Brazil’s Blessing in Disguise

How Lula turned an HIV crisis into a geopolitical opportunity.


Two decades ago, it would have been hard to imagine finding an upside to an HIV crisis of the scope that Brazil had on its hands. The World Bank estimated that 1.2 million Brazilians would be infected by the turn of the century — by far the highest number of any country in the region. But today, there is plenty of good news to go around. Thanks to aggressive intervention, Brazil has only about half as many HIV cases as predicted. And the country’s popular President Luiz Inácio Lula da Silva, or Lula for short, has taken the show on the road: HIV/AIDS assistance is becoming a powerful tool in the president’s growing diplomatic chest.

Few countries have been as widely praised for their response to AIDS as Brazil. In 1996, Brazil began legally guaranteeing the provision of free antiretroviral (ARV) medication for its citizens. It introduced innovative prevention campaigns targeting sex workers, intravenous drug users, and the gay community — an effort that won the 2003 Gates Award for Global Health from the Bill & Melinda Gates Foundation. Under Lula’s predecessor, Fernando Henrique Cardoso, international agencies, donors, and NGOs described Brazil as having a "model" response to AIDS. "The Brazilian response to AIDS has emerged as a model in tackling both HIV prevention and treatment head-on," said Peter Piot, then executive director of the United Nations’ AIDS program.

Lula, with a keen eye for South-South cooperation, saw an opportunity when he came to power in 2003. So he took the campaign global. He pushed hard to implement the World Trade Organization’s 2001 Doha declaration, an understanding that allows countries to circumvent patent laws on medicines deemed vital for treating life-threatening diseases, such as AIDS. He also upped the ante in his financial and technical assistance to other countries, focusing primarily on former Portuguese colonies in Africa. Speaking in Brasília in 2004 after a four-day visit by then Mozambican President Joaquim Chissano, Lula emphasized his moral commitment to the continent. The two countries promised to build a pharmaceutical lab in Mozambique intended to produce ARV medication. Lula lent a technical hand to Angola’s AIDS awareness campaigns and worked to expand drug production in Nigeria. Similar partnerships have cropped up with Ghana and South Africa.

After the United States, Brazil is the largest producer of sugar-cane-derived ethanol fuel. Here, too, Lula has leveraged success by helping developing countries acquire the technology needed to construct their own ethanol industries. Brazil has transferred biofuel technology to Mozambique and the Democratic Republic of the Congo, and in Nigeria it is in the process of setting up an ethanol plant and a "biofuel town" nearby that will house approximately 1,000 workers and facilitate production.

It’s clear what Lula gained from all this: access to markets and diplomatic influence. By working closely with Africa and other countries, Lula has been able to secure trade routes for oil and agricultural goods, both into and out of Brazil. His biofuel program has created a ready-made export market for Brazilian cars that use both ethanol and gasoline. Beyond Africa, Brazil has used a similar strategy to secure new trading opportunities with India, China, Japan, and several countries in Latin America.

At the same time, Brazil’s AIDS and ethanol policies have won the country even more diplomatic influence — and crucially, sway with Southern allies that Brazil relies upon to push for bigger goals, such as winning a seat on the U.N. Security Council or having a stronger voice in the international monetary system. Armed with such a coalition, Lula and his partners India and South Africa have been looking increasingly prominent at G-20 meetings in recent years. The moves have caught the attention of the United States as well. Lula has the ear of U.S. President Barack Obama, who refers to Lula as "my man" and might even want him to be the next World Bank president, according to some media reports.

All of this success has helped solidify Brazil’s transformation from an important country to an indispensable global player, from a recipient of aid to a donor of foreign assistance. The country now gives money to the International Monetary Fund (pledging $10 billion this year, for example) and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

If the world needed more proof that Brazil was up and coming, its strategic success with its AIDS campaign is as good as it gets. Brazil, too, has surely taken the lesson to heart; sometimes global influence comes not from carrots or sticks, but from an outstretched helping hand.

Eduardo J. Gómez is assistant professor of public policy at Rutgers University at Camden.