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Lancet. 2008 Jul 26; 372(9635):333-6.Funds available for HIV/AIDS programmes in low-income and middle-income countries rose from US$300 million in 1996 to $10 billion in 2007. However, a combination of worldwide economic uncertainty, a global food crisis, and publications that indicate discontent with progress in fighting the HIV/AIDS pandemic will not only threaten to restrict increases in the overall availability of both donor and national funds, but will also increase the competition for resources during the move towards universal access to treatment and prevention services. Thus, UNAIDS will be under increasing pressure in its presentation and justification of resources needed for HIV/AIDS programming. Here I discuss UNAIDS' 2007 estimates of resource requirements for fighting HIV/AIDS in terms of their usefulness to both donor and recipient governments for budget planning and for setting priorities for HIV/AIDS programmes. I identify weaknesses in the UNAIDS estimates in terms of financial transparency and priority setting, and recommend changes to improve budgeting and priority setting.
Setting national targets for moving towards universal access. Further guidance to complement “Scaling Up Towards Universal Access: Considerations for Countries to Set their own National Targets for AIDS Prevention, Treatment, and Care and Support”. Operational guidance. A working document.
[Geneva, Switzerland], UNAIDS, 2006 Oct. 23 p.This document provides operational guidance to country-level partners and UN staff to facilitate the next phase of the country-level consultative process on scaling up towards universal access to prevention, treatment, care and support services. It concerns the setting of ambitious targets for the national HIV response to achieve by 2008 and 2010, and builds on previous guidelines. Targets need to be ambitious in order to achieve the universal access goals. Analysis by UNAIDS of existing national targets and rates of scaling up indicates that current efforts are inadequate to achieve universal access in the near future. The process of countries setting their own targets will promote partner alignment to national priorities, strengthen accountability and facilitate efforts by countries and international partners to mobilize international support and resources. Targets should have political and social legitimacy. The consultative process should be multi-sectoral, include full civil society participation, lead to consensus on the targets, and formal approval of these targets before the end of 2006. (excerpt)
Geneva, Switzerland, UNAIDS, 2007 Mar. 4 p. (UNAIDS Policy Brief)Nearly 40 million people in the world are living with HIV. In countries such as Botswana, Swaziland, and Lesotho people living with HIV make up a quarter or more of the population. People living with HIV are entitled to the same human rights as everyone else, including the right to access appropriate services, gender equality, self-determination and participation in decisions affecting their quality of life, and freedom from discrimination. All national governments and leading development institutions have committed to meeting the eight Millennium Development Goals, which include halving extreme poverty, halting and beginning to reverse HIV and providing universal primary education by 2015. GIPA or the Greater Involvement of People Living with HIV is critical to halting and reversing the epidemic; in many countries reversing the epidemic is also critical to reducing poverty. (excerpt)
New York, New York, OSAGI, .  p.Her name is Joyce Puta, a 48-year-old Zambian army colonel on secondment to the United Nations. An unabashed fighter, her enemy for the last ten years has been HIV/AIDS. Her latest battleground is Liberia, and by all accounts she has been waging a successful campaign. Working with the United Nations Mission in Liberia (UNMIL), Colonel Puta points out that any environment requiring peacekeepers is also a risky one for the spread of HIV/AIDS. In post-conflict situations, social structures crumble and economies are unstable. In order to survive, desperate young women may turn to commercial sex work, often around military bases. So how did a career Zambian army officer find herself on the frontlines in the fight against HIV/AIDS? Joyce Puta joined the army at eighteen. Six years later she became a registered nurse and midwife, and then nursing services manager for Zambia's main military hospital. (excerpt)
CMAJ: Canadian Medical Association Journal. 2007 Jun 5; 176(12):1728-1730.Between the early 1980s and 2000 the prevalence rate of HIV infection in sub-Saharan Africa increased from less than 1% to 12%, as illustrated in the prevalence maps in Fig. 1. This represents an increase in the number of people living with HIV infection from less than 1 million to 22 million. During this period, neither African governments nor the international donor community sufficiently prioritized HIV/AIDS or allocated adequate resources to help prevent and control its spread. In sub-Saharan Africa, the total amount of official development assistance actually declined in the 1990s, to about $3 per HIV-infected person by 1999. By this time, the international donor community had begun to focus on the HIV/AIDS pandemic and in 2000 began to send billions of dollars to sub-Saharan Africa to tackle the crisis. These investments appear to have had a positive effect: between 2000 and December 2005, HIV prevalence rates among adults were reported to have decreased in more than two-thirds of the countries in sub-Saharan Africa, falling from a mean rate of 10% to 7.5%. (excerpt)
