{"id":169,"date":"2007-03-22T13:27:41","date_gmt":"2007-03-22T18:27:41","guid":{"rendered":"http:\/\/blogs.law.harvard.edu\/politicshiv\/2007\/03\/22\/aids-in-brazil-at-harvard-panel-1"},"modified":"2007-03-22T14:51:08","modified_gmt":"2007-03-22T19:51:08","slug":"aids-in-brazil-at-harvard-panel-1","status":"publish","type":"post","link":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/2007\/03\/22\/aids-in-brazil-at-harvard-panel-1\/","title":{"rendered":"AIDS in Brazil at Harvard, Panel 1"},"content":{"rendered":"<p>Panel I: Undergraduate and Graduate Student Research on HIV\/AIDS in Brazil<br \/>\nPanelists:<br \/>\nDavid Martin, Harvard College 07<br \/>\nAmy Nunn, ScD, Harvard School of Public Health, dissertation: &#8220;The Politics of Life and Death: A Historical Institutional Analysis of Antiretroviral Drug Policy in Brazil&#8221;; Corporate Relations Manager, Global Business Coalition on AIDS, Tuberculosis and Malaria<br \/>\nSophia Zamudio-Haas, M.S. Candidate in Population and International Health, Harvard School of Public Health.<br \/>\nModerator: Lorena Barberia, Program Associate, Brazil Office, David Rockefeller Center for Latin American Studies<\/p>\n<p>Amy Nunn:<\/p>\n<ul>\n<li> Global context of the epidemic.  In the world, only about 1.6 Million of 7 million needing HAART receive it<\/li>\n<li> Brazil was the first country to implement HAART and has the most people on it. ABout 175,000 right now.<\/li>\n<li> What social and political processes best explain the development of Brazil&#8217;s AIDS treatment institutions?<\/li>\n<li> -case study approach, 86 people in 91 interviews; 5000+ news articles, cong records, etc.; descriptive historical data.  Using a historical institutionalist approach.<\/li>\n<li>1990: Brazil&#8217;s first federal commitment to provididng drugs for AIDS treatment. <\/li>\n<li>1996: Law 9.313 establishes foree and unversal access to drugs and treatment (Sarney&#8217;s Law)<\/li>\n<li>1997: AIDS treatment costs rise dramatically b\/c of the scale up and the new regime of respecting intellectual property laws<\/li>\n<li>Inst&#8217;ns: 1998-scale-up of ARV prod&#8217;n.  2000&#8211;Brazil&#8217;s tradition of threatening to issue compulsory license to reduce the price of patented ARVs.  2001-06: Brazil&#8217;s contributions to international health, human rights and trade institutions related to essential medicines (introduction of a number of resolutions in international fora)<\/li>\n<li>Outcomes: USTR files but later drops trade complaint; Multinat&#8217;l pharma companies drop ARV prices; Brazil negotiates ARV prices and price negotiation traditions endure<\/li>\n<li>Brazil&#8217;s costs have gone up, but it has saved about $1B through it&#8217;s pricing negotiations<\/li>\n<li>Brazil&#8217;s actions have affected the global treatment<\/li>\n<li>&#8211; Showed that resource-poor settings could have treatment<\/li>\n<li>&#8211; dramatic increases in AIDS and global health spending<\/li>\n<li>&#8211; Flexibility on intellectual prop rights and public health issues<\/li>\n<li>-1.6M on ARV today<\/li>\n<li>-never would have happened if Brazil hadn&#8217;t taken its actions<\/li>\n<li>Key Findings:<\/li>\n<li>-Brazil&#8217;s strategies were born in Brazil and the result of local initiative<\/li>\n<li>-Democ and regime change have provided instituional openings for social movements<\/li>\n<li>-Middle-income countries can and do have an enormous impact on global policies and regimes<\/li>\n<\/ul>\n<p>David Martin, Undergrad H&#38;S Harvard<\/p>\n<ul>\n<li>Brazilian response has three factors<\/li>\n<li>-Social mob&#8217;n via civil society mechs<\/li>\n<li>AIDS policy via int&#8217;nal mechs<\/li>\n<li>Technological developments in HIV treatment<\/li>\n<li>Response successful becuase<\/li>\n<li>-AIDS elicited a quick response<\/li>\n<li>-adaptability of AIDS policy to changing face of the epidemic<\/li>\n<li>-intro of new, effective treatment options<\/li>\n<li>AIDS and democratization<\/li>\n<li>-umbrella mov&#8217;t for previously voiceless<\/li>\n<li>-reveled the public health crisi and the social fractures within Brazilian society<\/li>\n<li>Civil soceity&#8211;what&#8217;s its role?