HIV/AIDS: the pandemic hits the 'sleeping giant'

International Social Science Review, Spring-Summer, 2007 by Jose de Arimateia da Cruz, Becky K. da Cruz, Corrie Hammers

Introduction

Today, Brazil is home to more than half of all known HIV/AIDS cases in Latin America and the Caribbean. (2) As one of the world's five leading causes of death, the devastating impact of this disease is forcing government officials, political institutions, and civic organizations to recognize the seriousness of the problem. This study discusses the HIV/AIDS pandemic in Brazil by examining both those who have contracted the disease and the measures being taken by the government to minimize its consequences.

HIV/AIDS is an pandemic that has spread rapidly over the last two decades, causing massive human death and suffering, particularly in the developing world. (3) There is a growing recognition that HIV/AIDS is not only a serious health issue but also a major developmental catastrophe threatening to dismantle the social and economic achievements in all developing countries, including Brazil, of the past half-century. (4) According to the World Bank, HIV/AIDS is a unique disease due to its seven attributes. First, it spreads quickly. Second, those who contract HIV/AIDS may remain infected for years without showing any symptoms or knowing that they have the virus. This significantly increases the chances of spreading the disease. Third, HIV/AIDS reduces life expectancy, which is positively related to savings, productivity, and education. Fourth, HIV/AIDS primarily affects young people, ages fifteen to forty-nine, who are in the prime of their lives as workers and parents. Fifth, people infected with HIV/AIDS suffer repeated and prolonged illnesses, imposing great costs on households and health systems. Sixth, HIV/AIDS breaks down social cohesion, challenges value systems, and aggravates deeply rooted and sensitive gender inequalities. Lastly, there is no current cure for the disease. (5)

Statement of the Problem

In 1992, the World Bank estimated that by the turn of the century approximately 1.2 million Brazilians would be infected with HIV/AIDS. At the beginning of the twenty-first century, the government reported that there are 650,000 Brazilians infected with HIV/AIDS (See TABLE 1)--less than half of the World Bank's projection. (6) Of those living with HIV/AIDS, most are between the ages of fifteen to forty-nine, which constitutes 0.7 percent of Brazil's population. Since these individuals are considered the most productive members of society, Brazil must act quickly to curb the spread of HIV/AIDS in order to prevent an economic, political, and social catastrophe. (7)

To effectively respond to this pandemic, HIV/AIDS must be treated as both an emergency and a long-term developmental issue. In other words, governments must resist the temptation to view the disease as simply another of the world's many problems. The tenacity and the easy transmission of HIV/AIDS requires a response that is flexible, creative, energetic, and vigilant. (8) It must be treated as one of the greatest health crises the world faces today. As former U.S. Secretary of State Colin Powell declared, HIV/AIDS is the "greatest weapon of mass destruction on the earth." (9) Despite such recognition of the deadly nature of this disease, for the past twenty years few academicians and policy makers have debated the social, political, and economic impact of HIV/AIDS. Instead, most have ignored the problem or denied it completely. (10)

In its 2004 Report on the Global AIDS Epidemic, the Joint United Nations Program on HIV/AIDS (UNAIDS) presented a depressing but realistic picture of the world fight against the disease. It estimated that 4.8 million people became newly infected with HIV/AIDS, up from two million in 1999. This represented the largest number of newly infected cases recorded in a single year. Today, some 37.8 million people are living with HIV/AIDS, a disease that killed approximately 2.9 million people in 2003 alone, and over twenty million since the first cases of HIV/AIDS were identified in the early 1980s. (11) The human, social, and economic toll of the pandemic has been profound in Latin America and the Caribbean where two million people currently live with HIV/AIDS. Over the last two decades, nearly 600,000 people in the region have died from AIDS; approximately 567 people in Latin America and the Caribbean are infected with the HIV virus every day. (12)

The devastation caused by HIV/AIDS not only has a human cost, it also has a serious social impact on every nation-state touched by this disease. AVERT, an international HIV/AIDS charity involved in efforts to prevent the spread of the disease, reports that HIV/AIDS can devastate whole regions, knock decades off national development, widen the gulf between rich and poor nations, and push already stigmatized groups closer to the margins of society. (13) In Latin America and the Caribbean, the pandemic is heavily concentrated in groups which engage in high-risk sexual behavior--commercial sex workers (CSWs), men who have sex with men (MSM), and injecting drug users (IDUs) (14)--but it is spreading rapidly among the general population. In Brazil, the most populous country in the region and home to more than one in four of all those living with the disease across the globe, the national prevalence rate is well below one percent. (15)