Running up to World AIDS Day, campaigners have been looking for new ways to prevent the spread of HIV/AIDS, but there is one plan in the fight that has been working; hop over to Brazil, where the Government works in tandem with local prostitutes to combat the spread of the virus with impressive results...

In 1992, the World Health Organisation predicted Brazil would have 1.2 million people living with HIV within 10 years, but, in reality, the number of people was just over half that.  It is this simple statistic that has given the United Nations reason to consider Brazil's AIDS Program as one of the best in the world and caused many experts to call for its model be adopted elsewhere. Not bad for a developing country.

According to health officials, a working partnership with sex workers is key; various sex worker organisations, such as Davida, have been handing out leaflets, condoms and speaking to locals about the merits of protection.  The government also produces posters, promotes plays for children and even plays TV adverts to spread the word; not-to-mention the free testing available to all.  At carnival time, it has been known for 20 million condoms to be handed out.

'The World Health Organisation predicted Brazil would have 1.2 million people living with HIV within 10 years, but, in reality, the number of people was just over half that'

Brazil has 'Sex Profession' registered at its Labour and Employment  Ministry as an official job, enabling sex workers to contribute tax and claim a pension, and the denial and stigma attached to HIV and other sexual health issues isn't as evident as in other countries.

However, the country's model is not without criticism. In 2006, Brazil received a letter from USAID refusing the country's renewal for a $40 million AIDS prevention grant. As a county that officially advocates abstinence as its plan against the transmission of HIV and requires all countries receiving aid to declare prostitution illegal and immoral, the United States found Brazil's flexible stance a little too much.

Instead, Brazil pumps in around $600 million in every year to the cause and tackles the large pharmaceutical companies in an attempt to make the cost of Anti-Retroviral (ARV) drugs more affordable. With tricky patents on these drugs that last for 20 years and that allow only particular pharma companies to produce the drug driving the price upwards, a challenge is to find affordable ARVs sooner rather than later. One option is to action the Doha Declaration, an agreement that allows other countries to copy a patented drug in times of emergency, but some say that this is a risky political move.

However, the chance was taken in 2007 when former President Luiz Inacio Lula da Silva took on the Big Pharma, the pharmaceutical lobby in the US, and purchased copies of drugs. As a result Brazil can tick off Millennium Development Goal 6 as 'achieved' as it now provides ARVs universally to those who need it. At the time the President said: "When making a choice between trade and health, I chose health."

'Brazil has 'Sex Profession' registered at its Labour and Employment  Ministry as an official job, enabling sex workers to contribute tax and claim a pension'

In South Africa where the government recorded the first case of HIV the same year as Brazil, there are now 5.7 million people living with HIV - 680% more than Brazil. Despite the program's success, the war is not over yet. According to Avert there is a dramatic rise in the number of women and young people affected by HIV. So, not one to sit on its laurels, the ministry is taking another innovative approach and has started producing its own condoms from local rubber tress in an attempt to manage their cost and keep up with demand. As the largest single buyer of condoms in the world (with around 1 billion imported each year) this is no easy challenge.

Whilst the leadership's response has been mighty, the role of civil society and people living with HIV has become a trademark of Brazil's response to the disease. They too are already out fighting the next battle as prostitutes and hundreds of NGOs continue to work at grassroots level to educate young and old, rich and poor on the merits of safe sex. According to Avert almost half of sex workers are reached by prevention programs and 60% know where they can take a free test.

With such a high success rate and claims that the model has heavily influenced global AIDS and health policy, Brazil may be allowed to believe that the first battle has been won. But with some saying that the cheap ARVs mean that may not be as effective against new strains of the virus, time will tell if it’s innovative approach will win the next.

Words: Melanie Scagliarini

Photos: Flickr user Ugg Boy/Ugg Girl [PHOTO: WORLD: SENSE] and from Ctrl.Alt.Shift's World AIDS Day action here.