The Politics and History of AIDS Treatment in Brazil

The development of Brazil's AIDS treatment institutions over the past two decades has shifted global thinking on health care policy and access to essential medicines in poor countries. Moreover, it has paved the way for the current dramatic expansion of anti-retroviral therapy for people living with HIV/AIDS throughout the developing world. In "The Politics and History of AIDS Treatment in Brazil," Amy Nunn adeptly explores the historical and institutional forces which shaped Brazil's pioneering treatment initiative. This carefully researched account illuminates the complex political, social, and economic factors that influenced AIDS treatment policy in Brazil, and highlights key turning points. The picture that emerges is one in which political entrepreneurialism, civil society activism, international economic politicking, and chance all play defining roles. Particularly fascinating is Nunn's analysis of the symbiotic interplay between progressive policymakers and enterprising social movements. Also interesting given current trends in social policy is the contrast between the success of Brazil's centralized AIDS program and the challenges faced by other, decentralized health initiatives. Nunn also brings attention to the looming institutional and financial challenges that Brazil will face in maintaining and improving AIDS treatment in the future. Thoroughly researched, clearly written, and engaging, this book provides important insight into a policy process of historical significance. Brazil's AIDS treatment program is a major policy success achieved in the context of an otherwise weak institutional environment. Good studies of such achievements are hard to find, and Nunn's account is a valuable contribution to the literature.

Brazils AIDS program is world-renowned for its policy of providing free and universal access to AIDS treatment, successful civil society partnerships and prevention programs. This book, grounded in extensive qualitative, quantitative and historical research, and is an exceptional work that explains how Brazil improved access to AIDS treatment at both domestic and international levels. Amy Nunn begins with an excellent overview of the AIDS epidemic and genesis of AIDS treatment in Brazil. She then demonstrates how Brazil strategically used World Bank loans, public production of AIDS drugs, collaboration with international agencies, and strategic engagement with the media and global social movements to support its controversial, if highly successful, AIDS policies. This book is suitable for a wide audience and should be considered essential reading for anyone interested in AIDS policy and global health. Elize Massard da Fonseca is a PhD Student in Social Policy - University of Edinburgh, United Kingdom.

In developing countries, successful social policy initiatives are rare. Brazil, for instance, is notorious for having educational and health indicators that lag behind its economic development level. But as Amy Nunn analyzes in this very thoroughly researched book, Brazil did succeed in averting a looming health crisis by building up a rather successful program of AIDS treatment. The book skillfully traces the role of social movements and professional activists who found positions inside the Brazilian state in the course of the country's lengthy democratization. Nunn also analyzes Brazil's bargaining with multinational pharmaceutical companies. While not lighting any big theoretical fireworks, the book offers a highly informative, well-researched study of an interesting instance of "good government in the tropics."