A Brazilian Ministry of Health program, established in 1986 to coordinate the country's response to HIV and other sexually transmitted infections, best known for the 1996 law, Law No. 9313, that made Brazil the first middle income country to guarantee free, universal antiretroviral therapy to everyone living with HIV. The policy was made financially sustainable in part by Brazil's domestic production of generic antiretrovirals, including locally produced zidovudine from 1994 onward, which lowered treatment costs and let the program expand access despite initial opposition from multinational pharmaceutical companies and trade bodies. The program became an internationally cited model for combining free treatment access with domestic generic drug manufacturing in a middle income country.
Facts
Launch YearSourced to the subject's own account Program StatusSourced to the subject's own accountActive; expanded in 2013 to a Test and Treat policy and since 2017 offers pre-exposure prophylaxis (PrEP) through the public health system 1 Sponsoring BodySourced to the subject's own accountBrazilian Ministry of Health, with the National AIDS Control Committee (scientists and civil society) overseeing it from 1987 and World Bank-financed AIDS Project I and II funding it from 1992 to 2002 1 Target PopulationSourced to the subject's own accountPeople living with HIV/AIDS in Brazil, with targeted outreach to groups at higher risk including sex workers, injecting drug users, men who have sex with men, and transgender women 1 Health GoalSourced to the subject's own accountCoordinate Brazil's HIV/AIDS response, including universal free antiretroviral therapy, prevention campaigns, needle exchange and condom distribution, aimed at reducing new infections and AIDS mortality 1 Geographic ScopeSourced to the subject's own accountNational (Brazil), delivered through the SUS public health system 1 Measured ResultsSourced to the subject's own accountBy 2002 Brazil had fewer than 600,000 estimated HIV infections, less than half the World Bank's 1990 projection of 1,200,000 by 2000, and mother-to-child transmission fell to about 3 percent, comparable to developed countries 1 Classification
Program KindSourced to the subject's own accountDisease Surveillance Program 1 Connections
Sources
1. Wikipedia: HIV/AIDS in Brazil
WikipediaHistory section, sentence giving the National AIDS Control Program's 1986 founding date
The Brazilian Ministry of Health laid the groundwork for a National AIDS Control Program (NACP) in 1986.
History section, same sentence, parenthetical NACP abbreviation
The Brazilian Ministry of Health laid the groundwork for a National AIDS Control Program (NACP) in 1986.
History section, sentence on the National AIDS Control Committee's 1987 oversight role
In 1987, it was placed under the aegis of the National AIDS Control Committee, a group composed of scientists and members of civil society organizations.
Government policies > Test and Treat policy section, sentence on nationwide SUS eligibility
all people diagnosed with HIV, regardless of CD4 count or clinical stage, became eligible for immediate antiretroviral therapy through the public health system (SUS)
Government policies > Universal ARV provision section, opening sentence on Law No. 9313/1996
the free, universal provision of anti-retroviral drugs (ARVs), including protease inhibitors, starting in December 1996 with Law No. 9313/1996
Social policies section, sentence on the 3 percent mother-to-child transmission rate
Mother-to-child transmission was similarly practically eradicated, falling to a transmission rate of 3%, a level comparable to most developed countries
Government policies > Pre-Exposure Prophylaxis section, opening sentence on PrEP availability since 2017
Since 2017, tenofovir/emtricitabine (TDF/FTC) has been available free of charge through the SUS to individuals at substantial risk of HIV acquisition
Government policies > Pre-Exposure Prophylaxis section, sentence naming PrEP priority groups
including MSM, transgender women, sex workers, and serodiscordant couples
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