AIDS. 2007 May; 21(9):1205-1209.Thanks to the leadership of the World Health Organisation (WHO), and massive financial support from programmes such as the Global Fund and the US President's Emergency Plan for AIDS Relief (PEPFAR), the number of HIV-infected individuals accessing antiretroviral therapy (ART) in resource-limited settings has tripled from 2001 to 2005. An estimated 1.3 million HIV-infected individuals were on ART in 2005, representing 20% of those in need of treatment. Contrary to initial fears, numerous reports have now been published describing successful early outcomes in many ART patient populations. This is as a result of a number of factors including the fact that the majority of patients are treatment naive, that a low prevalence of primary drug resistance still prevails, and that adherence is better than expected, particularly in patients receiving treatment free of charge. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2006 Mar 30.  p.This independent formative evaluation was conducted by a team of six international consultants between August 2005 and January 2006 to appraise WHO's contributions and roles in implementing the "3 by 5" Initiative. Funded by the Canadian Government, and as a requirement for its grant to WHO, the evaluation investigated all three levels at which WHO operates (headquarters, regional offices and country offices), placing particular emphasis on Africa. This included seven country assessments and an extensive consultation of international and country-level partners and stakeholders. A number of focused technical studies were also commissioned. The evaluation reviewed how effectively WHO provided technical, managerial and administrative guidance and support pursuant to the "3 by 5" goals and target. An assessment was also made of the extent to which WHO has mobilized, sustained and contributed to this major global partnership through improving harmonization between United Nations agencies and working with other stakeholders and partners. Key lessons from "3 by 5" have been documented, including those on how the initiative contributed to health systems strengthening and HIV prevention, as well as the ways with which equity and gender concerns were dealt. Potential opportunities for future collaboration between WHO, main donors and partners were identified and recommendations have been provided for future plans and the way forward for WHO and its partners. (excerpt)
Are a past history of tuberculosis and WHO clinical stage associated with incident tuberculosis in adults receiving antiretroviral therapy? [letter [reply]
AIDS. 2007 Jan; 21(3):389-390.In two recent excellent articles, Lawn and colleagues [1,2] reported the incidence and risk factors for active tuberculosis among HIV-infected adults receiving antiretroviral therapy (ART) in South Africa. In both studies, they found contradictory results regarding the association between the baseline World Health Organization (WHO) clinical stage and the occurrence of incident tuberculosis during follow-up, and contradictory trends towards an association between a past history of tuberculosis at enrolment and a lower (first study) or higher (second study) incidence of tuberculosis during follow-up. (excerpt)
Past history of tuberculosis is not a risk factor for incident tuberculosis during antiretroviral treatment in South Africa [letter] [reply]
AIDS. 2007 Jan 30; 21(3):388-389.We thank Ouattara and colleagues for their letter concerning risk factors for incident tuberculosis during antiretroviral treatment (ART) in sub-Saharan Africa. In a study from Abidjan that included 12 cases, Seyler et al. identified a past history of tuberculosis as the sole risk factor for incident tuberculosis. We reported a larger number of cases (n = 27) within a hospital-based study cohort in Cape Town and, in contrast, a low baseline CD4 cell count and advanced World Health Organization (WHO) stage of disease were the principal risk factors. In a second, much larger community-based study, we found that the current CD4 cell count was the sole independent risk factor for incident tuberculosis (n = 81). In both our studies, a history of previous tuberculosis was consistently found not to be a significant risk factor, agreeing with other unpublished studies from South Africa, Uganda and Senegal; a further study from Uganda reported a strong but statistically nonsignificant trend towards an association. (excerpt)
New York, New York, IAVI, 2006.  p.Twenty-five years after the first five cases of a novel immunodeficiency disease were described, the AIDS pandemic has become the greatest global public health crisis since the Black Death in the Middle Ages. Although the ideal global response to HIV/AIDS must be a comprehensive approach that includes education, prevention, treatment, and care, the only way to end this epidemic is to develop a safe, accessible, and preventive vaccine. The ultimate goal is an AIDS vaccine that prevents infection from the wide spectrum of globally diverse HIV isolates and is applicable for use in the developing world, where the need is the greatest. However, a vaccine that suppresses viral load and slows progression to AIDS or suppresses and blunts transmission of HIV would have significant public health impact. To achieve that, a host of scientific, public policy, and political actions must be taken in a coordinated, interlinked fashion to make all of the necessary resources available (Figure 4). While scientific challenges continue to be the main obstacle in the search for an AIDS vaccine, countless examples of successful technology breakthroughs show that judicious policy changes and political will matters enormously. It is vital to enlist political leadership, non-governmental organizations, community groups, and a range of strategic coalitions that can amplify and reinforce support for AIDS vaccines. (excerpt)