<\/li>\n<li>-Augments the quality of the treatment program: provided some social infrastructure in geographic areas not covered and helped with the negative social manifestations of the disease(stigma, emotional support, reintegrate into society, poverty)<\/li>\n<li>Talked about an NGO in Recife as an illustration of the interaction of civil society institutions with government.  Specifically, &#8220;Gestos, Soropositividade, Comunicacao, e Genero&#8221;<\/li>\n<li>Tech and Civil Society<\/li>\n<li>-Response to HIV became subject to international influence (TRIPS, compulsory licensing, etc.)<\/li>\n<li>-Increasing reliance on ARV meant a decreasing role of civil society<\/li>\n<li>Medicalization of AIDS (neglect of the social problems that stem from having AIDS)<\/li>\n<li>-ARVs only address teh physical aspects, neglecting the social dimensions of HIV, which is what the civil-society groups did.<\/li>\n<li>Sustainability of Brazilian Response?<\/li>\n<li>-Precarious balance between the social and physiological mechs of epidemic control<\/li>\n<li>-society demobilizing as HIV has become a chronic, managed disease<\/li>\n<li>-not clear what the financial sustainability of ARVs is.<\/li>\n<\/ul>\n<p>Sophia Zamudio-Haas<\/p>\n<ul>\n<li>Presentation of the volunteer work she did for a year in Rio.<\/li>\n<\/ul>\n<p>One question that the first two panelists raised that I don&#8217;t think were adequately answered was whether Brazil&#8217;s HIV policies dramatically changed global practices regarding HIV.  From what I know of the global regimes, this isn&#8217;t a far-fetched notion, but I did not see any systematic evidence to support this sort of causal claim.  It&#8217;s a fairly strong causal statement, and I didn&#8217;t see evidence or methods that supported the reach of that claim.  In talking with Amy, she said that she&#8217;s been surprised that more people don&#8217;t know about the international dimension.  Her proof is in the historical documentation that she was able to do on Brazil&#8217;s action in multilateral fora.  I&#8217;m going to try to get a copy of the dissertation.<\/p>\n<p><!-- technorati tags start --><\/p>\n<p style=\"text-align:right;font-size:10px;\">Technorati Tags: <a href=\"http:\/\/www.technorati.com\/tag\/AIDS\" rel=\"tag\">AIDS<\/a>, <a href=\"http:\/\/www.technorati.com\/tag\/conferences\" rel=\"tag\">conferences<\/a>, <a href=\"http:\/\/www.technorati.com\/tag\/HIV\" rel=\"tag\">HIV<\/a>, <a href=\"http:\/\/www.technorati.com\/tag\/research\" rel=\"tag\">research<\/a><\/p>\n<p><!-- technorati tags end --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Panel I: Undergraduate and Graduate Student Research on HIV\/AIDS in Brazil Panelists: David Martin, Harvard College 07 Amy Nunn, ScD, Harvard School of Public Health, dissertation: &#8220;The Politics of Life and Death: A Historical Institutional Analysis of Antiretroviral Drug Policy in Brazil&#8221;; Corporate Relations Manager, Global Business Coalition on AIDS, Tuberculosis and Malaria Sophia Zamudio-Haas, [&hellip;]<\/p>\n","protected":false},"author":709,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1104,1107],"tags":[],"class_list":["post-169","post","type-post","status-publish","format-standard","hentry","category-events-past-present-and-future","category-politics-and-policy"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/posts\/169","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/users\/709"}],"replies":[{"embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/comments?post=169"}],"version-history":[{"count":0,"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/posts\/169\/revisions"}],"wp:attachment":[{"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/media?parent=169"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/categories?post=169"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/archive.blogs.harvard.edu\/politicshiv\/wp-json\/wp\/v2\/tags?post=169"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}