AIDS mortality rate reduction in Brazil: success or fallacy?
University of Liverpool, Grader - Post Graduation Program PH, Maputo, Mozambique
Background: Brazilian National AIDS Program is considered an example “best practice” in terms of prevention as well as treatment and care. However, there appear to be gaps in access to health care. This article examines to what extent health gains, obtained through the introduction of universal access to care and anti-retroviral treatment, are homogeneous across the country.
Methods: A descriptive study was conducted based on mortality rates, broken down by state, and obtained from Brazilian Surveillance System. This generated an analysis of AIDS-related deaths in general and particularly Sao Paulo State, the richest state in Brazil.
Results: Mortality rates were more than halved in some Brazilian states after 1997. In fact Sao Paulo has a more significant AIDS death rate in the country (SMR: 202.9; IC: 201.5~204.4, p< 0.05). However, reduction in overall mortality rates is not as marked when Sao Paulo State is excluded from the analysis, and the other 25 states and Federal District considered separately.
Conclusions: The presented data calls into discussion not only the AIDS response, in terms of treatment in Brazil, except Sao Paulo, but also it as a model for replication in other developing countries. There are still important health gaps to tackle to impact health outcomes in different regions of the country, especially those that present lower socio-economic indicators.
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