Wednesday, 10 April 2013


(Porto Alegre, April 10) -- Brazil is all the rage in the econ/finance world given its booming economy and increasing weight along with its the up-and-coming “BRIC” (Brazil, Russia, India & China) partners, reflecting the new role of what used to be called, somewhat dismissively, the “Third World.” While that hoary category clearly is inadequate, it’s interesting to see how much of the old lingers in the brave new BRIC world, as I am able to witness while here on a work trip.

Things are better and also just as bad as always, which is probably to be expected given Brazil’s entry into neoliberal heaven along with the rest of us. I was struck upon reading the Sunday paper (O Globo, a right-wing rag that monopolistically dominates the news biz here) at a story about the massive imports of tomatoes from, of all places, China to the Brazilian market. Turns out that Brazil can’t produce enough of the little red fruits or at least not as cheaply as the Chinese can, despite factoring in a six-day trip from western China to Pacific Ocean ports, then another 9 days on an ocean freighter, and finally trans-shipment into the vast Brazilian subcontinent [All these times corrected below.]

This we need? Because the numbers superficially add up and people can make money getting an agricultural product halfway around the world, we should celebrate the entry of Brazil into world marketplace? Think of the carbon footprint of that little piece of probably tasteless matter, a social cost not included in anyone’s calculations because we live in an econometric Fantasyland. But the local price of tomatoes has doubled in the past year, so from a business point of view, it’s a no-brainer.

It’s just a depressingly typical example of how Brazil fits into the modern scheme of things. (I marvel at the same phenomenon when I buy a packet of Chinese garlic in my Bronx greengrocer’s shop.) More telling is the steady collapse of the “Brazilian model” of HIV/AIDS prevention and care, which I saw first-hand in the 1990s and am here to explore once again. It’s a good story of how worship at the neoliberal shrine has gone global and is to be applied by one and all, left-ish or right-ish, come what may, forever and ever amen.

Brazil was a big star in the early years of the HIV epidemic because its traditionally militant health professionals, together with key players among the affected parties, developed a strategy of advocacy, direct services, and defense of the afflicted based on the radical idea that health is a human right—which they even managed to get enshrined in the post-dictatorship constitution. Governments in the newly re-established democracy were susceptible to pressures from these folks, and an interesting quasi-partnership evolved in which the state took seriously its relations with “civil society” as it came to be known in Latin America.

One concrete outcome was the successful fight by Brazilian activists for the inclusion of treatment in the country’s long-term strategy for epidemic control. A lot of people, including supposed experts from entities like the World Bank, said this was crazy, that the numbers were too great, that poor people wouldn’t take their medicines properly, that the infected would have to be written off in favor of preventing new infections among the so-far untouched. Activists considered that posture inhumane, counter-productive and unacceptable, and they won that fight. PePFAR, the Bush-era program that brought treatments to the poorest countries of Africa, couldn’t have come into being without the Brazilian example because public health authorities knew that widespread treatment programs could be successful despite the endemic poverty and infrastructure shortcomings in the beneficiary African countries.

But that remarkable Brazilian model arose out of very specific circumstances. There was great interest in the model itself and the spunky efforts of the Brazilian groups, building on the democratic movement that was itself a model for other Latin American countries trying to rid themselves of brutal military regimes. International development aid flowed to Brazil and strengthened the mobilized doctors, gays, social workers, lawyers, and even sex workers as they organized, attended meetings, developed independent projects, monitored government performance, and carried out their own research. Brazil’s HIV work had all the elements that made the foreign charities’ collective mouths water: local initiative, sophistication, principles they could support, and a government permeable to outside pressures and offers of cooperation.

At the same time, the Brazilian government knew it had a serious problem on its hands and was open to ideas about what to do. A disease concentrated among gay men and IV drug users was not something any health department knew how to address anywhere in the world, and Brazil was no exception. Then substantial funds became available as the multilateral lending agencies got into the game. The timely and smart interventions enabled Brazil to keep its case prevalence down (if “down” is the right word) to an estimated 600,000 cases of as of the late 1990s rather than the anticipated million-plus. Even with costly treatments provided free to any user of the public health system, the country was saving money on hospitalizations and lost productivity, and the AIDS response in Brazil made the country a poster child for the world movement.

Then economic growth took off, and Brazil became the “B” in BRICs, no longer “poor” but “middle-income.” Brazil even puts money into the pot for development aid to worse-off countries while the foreign agencies largely have pulled out of health promotion and health-related NGO support. Little by little, the local groups that had spearheaded a smart, critical response lost funding and now have shrunk to a shadow of their former commanding presence.

Meanwhile, the government went through an evolution of its own. I don’t pretend to understand it in any sort of deep way, but it appears that the post-Lula administration of his protégée Dilma Rousseff is monomaniacally focused on economic growth in partnership with the big industrial and commercial actors as a solution to the country’s problems, one and all. In fact, there has been an explicit marginalization of health as a priority concern in favor of putting money into the pockets of the poorest sectors, which is certainly admirable but hardly precludes trying to keep these same folks in good shape.

I’ll have more to say about all this in the next few days.

[UPDATE] My recollection of the newspaper article about the tomatoes was way off, which is understandable because the facts as presented as completely surreal. It turns out that the 2-3 week timeframe I mentioned for a Chinese tomato to reach the Brazilian market is a gross underestimate. The real length, according to the main business page of Folha de São Paulo for Tuesday, April 9, is as follows: seven days from the Urumqi region of western China, FORTY (40) days (!!) on the sea and upriver to a Paraguayan port, 13 more days for offloading, and another five days to get to the principal Brazilian market for the tomatoes in the state of Goiás. Total: two months to get a tomato halfway around the world.

I linger on this incredible fact because we live in a world where our leaders of all parties and inclinations constantly tell us that we cannot provide a decent life for the mass of the population because there just isn't enough of everything to go around. But we can, as a biped "society", and do spend vast resources to transport goods from one place to the next as part of our collective worship of the new God: Mr Market. Those of the twisted Greeks were amateurs by comparison.

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