Brazil Faces Fresh HIV/AIDS Fight

Brazil's response to its HIV epidemic, hailed as a model throughout the world, is changing to adapt to the evolving face of the disease. Widespread access to effective antiretroviral HIV medications has lengthened the lifespan of Brazil's HIV-positive population and left them susceptible to diseases associated with aging.

"These people are dying of preventable causes," says Mauro Schechter, professor of infectious diseases at the Federal University of Rio de Janeiro.

Public health officials credit Brazil's progress against HIV/AIDS to the government's support of three major efforts:

• beginning in 1996, free antiretrovirals for HIV/AIDS patients;
• aggressive prevention campaigns;
• pioneering public awareness initiatives.

As a result of these efforts, Brazilians are among the world's most knowledgeable in the areas of HIV avoidance and transmittal, according to a recent study by the country's Ministry of Health.

The country has saved $1 billion just by producing generic versions of HIV drugs and by negotiating discounts for the drugs it imports, according to estimates from researchers at Brown University and the Harvard School of Public Health. In addition, aggressive treatment of HIV/AIDS has saved the country $2 billion in hospital costs from 1996 to 2004.

In some ways, Brazil is a victim of its own success. When the country first guaranteed access to HIV medication, the program was organized to treat a small number of patients for a short period of time. Now, officials are caring for many times that number, for much longer periods of time.

"If the epidemic changes face, you need to adapt," said Schechter.

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