Can the concept travel?
But others have come to a different conclusion. Kenneth Camargo, a professor of public health at Rio de Janeiro State University, says there is indisputable evidence – published in The Lancet and The American Journal of Public Health, among others – that the program had direct impact on child and infant mortality. Previous rises in income or job booms never caused them to budge, he says.
What is less certain is whether the program can be transferred to other countries. The design is simple, easily replicated and scaled up, and the vast database makes it easy to track families and their well-being. But it may be unrealistic to think poorer nations can replicate its success. Few have Brazil’s level of penetration of financial services, or smooth and secure electronic banking that allows the benefit to be seamlessly deposited in millions of accounts each month. Few have an economy that has shown the growth rate or the vast economic potential of Brazil’s extractive and agricultural industries. Few have the capacity to deliver that Brazil’s comparatively functional federal government has. And few will have the collective political will to push through a program like this, as Brazil did a decade ago.
“These conditions are rarely available ... and frankly it alarms me that people want to copy this program,” Dr. Rocha says.
For Prof. Camargo, the public health expert, that’s missing the larger point. The true miracle of the program is what it says about how Brazil is defining itself as a place that must be more equal.
“A critical mass of people was invested in the idea of reducing inequality … It wasn’t an overtly discussed social contract, but it was a zeitgeist. There was public support for this. For the state to have a direct role in this. And there still is.”
The ‘other’ Rio
Complexo da Mare is a vast cement sprawl on the edge of Rio, home to 130,000 people. Its streets are controlled by skinny boys in shorts and flip-flops, dwarfed by the machine guns they carry. Crack cocaine is sold in neatly labelled packages on tables in the roads. Young men in plastic chairs in the lanes drink beer and fondle the pistols that lay in their laps; young women with pregnant bellies and faces preternaturally aged by drugs stumble past them. This is the other Rio, the one that doesn’t appear in the ads for the “Olympic City.”
Eliane Antunes, 57, is raising her four grandchildren in the middle of it. Her eldest daughter is addicted to crack and, after years of erratic attention to the children, finally disappeared to live on the streets three years ago; their father hasn’t been in touch in years. Ms. Antunes earns $340 a month working five-and-a-half days a week as a cleaner. And since she took over care for the kids, she receives another $155 a month in a Bolsa Familia grant. “You put it together, and you can just manage,” she says.
The big difference is in what she can feed the children. “Now they get milk and meat.” The effect of a few years of steady nutrition is visible in the difference between the children: the older boys are skinny and have pocked, scarred skin; 12-year-old Adriel is the size of a seven-year-old. Only the youngest, Edilaine, 6, who was young enough to catch up when she started to be well fed, is a typical size for her age; her hair is glossy and her skin clear.
The oldest boy, Wenderson, 14, left school this year – upset about his mother, Ms. Antunes said, and he’s always struggled in the classroom. The grant for him was cut off, and she feels it. “I still have to feed him.” She’s trying to get him back into school.
The Bolsa Familia means the kids get school supplies, she said. “And of course at the end of the year I can scrape all my money together and buy them a Christmas present. I buy on instalments, so it takes a long time to pay for it. But if I don’t, no one is going to buy them presents, ever.”
Ms. Antunes left school at 14 to start work as a maid; her own kids left even younger, for factory jobs, because the family needed the cash.
“I want my grandchildren to have a better life: they have dreams. One wants to be a firefighter, one an electrician. I couldn’t dream like that for my own children, I needed them to help me. This is better.”
Stephanie Nolen is The Globe’s South America correspondent.