A major player in the political economy of pharmaceuticals in the Global South, and boasting a universal health care system, Brazil offers fertile ground for exploring the unanticipated ways people have mobilized for treatment access in contexts of stark inequality. In this article, I place the ever-evolving twin phenomena of the pharmaceuticalization and judicialization of health in a multilayered historical context: the post–World War II push for states to embrace the idea that their citizenry had a right to health, and Brazil’s particular embrace of a constitutional right to health in 1988; the turn of the World Health Organization (WHO) to essential medicines in the 1970s, and the responses of both governments and pharmaceutical companies in the ensuing decades; the advent of neoliberal forces as they swept the globe, landing in Brazil in the early 1990s; and the HIV/AIDS pandemic in Brazil with the government’s precedent-setting provision of lifesaving antiretroviral therapies in the late 1990s. This dynamic context sheds light on a bottom-up ethnographic inquiry of the ways the poor in Brazil have turned in increasing numbers over the last two decades to the courts to litigate access to medicines. Through their collective trust in the judiciary and their willingness to be a frontline force against the ill effects of neoliberalism, citizen-litigants are instantiating a kind of magical legalism, opening up new possibilities for the state to live up to its human rights and medical commitments. People’s quests for accountability reveal an ambitious vision of justice at a local scale and a distinct sense of politics in-the-making, even alongside a resurgent authoritarianism.

中文翻译：

---

健康的药化和司法化

巴西是全球南方医药政治经济的主要参与者，拥有全民医疗保健系统，为探索人们在严重不平等的情况下动员起来获得治疗的意外方式提供了肥沃的土壤。在本文中，我将不断发展的健康药物化和司法化的双重现象置于一个多层次的历史背景中：二战后推动各国接受其公民享有健康权的观念，而巴西的特殊1988 年接受宪法规定的健康权；世界卫生组织 (WHO) 在 1970 年代转向基本药物，以及随后几十年政府和制药公司的反应；席卷全球的新自由主义势力的出现，1990 年代初登陆巴西；1990 年代后期，巴西政府率先提供了挽救生命的抗逆转录病毒疗法，从而导致了巴西的 HIV/AIDS 大流行。这种动态的背景揭示了自下而上的民族志调查，即巴西穷人在过去二十年中越来越多地向法院提起诉讼以获得药品。通过他们对司法机构的集体信任以及他们愿意成为对抗新自由主义不良影响的前线力量，公民诉讼人正在实例化一种神奇的法律主义，为国家履行其人权和医疗承诺开辟了新的可能性. 人们对问责制的追求揭示了在地方范围内的雄心勃勃的正义愿景和正在形成的独特政治意识，