Laurindo-Teodorescu L, Teixeira PR. Histories of AIDS in Brazil, 1983-2003. Brasília: Ministério da Saúde/Secretaria de Vigilância em Saúde/Departamento de DST, Aids e Hepatites Virais; 2015.

Laurindo-Teodorescu, L; Teixeira, PR. Histórias da aids no Brasil, 1983-2003. Brasília: Ministério da Saúde/Secretaria de Vigilância em Saúde/Departamento de DST, Aids e Hepatites Virais, 2015.

The Brazilian response to HIV/AIDS is known as an example of democratic public policy, constructed by various people. Affected by the epidemic in different ways, innumerable social actors participated, each in their own style and within their own possibilities, in the effort of developing strategies and actions for facing something that was unknown, and that presented a threat to life on a global scale.

This conjunction of multiple and varied initiatives, guided by perspectives that were often very different, but which found their point of convergence in their solidarity, constitutes an internationally recognized model, and is analyzed by different authors and from different points of view^1,2. In spite of their diversity, these analyses overlap in their confirmation that the crucial factors for the success of the Brazilian response to HIV/AIDS - aside from their formal aspects, which were adopted in other countries without similar results³ – were directly related to the Brazilian political context in the era of the epidemic's outbreak. The process of redemocratization of the country; the struggle for direct elections and for a system of universal healthcare; and the strong mobilization of civil society in light of these issues and others linked to the rights of citizenship formed the context in which the Brazilian response to HIV/AIDS came to be designed. However, its vibrant coloration was given by the passion of the activists and other social actors that dedicated themselves to its creation.

It is those passions and engagements, historically and politically situated, and in tune with biotechnological advances and the organization of the Unified Health System, that inspire the publication of “Histories of AIDS in Brazil, 1983-2003,” by Lindinalva Laurindo Teodescu and Paulo Roberto Teixeira, published with the support of the Ministry of Health and UNESCO.

Split into two volumes – one based on the construction of the response from the point of view of governmental agencies, with the other considering the organization of civil society – the book is comprised of stories narrated by more than two hundred individuals from various parts of the country and different social inclusions – activists, health professionals, politicians and managers – that had a presence in the construction of a Brazilian response to HIV/AIDS throughout the first twenty years of the epidemic. When the biomedical resources were still very limited, the best response lay with the efforts of social mobilization for the creation of preventative strategies that guaranteed the enjoyment of sexuality with the least possible risk; for raising of awareness of the population; and reduction of stigma; as well as for the right of access to available treatments at the time.

A thorough bibliographic and documentary review allows for situating the narratives in their respective historical and local-regional contexts, and provides the elements that express the different stories. This choice, and the completeness of the research, allows the reader to have a broader vision of the complexity of the process: the cultural, political, epidemiological, or organizational particularities of each state, city, or region demanded specific ways of crafting the response, which at the same time had to be coordinated with other local or regional initiatives, as well as being compatible with the national guidelines.

The way that the volumes are organized facilitates readers having this simultaneous vision of the local and regional articulations and their reflexivity in terms of national policy. Thus, Volume 1, “Governmental Responses,” tells of the origins of AIDS in the world and in Brazil, and the initiatives in São Paulo, Rio Grande do Sul, Rio de Janeiro, and Minas Gerais that contributed to the structuring of the National Program for STDs and AIDS in 1986. Following this, with a richness of details about the comings and goings, agreements and alliances, the different actions and policies that came to consolidate the national response are presented. The volume that deals with the organization of civil society is organized according to each region of the country, and has a section about exemplary initiatives of civil society that characterized the Brazilian response, such as support centers, and the organization of specific sectors in civil society, such as artists, religious communities, and academic workgroups for studies on AIDS. Special attention is given to the interdisciplinary Brazilian Association for AIDS, ABIA, which since its foundation has been characterized by a hybrid mission of activism, political interlocution, and the production of knowledge.

The organization of themes, sections, and chapters in each volume does not imply that each narrator has their testimony limited to only one topic. To the contrary, their voices reverberate throughout both volumes and the different chapters. Thus, if the response was constructed by various hands, the history of this construction also links different voices and visions.

This way of expressing the testimonials allows the book to be read in a non-sequential way. Each chapter or section deals with a theme, analyzed through different eyes, and at the same time some themes will appear again with a different focus in more than one topic. Like a jigsaw puzzle, each initiative – whether governmental, technical, or from civil society – with its historical and regional specificities, fits together with others to form a whole that takes on harmony, independent of the form assumed by each of its parts which, decontextualized, appear senseless.

The textual interventions of Lindinalva and Paulo Roberto are sparing. In this way, the presence of the authors materializes in the organizational choices of the text, the selection of sources, and most importantly in the methodological rigor that allows them to construct a dense text, albeit extremely agreeable and readable, in which the relevance given to the testimonials does not mean a story in which “the facts speak for themselves.” The analytical perspective of the authors is given in the way the data is organized and complements itself. According to Lindinalva and Paulo, the original idea of creating a “History of AIDS” in Brazil was substituted by the interest to tell the histories of AIDS, by the understanding so familiar to contemporary historians that there is not a single History, but rather histories which in a given moment become interlaced and reinforced⁴.

I found it very emotional to find friends in the pages of the book, familiar persons and situations being described and discussed from perspectives that often surprised my memory; I felt enriched to know about facts that occurred near me but which I did not observe or give their due importance at the time. I was also delighted to get to know the vision of the different personalities involved and their place in the history of AIDS in Brazil; we may think of these actors using their own analyses about themselves and their own actions, and to relive certain moments with a new perspective was a tender and gratifying lesson.

Nevertheless, this is not just a book for the nostalgic. Alongside the opportunity for any reader to know one of the most interesting histories of healthcare in Brazil, the book also provides valuable lessons for those interested in the theme of public policy, in addition to giving an extremely useful understanding of the research methodology.

These are already sufficient reasons to recommend “Histories of AIDS in Brazil.” However, reading it becomes even more relevant in the face of the sudden change of direction in the national and global policies on AIDS in recent years, with the hegemony of the “Treatment as Prevention” strategy, which privileges biomedical approaches to the detriment of more political and psychosocial approaches that characterized previous strategies⁵, as discussed in this publication.

Understanding the political and social dimensions of the Brazilian response to HIV/AIDS has become essential for contributing to a critical analysis of the current model, in the sense of assuring the best utilization of the biotechnological resources currently available without losing sight of the social and healthcare achievements accumulated throughout the epidemic, especially in the period documented by Lindinalva and Paulo Roberto.

The book can be obtained from the Ministry of Health, or downloaded free of charge on the internet. It's worth it! Happy reading.

Referências

• ¹
  Greco DB. Trinta anos de enfrentamento à epidemia da Aids no Brasil, 1985-2015. Cien Saude Colet 2016; 21(5):1553-1564.
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  Kadri MR, Schweickardt JC. As Organizações da Sociedade Civil no enfrentamento à AIDS no Amazonas, Brasil. Cien Saude Colet 2015; 20(5):1331-1339.
• ³
  Larson H J, Bertozzi S, Petin P. Redesigning the AIDS response for long-term impact. Bull WHO 2011; 89(11):846-851.
• ⁴
  Arruda JJ. A Linhagens historiográficas contemporâneas por uma nova síntese histórica. Economia e Sociedade 2016; 7(1):175-191.
• ⁵
  Seffner F, Parker R. The waste of experience and precariousness of life: contemporary political moment of the Brazilian response to aids. Interface (Botucatu) 2016; 20(57):293-304.

Publication Dates

• Publication in this collection
  May 2018