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

Thank You

mauro.figueiredo@saude.gov.br Phone# 5561-3315-3805