The Politics and History of AIDS Treatment in Brazil
While the CDC also reached out to AIDS activists during the s, it never went as far as to officially incorporate them into the agency. But Brazil's unique political situation also helped.
In , Brazil transitioned from a repressive military dictatorship to a vibrant democracy. Access to health care as a human right was penned into the constitution. Consequently, when AIDS emerged, the government was essentially forced to do whatever it could to guarantee access to medicine and health care. When short on cash, these commitments forced the national AIDS bureaucracy to engage in intensive bargaining negotiations with pharmaceutical companies to lower prices for drugs. If they failed to reach agreement, the pharmaceutical companies faced the specter that Brazil would produce and distribute generic versions of their patented medicines.
Sanjay Gupta as the "envy of the world" in , the government has been incentivized to increase its commitment to the epidemic. But this has also motivated the government to help African nations develop the capacity needed to produce ARV medications while using the international community's praise as a platform to address other related issues, such as poverty alleviation, human rights, and even biofuel technology. The United States has contributed its share to Africa. The program was re-authorized for another five years in The opinions expressed in this commentary are solely those of Eduardo J.
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The Politics and History of AIDS Treatment in Brazil | SpringerLink
By Eduardo J. Part of complete coverage on. Explain it to me AIDS. Sanjay Gupta explains how far we've come to finding a cure. AIDS in the '90s: 'God spoke to me'. Linda Scruggs went from a bewildered young woman with a deadly prognosis to a passionate leader in the HIV advocacy world.
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HIV in the s: Fear ruled. Like so many gay men in the s, Edmund White struggled with an illness that seemed like a death sentence. Moments to remember. These are the most important AIDS moments since then. Most Popular. Fine art from an iPhone? Brazil, in an unconventional manner, if compared to other disease control programs, confronted and continues to confront Aids head on in a resolute defense of human rights, with local production and distribution of contraceptives and antiretrovirals ARVs , and the implementation of a public network of laboratories and services to care for PLWHA, and research financing.
In Minas Gerais, this took place in As such, the HC would assume the dignified, ethical and competent care of people already marginalized by their sexual orientation, their activity sex workers , use of intravenous drugs or by a base disease hemophilia. Having failed to convince HC on the hospitalization issue, I took charge of out-patient care for people living with or at risk of HIV and on August 13, the Immunodeficiency Clinic was opened. The word AIDS was not used to avoid prejudice and discrimination and, for the same reason, the new clinic was set up alongside the general out-patient Infectious and parasitic diseases clinic.
On the eve of its opening, HC communicated that the proposed activity would not be permitted since there was no back-up for hospitalization. Fortunately, this threat did not materialize and care began to be provided in the out-patient facility. Zuleica Souza Silva and Mr. Raimundo Rezende. The battle continued to allocate beds in the HC. The arguments against continued to be the same and the undertone was one of fear, prejudice, and the lack of a humanitarian, scientific and academic view.
In , thanks to the efforts of Dr. Luiz Loures, Dr.
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It is worth describing the surrealism of the process: patients that required hospitalization were isolated, regardless of the reason for admittance: visits were prohibited, disposable plates were used and all the staff used masks, caps, gowns and boots. On discharge from the hospital, as if by miracle, everything went back to normal: the patient used the regular elevator and returned to the world of the common people.
This was the conduct required to enable hospitalization. In , the first sign of encouragement came when there was a decrease in mortality with the use of zidovudine AZT , opening up the path for the specific treatment of HIV 6. The initial objective was to obtain reliable estimates of HIV incidence. To this end, one priority was to create open cohorts to assess the impact of educative interventions in reducing vulnerability to infection and, with the information gathered, decide on participation in future vaccine trials.
Fritz Sutmoller. The Horizonte Project, the only one still ongoing, has admitted approximately 1, people since , with cases of HIV up to , with an incidence rate of 2. In , approximately volunteers are on follow up. Fritz Sutmoller, Dr. Marisa Morgado. Although at the time most phase I trials were carried out in developed countries, this one was approved ,after scientific and ethical scrutiny, in Brazil, China and Thailand, with healthy volunteers at low risk of HIV being recruited to assess safety and immunogenicity.
