Presentation given by

1. Brazil’s perspectives on priorities
and emerging issues for the global
health agenda
Juliana Vieira Borges Vallini
Health Surveillance Secretary
Brasília, 27 de outubro de 2011

2. 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”

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. 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.

13. 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;

14. 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.

15. 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.

16. 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.

17. Other issues in the
International Agenda
• WHO’s Reform
• WHO negotiation related do medicines
“falsification”
• Rio +20