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AJPH First Look, published online ahead of print Jun 2, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.054593

Public Health Matters

A Critical Analysis of the Brazilian Response to HIV/AIDS: Lessons Learned for Controlling and Mitigating the Epidemic in Developing Countries

Alan Berkman 1, Jonathan Garcia 1, Miguel Muñoz-Laboy 1, Vera Paiva 2, Richard G. Parker 1*

1 Mailman School of Public Health, Columbia University
2 University of São Paulo and Columbia University

* To whom correspondence should be addressed. E-mail: rgp11{at}columbia.edu.


  Abstract

The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care and treatment program in a developing country. This article critically analyzes the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can inform the development of similar programs in other low and middle-income and developing countries. Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that impacts increasingly on women, and special prevention and treatment programs for injection drug users.

Key Words: Ethics, Global Health, Health Policy, HIV/AIDS, Human Rights, Prevention




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