The Brazilian Response to AIDS
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Transcript of The Brazilian Response to AIDS
The Brazilian Response to AIDS
Mauro Teixeira de FigueiredoHead of the Division for Technical Cooperation
International AdvisoryMinistry of Health
Main strategies
The epidemic in Brazil
Brazil
• Total number of People Living with HIV (2006): 630,000
• HIV Prevalence: 0.61% (15-49)
Female: 0.42%; Male 0.82%
• Cumulative number of AIDS cases (06/2008): 506,499
• Incidence per 100.000 (2007): 17.8
• Mortality coefficient per 100.000 (2007): 5.8
• Cumulative number of deaths (2007): 205,409
Key figures
MAJOR ASPECTS IN BRAZILIAN RESPONSE TO HIV/AIDS
• UNIFIED HEALTH SISTEM - SUS
• EARLY GOVERNMENTAL RESPONSE – SINCE 1983
• STRONG CIVIL SOCIETY PARTICIPATION IN ALL DECISION LEVELS
• MULTISECTORIAL MOBILIZATION
• BALANCED PREVENTION & TREATMENT APPROACH
• FIGHT AGAINS HIV AND AIDS AS A STATE POLICY, WITH ROBUST
GOVERNMENTAL INVESTMENT
Human Rights perspective in all the strategies and actions
Government
UN Theme GroupUN Theme Group
Civil SocietyCivil Society
AIDS Business CoalitionAIDS Business Coalition
The strategic triangle to struggle HIV and AIDS – Since the beginning of the epidemic
NGO Commission (CAMS)NGO Commission (CAMS)
Ministry of Health
Other Ministries and governamental
institutions
Ministry of Health
Other Ministries and governamental
institutions
International Organisations
International Organisations
Finantial and technical support to projects from NGO
Finantial and technical support to projects from NGO
Investment on communication
and international relations
strategies
Investment on communication
and international relations
strategies
1. Federal Government:- National policy formulation- Technical Guidelines- Monitoring and Evaluation- Allocating funds to states and municipalities- NGO financing- Antiretroviral treatment- Tests
2. State - Medicines for opportunistic infection and STI NGO financing
3. Municipal Governments:- Coordination of local health services
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The three-level management structure of the Brazilian Response
Existence of Committees for coordination of the three level of management
• State and Municipal AIDS Programs work closely with the NAP and in accordance with the National Strategic Plan
• Strong participation of civil society in planning and implementation through:
a. Control bodies for monitoring the public health system
b. National AIDS Commission
c. NGO Commission
c. Direct financing
Joint work with Civil Society and State and Municipal AIDS Programs
Activities and approaches of the Brazilian STD and
AIDS Program
• Promotion of human rights
• Implementation of major national media campaigns
• Prevention actions for general population and specific groups
Early diagnosis of HIV infection
• STD diagnosis and treatment
• Prevention strategies centered on condom use - Access to
condoms
• Harm reduction policy
Activities and approaches of the Brazilian STD and AIDS Program
• Universal Treatment of people living with AIDS
• Access to HIV diagnosis – goal is to test 4,5 million a year• Impact of prevention interventions – vulnerable
populations Prevention actions for general population and specific groups Early diagnosis of HIV infection
• Reduction of mother to child transmission
• Research and Development of Vaccines
• Sharing experiences – South-South Cooperation
Activities and approaches of the Brazilian STD and AIDS Program
Impact of the Brazilian ARV Policy (1996-2002)
reduction of mortality 50%
deaths prevented 90,000
reduction of morbidity 70%
reduction of hospitalizations 80%
633,180 hospitalizations prevented - average of
hospitalizations / patient per year reduced from
1,65 in 1996 to 0,25 in 2003.
Estimate of HIV Infected Individuals (among 15 a 49 years old) by year 2000
Word Bank Projection (1992)
Brazilian MOH Estimate (2000)
0
200
400
600
800
1000
1200
1400
Thousands
1,200,000
600,000
MOH, 2002
50%
...Anti-retrovirals
• Universal and free of charge access to ARV - ruled by
Federal Law Nov.1996
• Incentives to Public-Private Partnerships aiming at
local production of ARVs
• Negotiations for price reduction
• Regulation of article 6 of the Doha Declaration (right to
import and export patented drugs)
• Presidential Decree authorising importation in case of
Compulsory Licensing
... Vaccines
• Incentives for R&D projects carried out by public research institutes
• Implementation of Training and Technical Assistance Projects
• Participation alongwith Civil Society and Communities