Accès au traitement du sida, marchés des medicaments et citoyenneté dans le Brésil d'aujourd'hui

This article addresses the politics and economics underlying Brazil's universal AIDS treatment policy and probes its social and medical reach in urban poor contexts where AIDS is spreading most rapidly. I argue that a combination of patient activism, pharmaceutical industry interests, and state reform has led to an incremental change in the concept of public health, now understood less as prevention and medical attention and more as access to medicines and community-outsourced care. AIDS therapies have indeed become universally available (the state is actually present through the dispensation of drugs), yet it is up to individuals and communities to take on the roles of medical and political institutions locally. Against the backdrop of limited infrastructures and through multiple circuits of care, the individual subjectivity of some AIDS patients is refigured as a will to live.