be revised on the basis of conference proceedings. The specific subject matter will include: (a) an overview of HIV/AIDS research in Brazil; (b) an overview of the epidemiology of HIV infection in Brazil; (c) an overview of the development of HIV/AIDS prevention programs (implemented by both governmental and non-governmental organizations in Brazil); (d) an overview of care and treatment programs, with special emphasis on treatment access issues (including linked texts that will address commerce and trade and intellectual property issues); and (e) an overview of civil and human rights works related to HIV/AIDS in Brazil. These background papers will provide a point of departure for the definition of the “Brazilian Model” of responding to HIV/AIDS, as well as for the discussion of transferability of some or all the components to other countries settings.
2) Organization of an intensive international conference, to be held at Columbia University in the first semester of 2002, to bring together policy makers, advocates and researchers from Brazil and other countries, as well as the representatives of international agencies involved in the response to HIV and AIDS in the developing world, to analyze the key components of the Brazilian response and their potential transferability to other country settings. The conference’s program will open with an introduction by conference organizers. It will be followed by a round-table session providing an overview of the “Brazilian Model.” In the afternoon of the first day there will be two sessions: human and civil rights in the response to AIDS and prevention programs in Brazil. During the morning of the second day there will be two sessions that will focus on treatment and care issues: one on development of programs for universal treatment and the other on the consequences and implications of these treatment access programs. In the afternoon of the second day there will be two sessions on evaluating the impact of AIDS programming in Brazil and on the influence of the Brazilian program on neighboring countries. The morning of the last day of the conference there will be two sessions, one on impact of the Brazilian program for treatment activism and the other on community organizing and the transferability of lessons learned in Brazil. The conference will conclude with a definition of the next steps for dissemination of conference findings and possible future collaborations.
3) To publish the results of these debates in order to disseminate findings among policy making, advocacy and research communities, in order to broaden the potential impact of the Brazilian experience in other middle and low income countries. Background papers in English will be prepared for publication internationally. This will be especially important because of the linguistic barrier posed by lack of knowledge of Portuguese has often made difficult for lessons to be shared with other international actors and developing countries policy makers and advocates involved in the global response to HIV/AIDS. Possibility of dissemination of the findings of the conference for the next International AIDS Conference (Barcelona 2002) will be explored. Conference findings will also be made available through the websites for the Department of Sociomedical Sciences, the Brazilian Interdisciplinary AIDS Association (ABIA), and the Brazilian National AIDS Program.