Strengthening HIV prevention policies and programmatic actions to expand universal access - improving the Brazilian AIDS programme
E.Z. Ayer1, E. Santos1, C. Bernardes1, H. Ribeiro2, J. Kraiczyk1
1Brazilian Ministry of Health, AIDS, SDT, Viral Hepatitis Department, Brasilia, Brazil, 2Brasilian Ministry of Health, Brasilian STD/AIDS Department, Brasilia, Brazil
Issues: Successful HIV prevention requires specific, sustainable, robust actions as Brazil's national response to fight AIDS and other STDs is based on simultaneously widening access to prevention and treatment with associated benefits that drive an agenda focussed on the most vulnerable populations, and political commitment to strategic partnerships.
Description: Enhancing the effectiveness of the national response in Brazil has been based on promoting, protecting and respecting human rights, and basing the expansion of activities on scientific evidence and sustainability. The following actions were contemplated: (a) expanding national production of strategic prevention and treatment inputs; (b) tax exemption over existing inputs; (c) incentive prizes for new prevention technology, such as condom machines and best prevention practices; (d) improving inputs in logistics with systematisation of stock, distribution and dispensing information; (e) accessibility achieved through less bureaucratic procedures facilitating user access to inputs; (f) expanding government procurement of prevention and treatment inputs; (g) inclusion of essential medicines and condoms in the Popular Pharmacy Programme, reducing the impact of prices on family budgets; (h) pressure to achieve technology transfer for prevention inputs and medicines; (i) national reference frameworks to promote universal access to prevention and treatment inputs; (j) investments to improve information systems.
Lessons learned: The adoption of primary strategic elements is fundamental to establishing HIV prevention programmes. Improving rapid access to prevention and treatment inputs linked to key populations are important elements for the national response to AIDS.
Next steps: Guarantee that measures to achieve sustainability of proposed actions are effectively adopted in a combined national response involving partners and actors in government, civil society organization and international bodies. Stress the need to adapt prevention strategies to local needs in order to maximise impacts of the AIDS response on public health.
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