Paris, France, UNESCO, 2006 May. 42 p. (ED-2006/WS/27- CLD 27702)The UNAIDS Inter-Agency Task Team (IATT) on Education promotes quality education as a human right and supports a rights-based approach to the implementation of all educational activities. If education is based on a commitment to rights, then it must embody rights in its conduct. This has implications when one considers the obligation of countries to provide a quality education for all -- including those infected and affected by HIV and AIDS. Because of the nature of the pandemic, those who are uninfected are also viewed as being affected. The topic is even more salient due to national governments', civil society groups', and development agencies' commitments to Education for All (EFA), as goal number six refers to addressing all aspects of the quality of education so that recognised and measurable learning outcomes are achieved by all, especially in literacy, numeracy and essential life skills. A quality education focuses on learning. (excerpt)
Paris, France, UNESCO, Education Sector, Division for the Promotion of Quality Education, Section for Education for an Improved Quality of Life, 2006. 38 p. (ED-2006/WS/13)This report presents the key points and recommendations that emerged over the course of a two day Technical Consultation on HIV and AIDS Treatment Education held in Paris, France, November 22-23, 2005. The Consultation was co-sponsored by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) and the World Health Organization (WHO), and aimed to: Review the current status of treatment education at the global country and community levels and "take stock" of experiences, lessons learned, and good practices in treatment education; Identify needs in the realm of treatment education, with a focus at this Consultation on treatment literacy and community preparedness; Develop an action framework with key priorities for work in the near future for the various partners, including UN agencies, national authorities and civil society, taking into consideration the value added of each and encouraging joint programming; and Identify how the UNESCO-led EDUCAIDS Initiative and the UNAIDS-led campaign on «Universal Access to Prevention, Treatment and Care» can contribute to treatment education. (excerpt)
HIV and AIDS treatment education: a critical component of efforts to ensure universal access to prevention, treatment and care. UNAIDS Inter-Agency Task Team (IATT) on Education.
Paris, France, UNESCO, 2006 Jun. 50 p. (ED.2006/WS/11309713)This paper explores some of the issues contained within the definition of treatment education, signalling ways that the education sector can play a role along with others engaged in treatment access and education. It considers some key strategies, including how to effectively engage and prepare communities and how to involve key constituencies, particularly people with HIV and those on treatment. Moreover, the paper reexamines the harmful effects of stigma and discrimination and how these impede progress in prevention as well as expanded treatment access. The paper also suggests some possible future directions, underscoring areas of particular priority. These include the need for: Identification, documentation and wide dissemination of effective approaches to treatment education that are feasible, sustainable and that can be scaled up; Development of practical guidelines and materials that can be used by programme implementers to support the integration of treatment education within ongoing HIV and AIDS education efforts; Ongoing and close communication with authorities and organizations responsible for expanding treatment access to ensure coherent and well-coordinated programming. (excerpt)
Rational Pharmaceutical Management Plus. Report of UNICEF-WHO consultation: Development of a Programming Guide for Scaling Up Treatment, Care and Support for HIV-Infected and Exposed Children in Resource-Constrained Settings, New York City, USA: January 11-13, 2006.
Arlington, Virginia, Management Sciences for Health, Rational Pharmaceutical Management Plus, 2006 Jan 24. 22 p. (USAID Development Experience Clearinghouse DocID / Order No: PN-ADG-534; USAID Cooperative Agreement No. HRN-A-00-00-00016-00)While many countries in resource-limited settings have made considerable progress in scaling up access to HIV care and treatment for adults, the provision of services, especially antiretroviral therapy (ART) for children, is still in the early stages. The United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) have agreed to develop appropriate programming guidance to assist countries in the scale up of pediatric HIV care and support. The consultation was convened jointly by UNICEF and WHO with the following goal and objectives. Goal-- The aim of this meeting is to review the draft UNICEF / WHO programming guidance and identify essential revisions and modifications and outline next steps. Specific Objectives -- 1. Review and agree on the essential package of services for treatment, care and support of HIV-exposed and HIV-infected infants and children. This will include, but not be limited to: a. Routine HIV testing; b. Follow up of children exposed to HIV and ensuring early testing (polymerase chain reaction [PCR] for infants and for older children, rapid antibody) through child and family care programs; c. Delivery of long-term care of symptomatic children in health care settings, including provision of cotrimoxazole prophylaxis and ART; d. Training to improve skill levels of health care providers and laboratory staff; e. Delivery of home-based care to both exposed and infected children; f. Provision of psychosocial support and counseling for HIV-infected children; g. Quality improvement activities. 2. Review the draft programming guidance to confirm its applicability, suitability, and relevance to the key intended audience. 3. To examine and endorse the identified key program elements of the draft programming guidance. (excerpt)
Handbook for appropriate communication for behavior change. Information / education / communication. A cultural approach to HIV / AIDS prevention and care.
