The Global Effort Against AIDS: Brazil, World Bank, and the Backstage of Health Governance

Forty years after the beginning of the HIV epidemic, the virus continues to challenge governments and international organizations. Although there has been a decline in the number of new infections globally since 2010, Latin America has not followed this pattern. Brazil, the regional epicenter, accounts for almost half of the cases and deaths and has registered an 8% increase in new cases.

The paper by Letícia Schabbach and Talita Eger, published in Espirales Magazine - Volume 9, explores the World Bank's influence on AIDS health governance and shows how the country constructed its response amid tensions between national autonomy and external dependency.

Furthermore, the research reveals three major phases of governance: during the 80s, highlighting the actions taken by NGOs and pioneer states, like São Paulo; in the 90s, emphasizing the centralization of the efforts on the Federal Health Cabinet, by the creation of the projects AIDS I and II, that were sponsored by the World Bank; and, in between the years of 2000 and 2015, with the decentralization of the efforts and transference of resources to the estates and municipalities.

Brazil gained international relevance by guaranteeing free, universal treatment using antiretrovirals, by challenging the big pharma industry in the “war against patents,” and by leading South-South cooperation. However, the country lost its central position after 2010, a consequence of cuts in foreign aid and internal political changes.

The article demonstrates that the fight against AIDS unveils current dilemmas: To what extent can countries from the Global South influence the international agenda? How can we balance neoliberal pressures, universal rights, and society's participation? Brazil’s work showcases that, even in an unequal world, it’s possible to turn resistance into leadership.

These facts are detailed in the article. Link to access the complete article.