The Ministry of Health of Brazil is about to publish an ordinance that allows states and municipalities to use, for “general health purposes”, those funds that had been originally transferred by the Union for the exclusive use of AIDS programs but were not used until december 2011, because of either inefficiency or lack of commitment.
For two years now, AIDS activist have denounced that specific HIV/AIDS funds had been kept for months or even years – without clear justification – in the coffers of states and municipalities across the country. We have tirelessly demanded the creation of a mechanism to compel States and Municipalities to spend these AIDS federal funds as required. In August 2012, the amount of these funds accumulated at decentralized levels was around 135 million Reais (US$70 million.)
Instead of positively responding to civil society claims, the recent decision by the Ministry of Health is but another indicator of the continuous dismantling of the Brazilian AIDS response, which we cannot accept. To worsen matters, the Brazilian government has also issued a new decree determining that, in 2013, the so called “incentives’ policy ” that earmarks amounts of the general health budget to specific programs will be terminated. This new rule, if approved, will mean the final blow to the Brazilian AIDS policy as we have known it.
Unilateral decisions are being taken by the executive branch without any discussion with civil society organizations, what will decidedly have detrimental effects on the lives of affected and infected populations. There are 700.000 AIDS cases recorded in Brazil, country with a long history of high social exclusion that, despite poverty-reduction, have not been fully resolved. If the funds transferred via the incentive policy were not properly used even when they were earmarked, it is difficult to believe that local public health managers will prioritize AIDS programs. Furthermore the new policy frames make it increasingly difficult for civil society to monitor and track the use of public health resources.
The experience tells that the majority of public health decision-makers at local level simply do not care and are not interested in people infected and affected by HIV. Many of them consider transvestites, whores, fags, junkies, and the homeless people that could be literally excluded from society. They cannot understand why these marginal populations have “dared” to try influencing social policies to get benefits. Or, why and how NGOs and academia have “dared ” to dialogue and work with these groups and defend their rights and self-determination.
Gone is the time when the Brazilian AIDS policies were built in partnership with civil society. We are now living in an era when public policies are dominated by private companies, when epidemiological analysis and the mapping of needs of PLWA has been eroded or is exclusively directed by economic interests. The Brazilian Public Health System is being increasingly privatized. And, very clearly, in what regards HIV and AIDS, specifically what is prevailing is a climate of cleansing. Recent states’ policies suggest that what is at stake is silencing and hiding of those “people” who may maculate the image of a successful new global player, the country that will host the World Cup and the Olympics. This is combined with the systematic and insidious influenced of dogmatic religious forces on public policy formation in all areas, in particular those sectors, such as HIV/AIDS, where issues of gender and sexuality are prominent.
The new MoH decision comes at a time when NGOs and academia have been systematically denouncing the serious setbacks observed in the Brazilian AIDS response that, as all know, had been considered one of the best in the world.
Please write to the Health Minister, Mr. Alexandre Padilha <email@example.com>, and ask him not to sign this new ordinance. He must fulfill his mandate, which is to work towards ending AIDS in Brazil, not killing the Brazilian National AIDS response.