Paris, France, UNESCO, Division of Cultural Policies, 2001.  p. (Methodological Handbooks, Special Series, Issue No. 1; HIV / AIDS Prevention and Care: a Cultural Approach)The Joint UNESCO/UNAIDS Project "A Cultural Approach to HIV/AIDS Prevention and Care" was launched in mid-1998, in relation to the new approach to HIV/AIDS prevention and care inaugurated by UNAIDS. The UNAIDS strategy emphasizes the necessity of giving priority to the multidimensional configuration of the issue and to the diversity of its environment, in order to build comprehensive and adaptable strategies and policies. In this sense, "A Cultural Approach to HIV/AIDS Prevention and Care", represents a new contribution towards finding solutions to this apparently insuperable challenge. Its major methodological output aims at tailoring the content and pace of action to people's mentalities, beliefs, value systems, capacity to mobilize and, as a consequence to accordingly modify international and national strategies and policies, project design and field work. In this respect, this initiative clearly meets the principles and orientations of the Declaration of commitment on HIV/AIDS adopted by the Special Session of the United Nations General Assembly on HIV/AIDS (June 2001), that states the importance of emphasizing the role of cultural, family, ethical and religious factors in the prevention of the epidemic and in treatment, care and support, taking into account the particularities of each country as well as the importance of respecting all human rights and fundamental freedoms. On the basis of the research carried out to date, this handbook deals with building culturally appropriate Information/Education/Communication (IEC) material. After a conceptual introduction, it presents the methodological research to be carried out: evaluation of the current activities, understanding, sensitizing and mobilizing cultural references and resources accordingly. Then it identifies the proposed target audiences and their specific characteristics. Finally, it proposes appropriate IEC models, combining message elaboration and delivery. (excerpt)
Adolescence Education Newsletter. 2005 Jun; 8(1):12.IN JUNE 2004, UNICEF, in collaboration with national organizations, launched Learning for Life, an AIDS education project for Classes 9 and 11 in Tamil Nadu. The plan was to hold HIV/AIDS prevention sessions for 8,185 schools by March 2005. The sessions aimed to give young people an opportunity to learn basic facts about HIV/AIDS and provide them a forum to raise issues related to growing up or the challenges of adolescence. A key material used for these sessions was the "Learning for Life" training manual, which was designed according to the national guidelines developed by the National Council of Education Research and Training (NCERT) and the National AIDS Control Organization (NACO). Partnering UNICEF in this initiative were the Department of Education; Directorate of Teachers Education, Research and Training (DTERT); District Institute of Education and Training (DIET); Tamil Nadu State AIDS Control Soceity (TANSACS); AIDS Prevention and Control Project (APAC-VHS); and core NGOs. (excerpt)
Strategies to support the HIV-related needs of refugees and host populations. A joint publication of the Joint United Nations Programme on HIV / AIDS (UNAIDS) and the United Nations High Commissioner for Refugees (UNHCR).
