Abstract
This study was intended to assess care provided to those living with HIV/AIDS in Brazil and the Brazilian Unified Health System (SUS) capacity of delivering interventions to cope with the epidemic as well as to discuss the sustainability of the Brazilian initiative of providing universal free access to antiretrovirals (ARVs). Original data from a study comprising 119 respondents on the potential capacity of delivering a prospective HIV vaccine in Brazil was used. Inpatient and pharmaceutical care was based on data from the SUS Hospital Information System and Drug Logistics Management Systems of the National Program for STD/AIDS. The study results indicate good performance of the Brazilian ARV Access Program but access to treatment of opportunistic infections was, however, unsatisfactory. The rates covered by SUS for AIDS hospital admissions remained very low, on average around R$700 in 2004. Health care to HIV/AIDS patients has been considered a citizen's right strongly supported by an effective joint action of the Brazilian government and civil society. The current challenges are fine monitoring of processes and program results and ensuring sustainability of universal free ARV access.
Highlights
The Care, Support and Treatment principle of the United Nations Declaration of Commitment on HIV/ AIDS* addresses two main points
Strengthening health care systems for safely and effectively providing antiretroviral (ARV) therapy and best care recommended for prevention and treatment of opportunistic infections, including actions on drug practices and policies that would allow a sustainable ARV provision
The Brazilian Health System first provided drug for opportunistic infection treatment in 1988, and zidovudine became available in 1991.3,4 In 1996, the government took a groundbreaking step and pioneered passing a law establishing as the State’s responsibility to provide universal free drugs for the treatment of HIV/AIDS patients.* In addition, the National Program for STD/HIV/AIDS (PN-DST/AIDS) has been historically characterized by taking thorough care measures and incorporating comprehensive strategies to fight against the epidemic and having a central role in promoting joined action with civil society.[2,7]
Summary
The Care, Support and Treatment principle of the United Nations Declaration of Commitment on HIV/ AIDS* addresses two main points. It poses challenges that indicate the need for finer monitoring of processes and results of care provided to those living with HIV/AIDS concerning drug therapy, and health services utilization as well as attention at the community level.
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