O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil

Abstract

The main objective of this thesis was to identify the processes of rupture and continuity in the policy of coping with AIDS in Brazil, from the legal-institutional point of view and from the organizational and political point of view, in the light of the paradigm of the Ethics of Care. The justification and relevance of the theme are due to criteria: a) epidemiological - the numbers show a worrying increase in the epidemic in an age group that is difficult to manage, such as male adolescents and young adults, and a higher incidence of this problem in historically marginalized groups, such as blacks and brown, being more relevant among black and brown women; b) political – changes that took place in the political scenario, with relevant effects on health policy, challenged the social arrangement that had ensured the policy to fight AIDS a prominent place, both nationally and internationally. The advance of decentralization in the SUS, associated with the taking of neoliberal measures in the scope of public policies, generated positive ruptures, such as the increase in the coverage of assistance to PLWHA. However, it had deleterious effects among them: the loss of prominence of the role of prevention as a right and a care tool, the reduction in the participation of social movements in decision-making, which resulted in the loosening of the collective and emancipatory pact historically associated with achievements of this confrontation; problems related to the limited capacity of some municipalities in the administrative management of public resources; difficulties, given the conservatism that asserted itself at the political level, in the implementation of ethically sensitive policies such as the case of AIDS. As well as the current proposal for fighting AIDS, since 2013 the pharmacological intervention has been adopted. This measure has been intensified to the present day, which occurred uncritically and even in the face of unsatisfactory indicators related to adherence to ARV's, especially when comparing adherence to ART in Brazil (69%) with countries like the United Kingdom (98 %). Which demonstrates some weakness of the policy in this regard. In this sense, assuming the ethics of care as a prevailing moral paradigm in health can contribute to wards escaping from the traps created by the State-control which, through biolaw and biopolitics, tends to homogenize bodies and vulnerabilities.