Years after awake praises in the international arena and be highlighted as a model, the Brazilian National STD/AIDS Program was criticized by a publication produced by the own government. A document launched by the Oswaldo Cruz Foundation (Fiocruz) and the Secretariat for Strategic Affairs, as part of the Health Brazil project 2030, says that the program “cooled”. The document recommends: “It is necessary to change the direction of the program.”
The publication indicates that AIDS care is now carried out in overcrowded services, the number of new infections is not lowing and many patients receive a late diagnosis of the infection. “In the opposite direction to what has been observed in other countries, which also have established programs for universal access to treatment followed by a decrease in the incidence of new infections, Brazil has failed to reduce the incidence of HIV/AIDS,” according to the document.
The publication condenses texts of 37 experts, who had the task of making diagnoses of problems faced in the health field and prospects for the next 20 years. “We try to remove all the political bias of the analysis,” says José Carvalho de Noronha, who organized the document.
For the Secretary of Health Surveillance, Jarbas Barbosa – one of authors of the publication – the data is outdated. “The document says that the epidemic is stationed at high levels. Over the past three years, we started to see a downward trend,” he said. He recognized that part of the care services is overcrowded – which for him is the result of the program effectiveness. “New services will be opened. In addition, patients who are in good condition can be treated in basic care.”
Mario Scheffer, president of Grupo Pela Vidda, agrees with the analysis made by the document produced by Fiocruz and the Secretariat for Strategic Affairs: “We have been doing this diagnosis for a long time. The program set back and need to correct its route,” he says. He also told that AIDS services lost quality because they are overcrowded and he also agreed with the need to reduce delayed diagnosis. “I would add another serious problem: the program does not respond to the epidemic concentrated in some groups, particularly homosexuals who, by the political option of the Brazilian government, have been neglected in prevention,” he complements.
A piece of Fiocruz document criticizing the Brazilian response against AIDS
During the first two decades of the HIV/AIDS pandemic Brazil has developed a successful control program, recognized as an international reference. The country became a reference because of the development of preventive strategies, health education, behavioral change, encouragement of safer sex and condom use, and the raise of a courageous debate with the whole society over issues such as sexuality, the use of drugs, confronting prejudices and barriers that traditionally involve these issues.
Brazil was also pioneer in the establishment of a program of universal treatment for patients with antiretroviral therapy of high impact. However, it seems like the initial impetus that characterized the program in its early decades cooled. The AIDS incidence has stabilized at a very high level: more than 30,000 cases annually in the last decade. The proportion of cases with late diagnosis is high. The network of specialized services is not increasing, and with the longer survival of the patients the network installed is overloaded.
Unlike what has been observed in other countries that also have established programs for universal access to the treatment, presenting a decrease in the incidence of new infections, Brazil has failed in the reduction of the incidence of HIV/AIDS. It is necessary to correct the course of the program to reduce the disease transmission. On the other hand, the increased survival of patients with HIV/AIDS requires a continuous effort in improving epidemiological surveillance of opportunistic agents associated to AIDS.
The aging population, combined with the increased number of patients using immunosuppressive therapies, in cancer treatment, organ transplant and other conditions, reinforces the need to improve the surveillance of these agents. The HSV8, HTLV, EBV, CVM, and the polyomaviruses are some agents that affect groups of immuno suppressed patients.”
*Source: O Estado de S.Paulo
Published on June 1st, 2012