[Ip-health] Civil Society follow up on the crisis Brazilian AIDS Response

Pedro Villardi pvillardi at gmail.com
Wed Dec 5 13:35:57 PST 2012

*Civil Society follow up on the crisis Brazilian AIDS Response*

(Also published at

Dear Friends,

We want to thank the entire regional and international HIV/AIDS community
for the support given to the Brazilian AIDS movement in relation to our
last appeal concerning the shifts in funding being proposed by the Ministry
of Health (click
 to read the NGOs note). We would also would like thank UNAIDS for its
immediate reaction in respect to the problem we have raised.

The Ministry of Health has recently responded to our concerns in a public
note to both the national and international communities (click
 to read the MoH public note).  While we welcome this manifestation we also
would like to express our view that that the current debate on the
strengthening the Brazilian AIDS response within the public health system
is based on facts and requires more transparency in regard to transitions
being proposed in regard to financial incentives for the implementation of
HIV/AIDS policies at local levels.  Furthermore the specific changes being
proposed must be placed against a broader context, whose main features can
be synthesized as follows:

•    While Brazil has grown economically, has reduced poverty levels
reduced and gained status as a global player, inequality, in it various
forms, remain unacceptably high and we are witnessing the continuous growth
of moral conservative influences in legal reforms and policy design, in
ways that put at risk sexual and reproductive rights broadly speaking as
well as in relation specifically to the intersection between human rights

•    Public funds available for financing civil society organizations
activities in advocacy and prevention are limited. Most principally, its
channeling is submitted to new strict bureaucratic rules that most NGOs are
unable to comply with. Public funds rule do not allow for the contracting
of permanent personnel and sharply restrict the percentage allowed for
administrative expenditures, in ways that have made organizations weaker.
New funding rules are also bound by vertical guidelines determining what
kind of activities can or not are financed. In many cases these rules have
created a widening gap between demands and needs identified at ground
levels and the ability of NGOs to respond to them. The gradual withdrawal
of key international donors from Brazil exacerbates these difficulties and,
in consequence, many organizations are closing down altogether.

•    The crisis experienced by civil society organizations must be placed
against the epidemiological reality of the epidemic, which on the one hand
is concentrated in MSM, gay and trans populations, sex workers, people who
use drugs and the prison population, while it is still imply morbidity and
mortality in the population at large as exemplified by the unacceptable
rates of vertical transmission. The role of NGOs cannot be dismissed as key
channels of access to these groups but also as voices that sustain public
awareness in relation to these patterns. Even today NGO work reaches out to
places where the State is absent to do the job that the State fails to do.
The silencing of voices of NGOs as persistent watchers of the HIV/AIDS
response is also to be seen as a democratic loss or deficit.

•    Furthermore it is important to reiterate that the Ministry of Health
is still proposing that funds transferred under the aegis of the incentives
policy for anti-AIDS actions up to December 2011 that have not been used
(around 80 million dollars) are freed to be used to general epidemiological
surveillance. Unfortunately we have not reason to believe that this fund
will be predominantly used for HIV/AIDS. Suffice to recall that had not
been used before when they had been earmarked.

In view of these many challenges and risk we are calling for a full
re-assessment of the Brazilian National AIDS response within a frame that
will allow to objectively Asses epidemiological data and the social reality
of the epidemics. Despite many years of work, discrimination and prejudice
continue to be a reality faced by people living with HIV and AIDS
everywhere. Each year 12,000 thousand people die of AIDS and 34, 0000 new
cases are registered; vertical transmission has not been eradicated– around
500 news cases per year; access to and quality of services, especially in
the South, North and Northeast regions is still problematic; while rapid
testing is rapidly expanding as an effect of the Ministry of Health
campaigns, the public health network does not have the capacity to absorb
the inevitable increase in demand for HIV/AIDS services creating by testing

