[procaare] Scaling-Up: Lessons from Brazil

[AIDS2002 & HDN <procaare@usa.healthnet.org>]

Scaling-Up: Lessons from Brazil
***************************

"There is no Brazilian model. What we have been doing is to put into practice principles
that have long been recognised by the international community," declared Dr Paulo
Teixeira, Director of the Brazilian STD/AIDS Programme in Thursday's plenary.

"At the very core [of Brazil's programme] is the Universal Declaration of Human Rights,
adopted more than 54 years ago. None of these outcomes could have been achieved without
embracing a balanced prevention and treatment approach and the firm advocacy of the human
rights of people infected and affected by HIV/AIDS," said Teixeira.

Brazil has implemented a comprehensive prevention programme focusing on condom use. It has
achieved a significant reduction in the rate of incidence particularly in more vulnerable
populations, including men who have sex with men, sex workers and injection drug users.

"No time can be spent with ambiguous prevention messages. HIV transmission happens
[primarily] through sexual contact and prevention is made through condom use. Other
alternatives, such as postponement and abstinence are indubitably incompatible with our
global reality," said Teixeira.

"Controlling the AIDS epidemic also [requires] mobilising the entire national capacity to
offer antiretroviral treatment, even when the optimal infrastructure is not available,"
said Teixeira.

The number of AIDS deaths has fallen dramatically since the adoption of antiretroviral
therapy. Survival has increased dramatically. The average survival time is now close to
five years, a twelve-fold increase reported Dr Ricardo Marins in a poster at this
conference.

In Brazil, the average treatment cost per patient each year decreased by half in recent
years. This occurred as a result of two related factors.
Firstly, investments were made by the Ministry of Health to establish domestic national
laboratories. Brazil distributes fifteen antiretroviral drugs of which eight are locally
produced.

Secondly, Brazil has effectively negotiated price reductions with Abbott, Merck and Roche
to cut the price of four drugs by more than 50%. Teixeira indicated that "national
production under compulsory licensing has been a strong argument to push these companies
to the negotiation table."

Brazil has 600,000 persons living with HIV and has had more than 220,000 cases of AIDS
reported to the Ministry of Health since the beginning of the epidemic. This is less than
50% of the number predicted by the World Bank a few years ago.

AIDS 2002 Conference News produced by Health & Development Networks/Key Correspondent Team
www.hdnet.org - correspondents@hdnet.org


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