Braiding Public Health and Human Rights: AIDS, Activism, and International Agencies in Brazil, 1987–1996

Abstract

This article examines the emergence of a synergy that allowed the early development of what was once considered the best anti-AIDS program in the developing world. Initial responses to AIDS in Brazil during the 1980s and early 1990s were marked by a confrontation between activists concerned with human rights, and a government focusing on biomedical management of the epidemic. After 1992, activists, medical researchers, government officials, international donors like the Ford Foundation, health officers, and multilateral agencies like the World Bank were galvanized to cooperate. This was a complex process of braiding knowledge and practices related to activism, science, public health, governance and philanthropy in which each constituency maintained its independence. The result was a complex, holistic, and nuanced AIDS program. The process helped bridge the gap between knowledge and advocacy, generated public awareness, and was instrumental to reducing AIDS mortality developing local human resources and comprehensive policies.

Participatory Health Governance and HIV/AIDS in Brazil

“…Examining the impact of these institutions and policies in the aggregate sheds light on the extent to which these dynamics are occurring across Brazil's municipalities and the potential limits of participatory health governance's reach. Assessing the relationship between municipal participatory spaces and HIV/AIDS outcomes is particularly important given trends in Brazil and HIV/AIDS policy since 2019, including the reduced status of HIV/AIDS as a special policy priority, decentralization of HIV/AIDS prevention, and the rise of radical conservative authoritarian and religious forces (Cueto and Lopes 2022a).…”

“…However, the commissions have historically been the greater sites for incorporating civic organizations into HIV/AIDS policymaking, particularly in more populous municipalities (Le Loup et al 2009; Rich 2019). Brazil’s vibrant environment braided knowledge and practices related to activism, science, public health, governance, and philanthropy in which each constituency maintained its independence, to ultimately advance progress on HIV/AIDS (Cueto and Lopes 2022b).…”