These peptides induced neutralizing antibodies against laboratory strains of HIV-1 but subsequent trials showed that this response was not sufficient for effective immunization and the rest of the story behind the search for a vaccine can be found elsewhere 8 , 9. This initial access to medication confirmed the social and human rights policy set out in the Constitution and in SUS precepts.
The number of pills to be taken daily was quite high, which hindered adherence and produced many side effects; its high cost restricted access to industrialized countries. Brazil was the first, exemplary exception with its enactment of the abovementioned Law in the same year. The 3 rd decade — — complex period, start of a new millennium. The concentration of capital intensified and there was a banking crisis that almost exclusively affected the populace, with perverse reflections on access to healthcare.
And perhaps just as serious as this, there was a worldwide expansion of conservatism. It set out parameters for patents, with a term of 10 years for each country to adapt. Unfortunately, the Brazilian government signed it prematurely, complicating the preparation of national production sector for the transition. Other countries, e. This easing of restrictions was used by Brazil in the compulsory licensing of Efavirenz. In , for the first time in its history, the United Nations held a Special Session dedicated to the specific problem of public health.
Yet again, the Brazilian example was used to demonstrate that these goals could be achieved. In , for the first time, the Brazilian government decided to compulsorily license a drug, permitting its local production. Over the course of these 30 years confronting AIDS in Brazil, it is worth addressing some of the lessons learned:. The initial mark of combining forces with a common goal : The State, Civil Society and Academia, structured a combined national response based on human rights and SUS principles.
http://count.developerinsider.co/coaching-y-sanacin-5-herramientas-claves-para-el.php In my opinion and metaphorically speaking, the Brazilian response took place in a manner opposite to that of a plane crash, in which small events add up to finally bring the airplane down. Here, people, groups and institutions overcame their problems with working together and united forces to confront the issue and they are co-responsible for the Brazilian response.
Lair Guerra de Macedo Rodrigues, an example of public spirit, competence and determination. The Brazilian state mobilized itself, proposed inter-institutional state commissions, and established a national policy to confront AIDS, with emphasis on human rights protection. Law 8. In its th meeting, an evaluation of its history and role was commissioned, and then published in It was coordinated by Prof. Mary Jane Spinks and is well worth reading The enactment of law , supported and pressured by organized civil society, transformed universal ARV access through SUS into a right.
This decision went against common sense, clearly vocalized by the World Bank, which declared that developing countries should concentrate their efforts on prevention, since the complexity of the treatment schemes would hinder adherence, increasing the risk of resistant strains.
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Today, the results of this vital decision are internationally recognized, and it has also been demonstrated that the percentage of resistant viruses in Brazil has remained equal to or even lower than in central countries. In providing universal ARV access and suitable health care for PLHA, it was unequivocally shown that a developing country could, even in the face of so many inequalities, treat people equally regardless of race, sex, sexual orientation or economic power.
One example is the participation of PLWHA in the struggle for their rights in all forums, especially in Health Councils and regulatory agencies. On the other hand, the participation of people exposed to, for example, schistosomiasis or Chagas Disease at decision making tables is much smaller, despite millions of people suffering from them. Power is never granted, it is always seized. According to Freire, emancipation will not happen by chance, or by concession, but will be a conquest carried out by the human praxis, which calls for uninterrupted struggle.
It allowed for the establishment of quality services, with technical and academic support for specific policies involving diagnosis, care, virologic and immunologic assessment, as well as research.
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Fifteen years later the positive results ARV combination brought hope to millions of PLWHA; however, this scientific victory was not used to worldwide benefit, but remained mainly restricted to central countries for many years, highlighting the urgent need to ethically discuss the right of access to scientific progress for all of the people who need it.