Although Evan Lieberman’s study on the boundary politics and government response to HIV/AIDS issue that permeates in Brazil and in South Africa is an insightful and a detailed account of social, historical, and racial backgrounds that led to these two countries on a similar scale of economic development to achieve dramatically different results on improving HIV/AIDS reduction strategies, his argument on racial boundaries in South Africa, compared to the “whitening” of racial boundaries in Brazil seemed to be just a tip of the iceberg. Beyond the relative differences in this case between Brazil and South Africa, the fundamental lack of systematic management tools for accountability in power struggles may exist in different forms in different countries. What struck me the most was the critical role of social activists and smaller NGOs in Brazil, such as gay rights organizations and various minority groups, and what brought them together to create such a fertile ground for decentralized policy reform.
To explore this, I decided to isolate what is considered here as pre-requisites (such as culture and history) to different responses to HIV/AIDS from what is instead, more fluid, and perhaps sometimes subtle, exchange of key ideas through social marketing, or ways deployed by stakeholders in the issue to promote what is “good” change to their society. This was highlighted better in the reading that took a closer look on Brazil’s response to HIV/AIDS (Berkman, Garcia, Munoz-Laboy, Palva, & Parker). The rhetoric such as “human rights”, “sexuality” (which Lieberman also mentioned), “solidarity”, and “citizenship” used are raw materials, or abstract concepts, that can be crafted and framed to define the stakeholders’ mission involved in this issue. They can be shared or framed differently beyond the lines of race and other social divisions as pre-defined boundaries, using the rhetorical tools. Key messages of HIV/AIDS prevention and treatment in Brazil was obviously framed with such keywords instigated and created synergy that moved the policy reform much further in Brazil compared to South Africa.
Abstractness in these concepts is exactly the reason that it can be crafted to a shape of a common interest and urgency to push multiple stakeholders in a collaborative direction, in this case prevention and non-discriminatory treatment of HIV/AIDS patients in Brazil. The art of crafting messages based on the key concept to best transcend public health realm, critical differences and impediments creates space for new understanding of overlapping interests and goals, not necessarily intentional collaborations, but shaping of a clear and convincing goal multiple actors make own decisions to move towards.
The research here is not sufficient to further validate the message framing argument through concrete examples in the recent Brazil’s HIV/AIDS movement. But I can speak from my own experience of working in non-profit marketing, the importance of “framing” the problem differently to gain support of a target audience. As a human trafficking organization for an example, the word “human trafficking” in a developed country like Japan or US may be a distant international news, but if it is framed as the issue affecting domestic adolescent girls being sold into sex industry (which fits right into the human trafficking box defined by the UN), there is a sense of urgency and room for synergy with youth organizations and local enforcement officers to occur. Finding effective ways to communicate the goal and the issue’s urgency is then the art of social marketing and technical as well as strategies to effectively project messages to the right people. The development of Internet and instant social media channels is also dramatically changing the ways voices are projected and goals are shared to reach wider audience, as well as adding complexity to be implemented effectively at the same time.
HIV/AIDS movement in Brazil, whether it was intentional or not, was able to progress by synergy fueled by the ways that the concepts of “human rights”, “citizenship”, and “universal access” were framed, delivered, and powerfully appealed to several minority and influential groups. The same message and social marketing tools may not work in the context of South Africa’s internal divisions due to the various factors that Lieberman explained. “Economic growth”, “gender equality”, or “education” may be different ways of international development community today is framing its key messages to bring about a large-scale change. There is no one cookie-cutter solution to framing an effective message in public health. The right tools and right channels including the appropriate stakeholders to carry influential voices need to be identified to spark synergy across sectors to push for a HIV/AIDS policy reform in a developing country.
*I found some examples of how HIV/AIDS message has been framed over time here: http://www.avert.org/aids-posters.htm