HTLV on the government agenda: the case of the states of Bahia and Minas Gerais, Brazil

Abstract

HTLV is a retrovirus that affects the human T-lymphocytes. Transmission is bloodborne, sexual, or mother-to-child. Most infected persons are asymptomatic carriers, but some may develop severe cases such as tropical spastic paraparesis, leukemia/lymphoma, and other manifestations. Brazil is considered the country with the highest absolute number of cases, with an estimated 800,000 infected individuals. This article aimed to investigate and analyze the process of inclusion of HTLV on the government agenda in the states of Bahia and Minas Gerais, and which impacted health sector actions and policies. Interviews were held with key actors, and a document search was performed for analysis, using as the main reference the Multiple Streams framework proposed by John Kingdon. Various factors contributed to the theme's inclusion on the health sector agenda in Bahia, the state of Brazil with the widest range of policies on HTLV, involving high prevalence of the infection, a favorable political context, and activism by infected individuals. In Minas Gerais, we observed difficulties in the implementation of this health sector policy; due to the lack of organized advocacy groups, the problem was not a priority in the state's Health Departments. In the current context, individuals with HTLV infection and other stakeholders still have a long road ahead with social mobilization for investments in the area, drafting and implementation of public policies, and guarantee of social rights.