“There is no Brazilian model. What we have been doing is to put into practice principles that have long been recognised by the international community,” declared Dr Paulo Teixeira, Director of the Brazilian STD/AIDS Programme in Thursday’s plenary.

“At the very core [of Brazil’s programme] is the Universal Declaration of Human Rights, adopted more than 54 years ago. None of these outcomes could have been achieved without embracing a balanced prevention and treatment approach and the firm advocacy of the human rights of people infected and affected by HIV/AIDS,” said Teixeira.

Brazil has implemented a comprehensive prevention programme focusing on condom use. It has achieved a significant reduction in the rate of incidence particularly in more vulnerable populations, including men who have sex with men, sex workers and injection drug users.

“No time can be spent with ambiguous prevention messages. HIV transmission happens [primarily] through sexual contact and prevention is made through condom use. Other alternatives, such as postponement and abstinence are indubitably incompatible with our global reality,” said Teixeira.

“Controlling the AIDS epidemic also [requires] mobilising the entire national capacity to offer antiretroviral treatment, even when the optimal infrastructure is not available,” said Teixeira.

The number of AIDS deaths has fallen dramatically since the adoption of antiretroviral therapy. Survival has increased dramatically. The average survival time is now close to five years, a twelve-fold increase reported Dr Ricardo Marins in a poster at this conference.

In Brazil, the average treatment cost per patient each year decreased by half in recent years. This occurred as a result of two related factors.

Firstly, investments were made by the Ministry of Health to establish domestic national laboratories. Brazil distributes fifteen antiretroviral drugs of which eight are locally produced.

Secondly, Brazil has effectively negotiated price reductions with Abbott, Merck and Roche to cut the price of four drugs by more than 50%. Teixeira indicated that “national production under compulsory licensing has been a strong argument to push these companies to the negotiation table.”

Brazil has 600,000 persons living with HIV and has had more than 220,000 cases of AIDS reported to the Ministry of Health since the beginning of the epidemic. This is less than 50% of the number predicted by the World Bank a few years ago.

AIDS 2002 Conference News produced by Health & Development Networks/Key Correspondent Team