Roadblocks on the Road to Treatment: Lessons from Barbados and Brazil

Abstract

On a beautiful tropical day, two women living thousands of miles apart enter public clinics. One walks past the neatly parked cars in the parking lot, to the front door of the newly built, well-equipped Ladymeade Reference Unit, which stands across from the largest public medical facility on the island of Barbados. Everything about this experience is neat and well-ordered, from the facilities the woman is entering, to the pill boxes bearing brand-name labels that she receives at the in-house pharmacy, to the referral system that sent her here after she delivered a baby across the street. The second woman's experience appears a bit less ordered. The clinic she enters, which sits on the outskirts of one of Brazil's slum-ridden cities, is shabby, with peeling paint and a utilitarian concrete structure. Inside, there are no shiny, manufacturer-sponsored posters to match the pills being dispensed, because these pills do not bear familiar brand-name labels. Though the pictures may appear quite different, they bear a crucial similarity—both women are living with HIV, and both are fortunate to live in countries that have committed themselves to providing universal treatment access for their HIV-positive citizens.Patricia Siplon is Associate Professor of Political Science at Saint Michael's College in Vermont (psiplon@smcvt.edu). Jamila Headley is a student activist and member of the Student Global AIDS Campaign. She received her BA in political science from Saint Michael's College in 2006 (jheadley@smcvt.edu). Both authors would like to thank the Provost's Office at Saint Michael's College for funding and support of this research.

Is universal access to antiretroviral drugs an emerging international norm?

“…The 3 Â 5 Initiative did not create calls for universal ARV access by any means (see, e.g. Farmer 1999 andHeadley and, but it focused them and gave them far greater prominence within the international community. Instead of being a relatively amorphous call to help people with AIDS, this new norm framed its calls for action in relatively concrete terms, of providing something tangible to individuals who could not otherwise acquire it, as a human right.…”