The AIDS movement is not dormant. We have been mobilizing unceasingly since
the beginning of 2012 and have put forward a number of proposals aimed at
overcoming the problems here identified. We have made efforts to mobilize
public opinion, organized acts of protest and voiced our concern in the
relevant spheres of dialogue between the government and civil society, such
as the meetings of the National AIDS Commission and of the Commission for
Articulation among Social Movements, which took place in October. We have
also carried our concerns to the highest social accountability mechanism of
the public health system, namely the National Health Council.  In its 239th
ordinary meeting held on November 9 and 10, the National Health Council, in
due exercise of its powers legally, has decided that:
*1.      ” The Variable Minimum Funding determined for Health Surveillance
associated to the Incentives for STD/AIDS and Viral Hepatitis related
health actions shall be maintained; guidelines, norms and regulations shall
be established to govern the use of such incentive funds for the purpose of
the implementation of STD/AIDS and Viral hepatitis related health actions,
duly respecting established priorities, epidemiological parameters, local
differences and specificities, civil society participation and the needs of
those populations most vulnerable to STD/AIDS and Viral Hepatitis.*

*1.    2.      Funds allocated up until 2011, as foreseen in the provisions
of Ordinance 2313 of 2002, that have been transferred to States and
Municipalities under the aegis of the Fund to Fund arrangement shall be
integrally re-invested by each sphere of administration in the year 2013 in
direct actions to confront the STD/AIDS epidemic and the respective plan
shall be inserted in the overall Health Plan and include those funds that
are passed on to finance actions executed by Civil Society Organizations*

*Furthermore, in clear recognition of the urgent need to improve the
current response to HIV and AIDS in Brazil the National Health Council went
on to recommend that:*

*1.    “The Ministry of Health in articulations with the States,
Municipalities, civil society and the academic sector should undertake an
analysis of the AIDS epidemic, including in regard to prevention policies
and related actions and the expansion of diagnosis and the quality of the
care designed to address the epidemic in Brazil, making it possible to
re-assess their significance and thereby support the definition of goals
and actions to be implemented, in the light of the current context and in
harmony with the regulatory norms in force in the Unified Health System
-SUS “.

Thus it is our we wish that World AIDS Day 2012 was not merely a moment of
commemorations, but a critical moment for reflecting on what is required to
be improved or changed in our current and future efforts to consistently
respond to the HIV/AIDS epidemic in Brazil. We are decidedly alert and
fully expect that the decisions of the National Health Council, the highest
body with powers of deliberation in the field of public health policies in
Brazil, be implemented with no delay.   Furthermore, we will continue to
mobilize and will keep open the dialogue with spheres of authority as to
ensure the strengthening of effective, equitable responses that also imply
a full commitment to solidarity, in our persistent quest to overcome HIV
and AIDS.

Yours in solidarity,


*ABGLT- Associação Brasileira de Lésbicas, Gays, Bissexuais, Travestis e
Transexuais* (Brazilian Association of Lesbians, Gays, Bisexuals,
Transvestites and Transsexuals)

*ABIA- Associação Brasileira Interdisciplinar de AIDS* (Brazilian
Interdisciplinary AIDS Association)

*Associação Alternativa Terrazul *(BlueEarth Alternative Association)

*CUT – Central Única dos Trabalhadores – Brasil *(Brazilian Trades Union
Confederation –CUT)

*Fórum de ONGs de São Paulo *(São Paulo NGOs Forum)



*GESTOS- HIV, Comunicação e Gênero* (GESTOS- HIV, Communication and Gender)

*GRAB-Grupo de Resistência Asa Branca- GRAB* (Asa Branca Resistance Group)

*Grupo pela VIDDA/RJ *(Group for Life –RIO)

*Grupo pela VIDDA/SP *(Group for Life –São Paulo)

*Grupo de Incentivo à Vida – GIV* (Incentive for Life Group)

*Rede Feminista de Saúde Direitos Sexuais e Direitos Reprodutivos* (Sexual
and Reproductive Rights Feminist Network)

*Relatoria Nacional do Direito Humano a Saúde Sexual e Reprodutiva da
Plataforma Dhesca Brasil *(National Human Right to Sexual and Reproductive
Health Monitor of the Dhesca Brazil Platform)

*Rede de Pessoas Vivendo com HIV e AIDS - RNP+ Brasil *(National Network of
People Living with AIDS - Brazil)

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