Lula's Reelection Renews Expectations, but HIV Leaders Demand Results in Healthcare and Human Rights

The reelection of Luiz Inácio Lula da Silva (PT) to a fourth term as President of the Republic stirs new expectations among civil society organizations working in the HIV/AIDS response and human rights defense. However, for leaders interviewed by the AIDS Agency (Agência Aids), the continuation of the government also brings a demand: turning commitments into public policies with funding, social participation, and concrete results. Priorities include expanding access to prevention and treatment, incorporating new technologies into the Unified Health System (SUS), tackling discrimination, and ensuring dignified living conditions.

The accounts of João Cavalcante from the National Network of People Living with HIV and AIDS (RNP+); Robson Oliveira from the Network of Adolescents and Youth Living with HIV/AIDS of the State of São Paulo; João Geraldo Netto from the Multiverso Institute and the Super Indetectável Channel; and Gregory Rodrigues Roque de Souza from the National LGBTI+ Alliance reveal different dimensions of this agenda. Although they represent different organizations and experiences, all four advocate for greater community participation in government decisions and measures capable of addressing the inequalities that still hinder access to healthcare and rights.

RNP+ Demands Policies That Go Beyond Access to Medication

For João Cavalcante of RNP+, the next term must consolidate public policies aimed at people living with HIV, complete with adequate funding, goals, transparency, and coordination between the federal government, states, municipalities, and social movements. The representative highlights that the election result does not eliminate historical problems, such as stigma, discrimination, and the inequalities that directly affect this population's quality of life.

"We need to turn these commitments into concrete results as quickly as possible to reduce inequality, expanding access to services and ensuring that no one is left behind," he states.

One of João's main demands is that community organizations participate not only in discussions but also in the formulation, execution, and oversight of healthcare policies, including monitoring the funds allocated to prevention and care initiatives.

"We don't just want to be heard, right? During consultations, as part of a survey or as a statistic—we want to participate in these decisions, monitor the execution of these projects and their funds, and help ensure that policies reach those who need them most," he emphasizes.

Tackling racism, LGBTphobia, and other forms of exclusion is also among his concerns. João draws attention to the needs of Black people, women, youth, members of the LGBTQIAPN+ community, and aging individuals living with HIV. For him, care must consider the social and economic conditions that influence access to services and continuity of care.

"People living with HIV don't just need medication; they also need food, housing, and a dignified life," he states.

Youth Want Prevention in Schools and Access to New Treatments

The need to bring public policies closer to the reality of new generations is highlighted by Robson Oliveira, representative of the Network of Adolescents and Youth Living with HIV/AIDS of the State of São Paulo. Among his concerns is the absence, according to the organization, of a specific program for addressing HIV/AIDS in the government plan presented during the campaign.

Robson advocates for expanding sexual health education in schools, featuring scientifically sound information about HIV, other sexually transmitted infections (STIs), and combined prevention. For him, the debate must reach adolescents and youth without embarrassment or discrimination.

"Talking about prevention shouldn't be a reason for criminalization, censorship, or embarrassment. It's an issue that concerns all of society, especially the youth, and it must be treated with responsibility, scientific information, and a commitment to life," he asserts.

The representative also demands broader access to long-acting injectable medications, which can offer more convenience, privacy, and autonomy in treatment. The Network supports discussing the incorporation of these technologies into the SUS, as well as legally viable measures regarding patents and medication costs, to expand access.

Another priority is funding community organizations through public grants to develop projects for prevention, support, and the promotion of rights. Robson also advocates for permanent campaigns on treatment, undetectability, and combating prejudice, designed with youth participation.

"It is fundamental to strengthen the dialogue with youth networks, social movements, and people living with HIV, ensuring that their experiences and demands are considered in the development and execution of policies," he argues.

In Robson's assessment, adolescents and youth need to participate in decisions right from the formulation of actions, no longer being seen merely as recipients of public policies.

Communication About HIV and New Technologies Need to Gain Ground in the SUS

Health communication occupies a central role in the expectations of João Geraldo Netto, from the Multiverso Institute and the Super Indetectável Channel. For him, expanding the reach of information requires more than traditional campaigns: it is necessary to use language that resonates with the public, harness the potential of digital platforms, and establish a dialogue with organizations that understand the realities of local communities.

