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Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:42-51.Items from the UNGASS Draft Declaration of Commitment on HIV/AIDS (2001) are analyzed. The Brazilian experience of new methods for testing and counseling among vulnerable populations, preventive methods controlled by women, prevention, psychosocial support for people living with HIV/AIDS, and mother-child transmission, is discussed. These items were put into operation in the form of keywords, in systematic searches within the standard biomedicine databases, also including the subdivisions of the Web of Science relating to natural and social sciences. The Brazilian experience relating to testing and counseling strategies has been consolidated through the utilization of algorithms aimed at estimating incidence rates and identifying recently infected individuals, testing and counseling for pregnant women, and application of quick tests. The introduction of alternative methods and new technologies for collecting data from vulnerable populations has been allowing speedy monitoring of the epidemic. Psychosocial support assessments for people living with HIV/AIDS have gained impetus in Brazil, probably as a result of increased survival and quality of life among these individuals. Substantial advances in controlling mother-child transmission have been observed. This is one of the most important victories within the field of HIV/ AIDS in Brazil, but deficiencies in prenatal care still constitute a challenge. With regard to prevention methods for women, Brazil has only shown a shy response. Widespread implementation of new technologies for data gathering and management depends on investments in infrastructure and professional skills acquisition. (author's)
WHO consultation on technical and operational recommendations for scale-up of laboratory services and monitoring HIV antiretroviral therapy in resource-limited settings.
Geneva, Switzerland, WHO, 2005. 42 p.The aim of the consultation was to obtain clear and realistic guidelines as to which diagnostic and monitoring schedules were optimal and how they could be delivered in order to assist decision-making on treatment and facilitate the implementation of strategies and necessary actions for scaling up diagnosis and monitoring at the local, regional and global levels, with particular emphasis on resource-constrained settings. It was required that the resulting recommendations would provide useful tools for the rational implementation of scaling-up processes, taking into consideration variations between developing countries in human resources, health structures and socioeconomic contexts. (excerpt)
Geneva, Switzerland, WHO, 2003.  p.The World Health Organization (WHO) promotes an evidence-based approach to public health. To date, most of the experience and evidence about the treatment of HIV/AIDS with combination drug therapy has been generated in industrialized countries, where physician-led, individual case management is the standard model of care. Unfortunately, relatively few of these data are of immediate relevance to the delivery of antiretroviral therapy (ART) in resource-constrained settings. UNAIDS and WHO have established the 3 by 5 target and announced that closing the treatment gap is a global health emergency. It is therefore clear that an incomplete evidence base on how to most effectively implement ART in resource-limited communities cannot be a constraint to emergency approaches to close the treatment gap in line with the 3 by 5 target. In contrast, lack of knowledge mandates “learning by doing”—the implementation of an operational research agenda of relevance and importance for ART programmes. As treatment programmes go to scale, it is critical to derive data about what works, and what does not work and why, as fast as possible. This is implicit in the 3 by 5 strategy, where one of the two strategic elements in Pillar 5 “The rapid identification and re-application of new knowledge and successes” is to continuously learn by doing—with ongoing evaluation and analysis of programme performance and a focused operational research (OR) agenda. (excerpt)