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The Brazilian Response Toward Universal Access
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The Brazilian Response Toward Universal Access. Department of STD, AIDS and Viral Hepatitis – Ministry of Health of Brazil. HEALTH AS A DEMOCRATIC ACHIEVEMENT. 1988 Constitution: landmark for health The Unified Health System (SUS) UNIVERSALITY – as a fundamental right - PowerPoint PPT Presentation
Transcript of The Brazilian Response Toward Universal Access
1988 Constitution: landmark for health
The Unified Health System (SUS)
•UNIVERSALITY – as a fundamental right
•INTEGRALITY – from prevention to treatment
•EQUITY – no distinction with recognition of populations'
specificities
HEALTH AS A DEMOCRATIC ACHIEVEMENT
80% 74%
61%
44%
33%
HIV CONTINUUM OF CARE (Cascade) Brazil 2012
COMBINATION HIV PREVENTION
HARM REDUCTION
CLASSIC PREVENTION STRATEGIES
CONDOMS
Focus on Key Populations •33 supported projects -HIV Screening with Oral Fluid RT technology
• Trans • Gays and MSM• PUD• SW
STRUCTURAL INTERVENTIONS
Social NameTransgender and Transsexuals, you deserve a friendly service
“You can be served in public health system with the name you chose. Order SUS card with your name that you decide to use and exercise your right.”
STRUCTURAL INTERVENTIONS
President Dilma Roussef receives the LGBT Movement
June, 2013
STRUCTURAL INTERVENTIONS
Keila Simpson, Human Rigths Award, by President Dilma Roussef
December, 2013
International Drug Simposium: “From Coersion to Cohesion”
STRUCTURAL INTERVENTIONS
“The results have galvanized efforts to eliminate the global AIDS epidemic”
Dr. Bruce Alberts, Science’ Editor
TREATMENT AS PREVENTION
NEW GOVERNMENT DIRECTIVE (DECEMBER 2013)Introduces 5 new algorithms aimed at increasing access to
testing and diagnosis
Algorithms 1 screening + confirmation - > RT finger prick
Algorithms 2 - screening RT finger prick + confirmation Oral
Fluid
Algorithms 3 screening 3rd generation immunoassays +
confirmation VIRAL LOAD quantification
FIRST STEP: NEW TESTING ALGORITHMS
Algorithms 4 - 4th generation immunoassays as
screening + confirmation VIRAL LOAD quantification
Algorithm 5 - combines 3rd generation
immunoassay screening followed by Western
Blot/Imunoblot confirmatory test.
FIRST STEP: NEW TESTING ALGORITHMS
The new Clinical Protocol and Therapeutic Guidelines (CPTG) for Treatment of HIV Infection in Adults was discussed with an Advisory Board of experts, submitted to a public consultation for 30 days, and published in a Government Directive no. 27, of November 29, 2013. * SVS: Health Surveillance Secretariat
Both the complete document (in Portuguese) and the Quick Consultation Guide are available in PDF and in an on-line version at www.aids.gov.br/pcdt
SECOND STEP: NEW TREATMENT PROTOCOL
A highlight among the main new items of the
CPTG is the recommendation to start
antiretroviral therapy for all HIV positive
people, regardless CD4, based on the possible
impact on morbidity and mortality, but also in
the reduction of HIV transmission. A Public
Health Approach.
SECOND STEP: NEW TREATMENT PROTOCOL
TREATMENT2.0
Adapt delivery systems
Mobilize communities
POC and other
simplified monitoring
Optimize drug
regimens
Reduce costs
TREATMENT 2.0
IOS (Apple) and Android platforms
Smartphones and Tablets
Free of charge
Offline access to national guidelines
Updates – downloadable new contents and modifications
New functionalities will be added: ie: interactions of ARV and other drugs.
PCDT HIV
TREATMENT PROTOCOL - APP
• We are customizing the response working in the concept of
Hot Spots (two initial Task Forces: RGS and Amazon) ;
• Starting a National Study on PREP in Public Health Services in
4 different sites (2 SP, 1RJ and 1 RGS);
• Intensifying PEP at least in the hot spots;
• Enhancing the universal and free of charge access to
Hepatites B and C Treatment (including triple therapy with
first generation of antivirals);
• Has lead the 2014 WHO/WHA resolution on universal
treatment for Hepatites.
WHAT ELSE?
80% 74%
61%
44%
33%
HIV CONTINUUM OF CARE (Cascade) Brazil 2012
2020
578
HIV CONTINUUM OF CARE (Cascade) Brazil 2012
HIV CONTINUUM OF CARE (Cascade) Brazil 2012
HIV CONTINUUM OF CARE (Cascade) Brazil 2012
Community of Portuguese Language Countries - CPLP
Thematic Research and Development Networks (Rides CPLP ) are part of the CPLP Strategic Plan in Health, focusing the following themes:
•Network in STI - AIDS •Network in Malaria •Network in Tuberculosis
Community of Portuguese Language Countries - CPLP
• Brazil was elected to be the executive secretary of the “STI, AIDS Rides/CPLP” for the 2014-2016 period .
• Joint Work Plan (STI/AIDS Rides; Rides Mal ; TB Rides): “Elimination of MTCT transmission by 2017”.
Implementation of national PMTCT plans under the perspective of the B + Recommendation (WHO).
This initiative also includes HIV/TB co-infection diagnosis and treatment, as well as malaria testing and treatment (as a risk factor for HIV transmission during pregnancy).
Fabio Mesquita – Director
Marcelo Freitas – Treatment Coordinator
Cristina Raposo – Head of International Cooperation
OBRIGADO!
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