As Brazil continues its fight to contain the HIV epidemic and treat those who are already infected, the nation is also facing larger economic and societal challenges.

A persistent problem for Brazil has been its debilitating poverty and the limited opportunities available for those in its grip. Brazil's general economic productivity means it can be considered a middle-income country. But according to The Economist magazine, that industrious exterior belies its internal problems because of its extreme imbalance in wealth distribution.

"Its glaringly unequal income distribution," The Economist explained in a February 2003 issue, "means that the poorest 50 percent account for 10 percent of national income -- and so do the richest one percent."

Brazil's gross domestic product in 2002 was an estimated $452 billion total and $2,600 per capita, according to The Economist. The United States, Brazil's largest trading partner, had a GDP of $10.5 trillion total and $36,400 per capita. Argentina, Brazil's northern neighbor and second largest trading partner had a 2002 total GDP of $102 billion and $2,700 per capita.

The inequality in wealth and educational opportunities has added to the Brazilian government's challenges as it administers its HIV treatment and prevention programs. While some 48 percent of Brazil's young people used a condom the first time they had sex, that number rose to 71 percent among those with higher levels of education according to a Durex study released in 1999. As in most nations, more educational opportunities in Brazil are available to those with higher incomes. In 2000, the United Nations Development Program reported that more than 90 percent of the poorest four-fifths of the Brazilian population did not attend secondary school, and practically none made it to universities.

Brazil's size also makes containing HIV a daunting task. At 3,290,000 square miles, Brazil is larger than the continental United States. However, according to Dr. Artur Kalichman, coordinator of the STD and AIDS programs for the São Paulo Health Department, Brazil has been able to keep HIV from spreading rapidly in rural areas as it has in Africa.

Recent Political Changes

Luiz Inacio Lula da Silva, known by Brazilians simply as Lula, was elected in October 2002 on a radical reform platform. Lula has also, however, promised major changes in Brazil's social policies and has promised to make life better for all Brazilians, a goal that could prove difficult in light of the country's economic woes. As he campaigned, Lula promised to improve Brazilians' finances, health and welfare while imposing disciplined reforms on the finances of the state. Keeping this promise could prove a daunting task.

Political observers predict showdowns between the administration and various stakeholders over budget decisions.

A former socialist, Lula has pursued free trade agreements he believes will benefit Brazil, and he recently assured investors and the International Monetary Fund that his country will not default on its public debt. Brazil’s public debt now stands at 56 percent of the country's GDP, an amount analysts say could eventually cripple the economy if left unchecked.

Dr. Humberto Costa, Brazil's health minister, assured the NewsHour in a May 2003 interview that the new administration will continue the nation's AIDS and HIV programs.

"This is a program that was started in 1986, and we must maintain and... improve it," Costa said.

-- By Jason Manning, Online NewsHour