GARD - Country Initiatives BRAZIL
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GARD - Country Initiatives BRAZIL Alvaro A. Cruz, M.D. Associate Professor of Universidade Federal da Bahia Scientist of CNPq - National Research Council Co-chairman of ARIA Brazil
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GARD - Country Initiatives BRAZIL. Alvaro A. Cruz, M.D. Associate Professor of Universidade Federal da Bahia Scientist of CNPq - National Research Council Co-chairman of ARIA Brazil. GARD - Brazil. Pop. 180 million Area 8,511,965 sq km GDP per capita $7,762 Life expect. 70 years - PowerPoint PPT Presentation
Transcript of GARD - Country Initiatives BRAZIL
GARD - Country InitiativesBRAZIL
GARD - Country InitiativesBRAZIL
Alvaro A. Cruz, M.D.Associate Professor of Universidade Federal da Bahia
Scientist of CNPq - National Research Council
Co-chairman of ARIA Brazil
GARD - Brazil GARD - Brazil
Pop. 180 million Area 8,511,965 sq km GDP per capita $7,762 Life expect. 70 years Child mortality 36/1000 Health exp. per capita $611,
7% of GDP
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AA Cruz, 2006.
GARD - Brazilobstacles and advantages
GARD - Brazilobstacles and advantages
Poverty / unemployment Limited education Poor transportation system Inadequate health care
Low wagesPoor facilitiesUnsatisfactory training
Poverty / unemployment Limited education Poor transportation system Inadequate health care
Low wagesPoor facilitiesUnsatisfactory training
Universal coverage of PHS National health database Primary care priority Growing family health program Qualified reference and
research centres Active NGOs National telecommunication
networks
Universal coverage of PHS National health database Primary care priority Growing family health program Qualified reference and
research centres Active NGOs National telecommunication
networks
AA Cruz, 2006.
Recife
Salvador
Uberlândia
Itabira
São Paulo
Curitiba
0 5 10 15 20 25 30 35
Asthma Rhinitis
Prevalence of Asthma and RhinitisBrazil - ISAAC Phase I, 13 -14 years old
Prevalence of Asthma and RhinitisBrazil - ISAAC Phase I, 13 -14 years old
Solé et al, 2002.
%
GARD - Brazilcountrywide approach
GARD - Brazilcountrywide approach
Asthma/Rhinitis:Prevalence may be > 20%4th. cause of hospitalizations
Over 2,000 deaths a year
COPD:Prevalence of 14.9% (S. Paulo)5th. cause of death
Asthma/Rhinitis:Prevalence may be > 20%4th. cause of hospitalizations
Over 2,000 deaths a year
COPD:Prevalence of 14.9% (S. Paulo)5th. cause of death
Meeting of national CRD leaders to discuss GARD proposal in Rio, 2005
GARD Brazil Working group:AA Cruz (asthma and rhinitis)JR Jardim (COPD)PA Camargos (pediatrics)ML Barreto (epidemiology)
Meeting of national CRD leaders to discuss GARD proposal in Rio, 2005
GARD Brazil Working group:AA Cruz (asthma and rhinitis)JR Jardim (COPD)PA Camargos (pediatrics)ML Barreto (epidemiology)
AA Cruz, 2006.
GARD - Brazil Ministry of Health and WHO
GARD - Brazil Ministry of Health and WHO
Recent actions, Brazilian Ministry Ban on tobacco advertisement Free pharmaceutical assistance
to severe asthma/rhinitis, 2002 Publication of Asthma/Rhinitis
Guidelines, 2005 Free medication for
asthma/rhinitis in primary care, 2006
Recent actions, Brazilian Ministry Ban on tobacco advertisement Free pharmaceutical assistance
to severe asthma/rhinitis, 2002 Publication of Asthma/Rhinitis
Guidelines, 2005 Free medication for
asthma/rhinitis in primary care, 2006
Preliminary contacts GARD Working group have
consulted for Ministries of Health, Education and National Research Council
GARD Working group offered advisory collaboration
Meeting with Head of Primary Health Department scheduled
Preliminary contacts GARD Working group have
consulted for Ministries of Health, Education and National Research Council
GARD Working group offered advisory collaboration
Meeting with Head of Primary Health Department scheduled
AA Cruz, 2006.
GARD - Brazil role of primary health care
GARD - Brazil role of primary health care
Decentralization of management each city may control its health
budget in agreement with Ministry of Health
example: Salvador (Pop. 2.5 million) will receive US$ 1.2 million specifically for asthma and rhinitis medication in primary care in 2006
Decentralization of management each city may control its health
budget in agreement with Ministry of Health
example: Salvador (Pop. 2.5 million) will receive US$ 1.2 million specifically for asthma and rhinitis medication in primary care in 2006
Primary Care, a Priority in Brazil A Family Medicine approach
recently developed already covers 45% of population
Guidance and means The Asthma and Rhinitis
Guidelines was developed for the primary care professional
Primary Care, a Priority in Brazil A Family Medicine approach
recently developed already covers 45% of population
Guidance and means The Asthma and Rhinitis
Guidelines was developed for the primary care professional
AA Cruz, 2006.
GARD - Brazil role of NGOs
GARD - Brazil role of NGOs
CRD NGOs and Ministry of Health Medical associations:
Pulmonary, Allergy, Pediatrics ARIA, GOLD Patient associations:
asthma, COPDCollaboration for the Asthma andRhinitis Guideline and training
CRD NGOs and Ministry of Health Medical associations:
Pulmonary, Allergy, Pediatrics ARIA, GOLD Patient associations:
asthma, COPDCollaboration for the Asthma andRhinitis Guideline and training
Tradition of NGOs Hospital care Health professional
associations
New perspectives for NGOs Patient associations “Problem based” NGOs
Tradition of NGOs Hospital care Health professional
associations
New perspectives for NGOs Patient associations “Problem based” NGOs
AA Cruz, 2006.
GARD - Brazil successful experiences in CRD control
GARD - Brazil successful experiences in CRD control
A research project intervention inSalvador City (ProAR) focusing onsevere asthmatics (n=1405): reduction of admissions by 90% reduction of family expenses
with asthma by 86% reduction of public expenses
with asthma by US$566.00 per patient/year
A research project intervention inSalvador City (ProAR) focusing onsevere asthmatics (n=1405): reduction of admissions by 90% reduction of family expenses
with asthma by 86% reduction of public expenses
with asthma by US$566.00 per patient/year
Various local asthma programs Care by specialists, education
and ... medication? Some city programs with free
medication available in multiple facilities, from 1997 (as in Belo Horizonte)
Various local asthma programs Care by specialists, education
and ... medication? Some city programs with free
medication available in multiple facilities, from 1997 (as in Belo Horizonte)
AA Cruz, 2006.
GARD - Brazil hospitalizations in public health system, Salvador
GARD - Brazil hospitalizations in public health system, Salvador
AA Cruz, 2006.
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1000
2000
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4000
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2000 2001 2002 2003 2004 2005
pneumonia
asthma
acute m. infarction
ProAR ProAR ProAR
GARDGARDGlobal Alliance againstGlobal Alliance againstChronic Respiratory DiseasesChronic Respiratory Diseases
GARDGARDGlobal Alliance againstGlobal Alliance againstChronic Respiratory DiseasesChronic Respiratory Diseases
