Casa de Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil.
Glob Public Health. 2022 Jun;17(6):815-826. doi: 10.1080/17441692.2021.1896764. Epub 2021 Mar 9.
This paper examines the decline of the AIDS Programme in Brazil, the Latin American country most affected by the epidemic, with emphasis in the second decade of the twenty-first century. For many years, Brazil served as a model in Global Health due to a comprehensive preventive policy, a partnership between the government and health activists and the support of life-saving drugs as public goods rather than commodities. The regression of AIDS policies in Brazil interacted with developments in the United States as well as with multilateral agencies like UNAIDS that emphasised biomedicalisation in the response to the disease where broad human-rights programmes and alliance with activists were not priorities. International programmes like the 'Ending AIDS' campaign indirectly undermined the exceptional status AIDS enjoyed since the late 1980s. The backlash in Brazilian policies to fight AIDS was a result of the fragmentation of the left and the empowerment of radical conservative authoritarian and religious forces. The result was the breakdown of the long-held belief that successful anti-AIDS disease programmes could simultaneously help control the disease and build better healthcare systems and ultimately prompted the end of the special place AIDS' policy had in Brazil.
本文探讨了艾滋病规划在巴西的衰落，巴西是受该流行病影响最严重的拉美国家，重点是在 21 世纪的第二个十年。多年来，由于全面的预防政策、政府与卫生活动家之间的伙伴关系以及将救命药物作为公共产品而不是商品的支持，巴西在全球卫生领域堪称典范。巴西艾滋病政策的倒退与美国以及艾滋病规划署等多边机构的发展相互作用，这些机构在应对艾滋病时强调了生物医学化，而广泛的人权方案和与活动家的联盟并不是优先事项。像“终结艾滋病”运动这样的国际项目间接地破坏了自 20 世纪 80 年代末以来艾滋病享有的特殊地位。巴西抗击艾滋病政策的倒退是左派分裂和激进保守的独裁和宗教势力增强的结果。其结果是，人们长期以来一直认为，成功的艾滋病防治方案既能帮助控制疾病，又能建立更好的医疗保健系统，最终导致艾滋病政策在巴西的特殊地位终结。