João also advocates for greater agility in incorporating prevention and treatment technologies, as well as more diverse and effective participation from people living with HIV in the creation of public policies.

"My expectation for the next four years is for the government to make much greater strides in public policies for HIV and other sexually transmitted infections, investing more in breaking down prejudice, in prevention and treatment, expanding access to new technologies, and truly listening to those who live this reality every day.

The first point is to invest more in HIV communication. It's not enough to create campaigns, spend millions of reais on mainstream media broadcasts, and expect that same information to reach people efficiently. We need to use the tools and languages that are part of the population's daily lives, especially on social media and digital platforms. It's important to speak simply, directly, and free of judgment and prejudice, bringing quality information to those who need it most, without leaving anyone behind. I know this is difficult, but I also know there are organizations that can help with this work.

We also need to talk to the youth, the LGBTI+ population, people experiencing homelessness, the most vulnerable individuals, Indigenous people, and all the groups that face the most barriers to accessing healthcare services. But this doesn't mean sidelining the rest of the population. Information about HIV must reach everyone, helping to combat fear, prejudice, stigma, and misinformation, but in a tailored and targeted way. As a communicator, sexuality expert, and social mobilizer, I see every day how well-crafted information can change the way people understand sexual health and strengthen self-care.

Second, we need to accelerate the arrival of new prevention and treatment technologies in the SUS. Brazil needs to update its protocols and negotiate more firmly with the pharmaceutical industry to ensure these innovations reach the population. We can't just sit around waiting for the pharmaceutical industry to come to us. We have to be proactive. We used to be. Why aren't we anymore? Injectable PrEP and injectable antiretroviral treatments can expand prevention and treatment options. DoxyPEP, which can help prevent certain STIs, also needs to be expanded. It makes no sense for us to have to wait so long to access advancements that could already be making a difference in our lives.

The third point is to strengthen civil society's participation in government decisions. For many years, activists, organizations, and people living with HIV have contributed to the fight against the epidemic, but we are not always heard. Often, the dialogue is concentrated among a few representatives who do not reflect the full diversity of those living with HIV in Brazil.

Speaking from my own experience, the government needs to open more spaces for dialogue, listen to different groups, and take our contributions seriously. It's not enough to invite civil society to meetings. We must be allowed to participate in decisions and help define the priorities of public policies. Especially because, one way or another, we will be the most impacted by progress, by stagnation, and also by setbacks."

The National LGBTI+ Alliance Advocates for Permanent Policies and a Dedicated Budget

The need to transform commitments into long-term actions is also reflected in the assessment of Gregory Rodrigues Roque de Souza, Communications Coordinator for the National LGBTI+ Alliance, President of the Sinergia Sexual Diversity Institute, and Vice-President of the State Council for the Defense of Human Rights of Minas Gerais.

For Gregory, the fourth term represents an opportunity to consolidate policies to combat LGBTIphobia and expand social protection. He emphasizes, however, that the continuation of the government does not mean the disappearance of the inequalities, violence, and barriers faced by the LGBTI+ population, especially in municipalities that lack specialized services and structures.

"We cannot settle for merely maintaining existing achievements. We need to move forward in building permanent, structured public policies with their own dedicated budgets, monitoring mechanisms, and effective participation from civil society," he argues.

Among the demands presented are the expansion of access to comprehensive healthcare, the promotion of employability, tackling school dropout rates, the protection of trans and travesti people, and guaranteeing the rights of the elderly LGBTI+ population.

Gregory also highlights that social movements need autonomy to monitor government actions, acknowledge implemented measures, and demand the fulfillment of commitments.

"Our role as social movements is to contribute proposals, recognize achievements, and demand results. The defense of democracy also relies on the autonomy of civil society," Gregory states.

The statements from all four leaders place social participation at the center of expectations for the next term. Beyond investments and the expansion of services, the organizations are demanding mechanisms that allow them to monitor the use of funds, evaluate programs, and participate in the decisions that directly affect their communities.

With the election results decided, the demands are now directed toward the priorities, investments, and measures to be adopted over the next four years. For the interviewed representatives, access to healthcare, the reduction of inequalities, and the guarantee of rights will be central aspects in monitoring the actions of the new government.

Glaucia Magalhães for the Agência de Notícias da Aids