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS UNAIDS], 2005 Oct. 38 p. (UNAIDS Best Practice Collection; UNAIDS/05.21E)Many countries are already overburdened by the impact of AIDS, and are often unable or unwilling to provide these populations with the HIV-related services they require. This places many refugees in a unique situation. They are no longer guaranteed the protection of their country of origin, they often do not have the assistance of the country of asylum, and they go without the HIV-related services which they need and to which they are entitled under international human rights instruments. This failure to provide HIV prevention and care to refugees not only undermines effective HIV prevention and care efforts, it also hinders effective HIV prevention and care for host country populations. Since refugee populations now remain on average in their host country for 17 years,2 the implications for both refugee and host populations are very serious. Addressing HIV-related needs in the context of refugee situations requires a change in the thinking of the authorities in many countries of asylum. It is impossible to determine the actual length of time that refugees will remain in the host country. However, it is critical that during this time both refugees and surrounding host populations receive all necessary HIV related services, including those that require long-term funding and planning. Failure to provide these interventions could be very harmful to both refugees and the surrounding host populations. In order to meet the HIV-related needs in the context of refugee situations, UNHCR and UNAIDS advocate for the implementation of the best practices described below. Both organizations believe that these practices will generate more effective, equitable and sustainable frameworks to help countries better address both the needs of refugees and their own citizens, whether they are displaced themselves or hosting refugees in their communities. (excerpt)
New England Journal of Medicine. 2006 Jun 8; 354(23):2414-2417.On June 5, 1981, when the Centers for Disease Control reported five cases of Pneumocystis carinii pneumonia in young homosexual men in Los Angeles, few suspected it heralded a pandemic of AIDS. In 1983, a retrovirus (later named the human immunodeficiency virus, or HIV) was isolated from a patient with AIDS. In the 25 years since the first report, more than 65 million persons have been infected with HIV, and more than 25 million have died of AIDS. Worldwide, more than 40 percent of new infections among adults are in young people 15 to 24 years of age. Ninety-five percent of these infections and deaths have occurred in developing countries. Sub-Saharan Africa is home to almost 64 percent of the estimated 38.6 million persons living with HIV infection. In this region, women represent 60 percent of those infected and 77 percent of newly infected persons 15 to 24 years of age. AIDS is now the leading cause of premature death among people 15 to 59 years of age. In the hardest-hit countries, the foundations of society, governance, and national security are eroding, stretching safety nets to the breaking point, with social and economic repercussions that will span generations. (excerpt)
The added value of a CD4 count to identify patients eligible for highly active antiretroviral therapy among HIV-positive adults in Cambodia.
Journal of Acquired Immune Deficiency Syndromes. 2006 Jul; 42(3):322-324.In a retrospective study of 648 persons with HIV infection in Cambodia, we determined the sensitivity, specificity, and accuracy of the 2003 World Health Organization (WHO) criteria to start antiretroviral treatment based on clinical criteria alone or based on a combination of clinical symptoms and the total lymphocyte count. As a reference test, we used the 2003 WHO criteria, including the CD4 count. The 2003 WHO clinical criteria had a sensitivity of 96%, a specificity of 57%, and an accuracy of 89% to identify patients who need highly active antiretroviral therapy (HAART). In our clinic, with a predominance of patients with advanced disease, the 2003 WHO clinical criteria alone was a good predictor of those needing HAART. A total lymphocyte count as an extra criterion did not improve the accuracy. Nine percent of patients were wrongly identified to be in need of HAART. Among them, almost 50% had a CD4 count of more than 500 cells/KL, and 73% had weight loss of more than 10% as a stage-defining condition. Our data suggest that, in settings with limited access to CD4 count testing, it might be useful to target this test to patients in WHO stage 3 whose staging is based on weight loss alone, to avoid unnecessary treatment. (author's)
Lancet. 2006 Jun 10; 367(9526):1876.In the past few weeks, India made headlines for two very different reasons. The good news was that India's economy grew at the fastest pace in more than 2 years, surpassed only by China. The bad news soon followed, however. India has overtaken South Africa as the country with the highest number of people living with HIV/AIDS, according to the latest figures from the Joint United Nations Programme on HIV/AIDS (UNAIDS). In its 2006 Report on the Global AIDS Epidemic, released ahead of the UN General Assembly Special Session on HIV/AIDS in New York, UNAIDS estimated that India now has 5.7 million HIV-positive people. India's government disagrees with these figures, which for the first time include estimates of children younger than 15 years and adults older than 50 years. (excerpt)
