Juliana Vieira Borges ValliniHealth Surveillance Secretary

Brasília, 27 de outubro de 2011

Brazil’s perspectives on priorities and emerging issues for the global

health agenda

Brazilian Context

• Health system: universal access; • Constitutional concept of "health" as

global welfare - citizen's right and duty of State - Structured Programs as HIV, TB, malaria, neglected diseases, NCDs etc.

• “Brasil sem miseria”

Achievements - Global framework for health sector response to HIV/AIDS

• We have attained many achievements such as expanding HIV testing and counseling; improving the HIV prevention; accelerating treatment scale up; strengthening health systems; and improving strategic information to better inform the HIV response.

International Agenda• WHA/WHO.• HLM (HIV and NCDs);• Other multilateral organizations.• World Conference on Social

Determinants of Health.• South-south cooperation such as

BRICS, IBSA, UNASUL, CPLP.

International Context • Improvements in the global response to the

HIV/AIDS epidemics, which were translated in the establishment of the UNAIDS and WHO’s strategy 2011-2015.

• We emphasize the linkages between HIV and NCDs response and the achievement of the Millennium Development Goals (MDGs),for example.

• Tackling the Social Determinants of Health is also a powerful tool for improving quality of life.

New goals – HLM HIV/AIDS

• The elimination of mother to child transmission of HIV by 2015 and substantially AIDS-related maternal deaths;

• The acceleration of efforts to achieve access to antiretroviral treatments with the target of working towards 15 million people living with HIV on antiretroviral treatment by 2015.

HLM HIV/AIDS - Challenges• The guarantee of the human rights of key

populations, mainly MSM, sex workers and drug users, but also transgenders, travesties and prisoners, among others; 

• The promotion of evidence-based strategies, such as use of condoms as the most effective prevention tool; 

• The removal of all barriers to access, mainly in terms of the management of intellectual property rights through the public health lens.

Not only for HIV/AIDS

• As stated by the TRIPS agreement, countries have to enforce IPR, but it is not a prerogative of the health authorities. We have to guarantee that, right after patents expiration, generic medicines can be legitimately traded with quality, safety and efficacy, in order to strengthen generic policies and to promote access.

Access to medicines

• We have strong evidences on the cost-effectiveness of interventions that combine early detection and care of NCDs, helping cancer patients, for instance, living longer and in good health conditions.

• People at high risk of developing cardiovascular diseases may be treated with low cost generic drugs, reducing significantly the risk of heart attack and/or death.

Pharmaceutical Care• Pharmaceutical care is a key element

on the Brazilian policies dedicated to curb the increasing trends of NCDs for example.

• The Policies are planned in a comprehensive manner, in order to keep the balance between prevention, treatment, access to affordable quality, safe and efficacious drugs, and their rational use.

Vulnerabilities

• These diseases are strongly prevalent among the poorest and most vulnerable groups, such as elderly people and individuals with low educational level and income.

• Other diseases determined by poverty and impacts on this.

Chronic and Non-Communicable Diseases (NCDs)

• NCDs goes beyond the health sector.• Intersectoriality is a key element:

governments, civil society and the private sector.

• The adoption of healthy lifestyles is, of course, a major step on preventing NCDs.

• If we do not address the factors and determinants that make people more vulnerable to NCDs, we risk on failing on our efforts.

Chronic and Non-Communicable Diseases (NCDs)

• It represents 72% of death in the country and also lead to early retirement and loss of workforce;

• Brazil, or any other country, relying on its own means, cannot face the challenges posed by NCDs;

• Pursuing technical and political dialogue with other Nations and stakeholders at the global level to find solutions for this health challenge;

NCDs: actions to promote health and prevent the surgeance of new cases.

Brazilian Context

• The launch of the 2012 – 2022 Strategic Action Plan to Fight NCDs;

• The program to fight breast and cervical cancers among women;

• The so-called “Health has no Price” program, which includes free of charge drug deliverance for diabetes patients, among others;

• The program to cease the use of tobacco products.

International Context

• The importance of the World Health Organization and its articulation role for technical support for developing countries on these issues;

• The WHO reform in order to make it able to accomplish its mandate on leading the health sector at the global level.

Challenges

• We cannot put on individuals the responsibility for getting sick if we, governments, do not offer them the means to face the obstacles they need to overcome in order to be healthy.

• We have to put the agendas of health, development and human rights at the same tune. We have to work to abolish inequalities.

Other issues in the International Agenda

• WHO’s Reform

• WHO negotiation related do medicines “falsification”

• Rio +20