The Brazilian AIDS Program combines prevention with free distribution of antiretroviral therapies and is widely touted as a model for stemming the AIDS crisis in the developing world. In the face of the devastation brought on by AIDS, the unlikely availability of a vaccine in the near future, and the relatively few interventions that seem replicable, this is a most welcome success story. It emerges not out of utopian principles or privileged contexts but out of a desperate reality and redirection of what seemed inflexible, commercial, scientific, and state logic toward equitable outcomes. In 1992 the World Bank and the Brazilian government approved an unprecedented $250 million aid package for the creation of a new National AIDS Program whose aim was to reverse what international experts were calling the “Africanization” of AIDS in Brazil.1 AIDS activists, politicians, economists, and scientists organized an impressive governmental and nongovernmental administrative apparatus that is believed to have contained the epidemic’s growth through massive and community-mediated prevention projects, with a focus on condom distribution, HIV testing, and behavioral change among the so-called high-risk groups.2 In 1996, for the first time, national data showed a decrease in the epidemic’s growth rate. The National AIDS Program and the World Bank now report that half of the projected 1.2 million HIV cases have been averted.3