Paris, France, UNESCO, 2004 Jul. 13 p. (Literacy, Gender and HIV / AIDS Series)This booklet is one of an ever-growing series of easy-to-read materials produced at a succession of workshops supported by UNESCO and UNFPA. The workshops are based on the appreciation that gender-sensitive literacy materials are powerful tools for communicating messages on HIV/AIDS to poor rural people, particularly illiterate women and out-of-school girls. Based on the belief that HIV/AIDS is simultaneously a health and a social cultural and economic issue, the workshops train a wide range of stakeholders in HIV/AIDS prevention including literacy, health and other development workers, HIV/AIDS specialists, law enforcement officers, material developers and medial professionals. Before a workshop begins, the participants select their target communities and carry out needs assessment of their potential readers. At the workshops, participants go through exercises helping them to fine-tune their sensitivity to gender issues and how these affect people's risks of HIV/AIDS. The analysis of these assessments at the workshops serves as the basis for identifying the priority issues to be addressed in the booklets. They are also exposed to principles of writing for people with limited reading skills. Each writer then works on his or her booklet with support from the group. (excerpt)
Paris, France, UNESCO, 2005. 48 p.HIV/AIDS has reached crisis proportions in many parts of the world, particularly in Southern Africa. To curb its spread, political leaders as well as health care and development specialists and practitioners have made concerted efforts to generate awareness and introduce education relating to this disease. Nevertheless, despite the abundance and availability of educational programmes aimed at the general public on HIV/AIDS, people in poor countries are dying faster than ever before, especially in Southern Africa. This puzzle leaves observers asking questions, such as "Why is this happening?", "Why has the infection rate increased?", "Are the educational materials reaching the right people?", "Are they affecting people who are at greatest risk?", "What is missing or wrong with them?", and "Where are the information gaps?". (excerpt)
Responses to AIDS challenges in Brazil: limits and possibilities. [Respuestas a los desafíos del SIDA en Brasil: límites y posibilidades]
Brasilia, Brazil, UNESCO, 2005 Jun. 680 p.UNESCO and the National Program on STD/AIDS, of the Brazilian Ministry of Health, once again establish a partnership to carry out an activity, which records and cooperates towards implementing one of the most successful Brazilian public policies in health, worldwide acknowledged: those oriented to the fight against AIDS. This publication, basically addressed to tackle the dynamics of those agencies participating in AIDS-related governance in Brazil, lists and itemizes practices and representations of collective civil society units, at different territories. Furthermore, it records contemporaneous debates, assessments, criticisms and suggestions, aiming at adjusting the path. (excerpt)
Proceedings of the International Congress of Dialogue on Civilizations, Religions and Cultures in West Africa, held at Abuja (Nigeria), 15-17 December 2003.
Paris, France, UNESCO, 2005.  p. (CLT-2005/WS/2)This is the third in the series of meetings organised by UNESCO within the context of its programme of civilisation, dialogue, religion and culture. This is the West Africa meeting. It is the first meeting in the series. But it is certainly not going to be the last. UNESCO's role in this mission is not just to design something afresh, but to simply capitalise on a movement, which, I am sure you all agree, has been on the way for quite some time. Religious leaders and religions have become respected elements in civil society. If you look at Latin America, and certainly across Africa, you will find that religious movements are forging ahead. Young men and women are being called to engage in community work. They are being called to engage in a different type of political enterprise. In fact, religious movements in Latin America, and certainly in Africa, are going against the trends in the rest of the world, particularly in the First World, where people are actually moving away from organised religion. We wish to capitalise on these movements and recruit the leadership acumen for a new set of issues to increase democratisation, and certainly to build peace. (excerpt)
Shock therapy in Brazil. By combining prevention campaigns and free access to drug treatment, Brazil has successfully curbed the AIDS epidemic. [Tratamiento de shock en Brasil. La combinación de campañas de prevención con el libre acceso al tratamiento con fármacos ha permitido a Brasil frenar exitosamente la epidemia de SIDA]
New Courier. 2004 Oct; 46-47.Explosive. That was the word to describe the AIDS epidemic in Brazil. In 1992, the World Bank predicted that the number of cases would exceed one million in the year 2000. The demographic growth of Brazil, a country of nearly 170 million people, heightened fears of an epidemic comparable to that sweeping Africa. But while Brazil is one of the countries in Latin America that has been hardest hit by the disease, with more than 600,000 people living with HIV, the numbers are far below the catastrophic forecasts made 10 years ago. The country has even become a point of reference for numerous developing countries in the throes of the epidemic. The daring policy adopted by the authorities in Brasilia - based on active prevention campaigns and, since 1996, the free distribution of anti-retroviral drugs to those who are sick - has turned out to be particularly effective. Currently, 140,000 Brazilians, or nearly all of those who are aware that they have the disease, are receiving free medication. Result: the AIDS related death rate has been cut in half since 1997. And contrary to what some people feared, the widespread access to treatment has not had an adverse effect on prevention. The number of new HIV infections stood at 22,000 in 2003, down from 25,000 in the 1990s. In addition, the incidence of high-risk behavior has dropped. For example, the percentage of soldiers who use a condom when having sex with a paid partner increased from 69 percent in 1999 to 77 percent in 2002. (excerpt)