Brazilian policy of universal access to AIDS treatment: sustainability challenges and perspectives.
BACKGROUND
The Brazilian AIDS Programme success is recognized worldwide, due to its integrated approach of prevention, respect for human rights and to free of charge universal access to state of the art antiretrovirals.


BACKGROUND
As of 2006, 180,000 people living with AIDS are on HAART with 17 drugs available, receiving medical and laboratory care through the public health system. Costs for ART drugs reached US$ 400 million in 2006 and will increase steeply if the current trends are maintained: uptake of approximately 20,000 new patients/year and the need for more expensive, patent-protected second and third line drugs.


CONCLUSIONS
We discuss the strengths and weaknesses of the programme, budgetary pressures, the need for more intense preventive efforts, for boosting local production of new drugs, for more investment in research and development and the issue of voluntary and compulsory licensing. There are many hurdles in pursuing long-term sustainability, which depends on country driven initiatives and international collaboration and participation.


CONCLUSIONS
We conclude that the Brazilian experience demonstrated the capability of a developing country to treat people with equity, independently of race, gender or economic power and that this equality "seed" has already spread to other countries. Internally this experience must be used to tackle other endemic diseases, such as leprosy, malaria, dengue and leishmania. The Brazilian political will has been proven but, once again, there will be the need for concerted action by civil society, researchers, health professionals, people living with HIV/AIDS and the government to convince the world that health needs should not be treated as commercial issues, and that progress in research and development must be shared throughout the world if we expect to survive as a civilization.
Greco
Dirceu B
DB
Internal Medicine Department, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, CEP 30130-100 Belo Horizonte, MG, Brazil. greco@medicina.ufmg.br
Simão
Mariangela
M
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D003906:Developing Countries; D004196:Disease Outbreaks; D016527:Drug Costs / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans
D019380:Anti-HIV Agents