NGOs, Governmentality, and the Brazilian Response to AIDS: A Multistranded Genealogy of the Current Crisis

Abstract

In recent years, Brazilian AIDS activists have faced a growing economic and political crisis that threatens sustainability of the movement and the country's response to the epidemic. Drawing on Michel Foucault's concepts of governmentality and biopolitics, this article offers a multi-stranded genealogy of the Brazilian response to HIV/AIDS to explain the structural fragilities underlying this crisis. Specifically, it traces how a tense constellation of actors, including healthcare reformers, AIDS and sexual rights activists, Brazilian state reformers and the World Bank, came together around a model that has relied heavily on the construction of public-private partnerships and larger policy networks. While these actors' larger visions were often in conflict, their projects partially overlapped around the principles of civil society participation and decentralized administration. Underlying tensions, however, are currently experiencing new pressures, with changes in the regulatory and economic environment and the growing political influence of conservative evangelical sectors. That these shifts are imperiling a model of AIDS prevention long touted as a model for the global South suggests larger implications for AIDS policy and sexual rights activism beyond Brazil.