AIDS patients in Brazil who visit any of the 111 antiviral treatment centers throughout the country come armed with a bar-coded card that immediately grants them access to their health care account. In addition to establishing their identity, the card provides access to records of diagnosis, current treatment, last doses of medication, specific complications, dates of recent visits, and the person’s medical history.
pBrazil’s Computerized Logistics Control System for Antiretroviral Drugs, known by its Portuguese acronym SICLOM, makes it possible for health care officials to closely track each one of the 105,000 cases of people stricken with AIDS in the country. The system also enables rigorous control over supply and distribution of drugs, while monitoring and updating the appropriate regimen of drugs for each particular case.p
In 1996, Brazil took on a task of colossal complexity when it began to offer free, universal treatment and care to all of its citizens who were infected with HIV, a category that today includes 597,443 individuals. Providing the famous drug "cocktail" to all patients at a reasonable price was only a small part of the challenge, although it came only after long and arduous negotiations with multinational pharmaceutical companies over patent issues.
People with AIDS develop a wide variety of physical and emotional complications. Patients therefore require constant monitoring, periodical tests, and ongoing psychosocial support. Because of the highly complex nature of this care, which is now available on the local level throughout the country, it has been necessary to deploy legions of health forces nationwide. Brazil has had to build a comprehensive network, train specialists, manufacture medications, sensitize and educate the country and the media, gain the support of the Church and of political parties, as well as approve laws and budgets.
Today the Brazilian AIDS patient assistance network has 133 diagnostic and follow-up laboratories, 656 alternative care centers, and 424 special treatment centers. Some 40 universities collaborate in the training of specialized personnel. Nearly 800 NGOs are an integral part of the strategy. The country is bombarded by mass media campaigns on AIDS each year.
Despite the program’s complexity and cost, the Brazilian government estimates that it has saved nearly $700 million in hospital expenditures over the last five years by helping the AIDS-related mortality rate to drop by between 40 percent and 70 percent and the morbidity rate to fall by between 60 percent and 80 percent. In the absence of a cure, Brazil has succeeded at providing people with HIV/AIDS with a better quality of life.
The visibility of Brazilian leaders at international AIDS events—including, on several occasions, of President Fernando Henrique Cardoso—underscores the political importance that these programs have acquired. Now the international community is increasingly looking to Brazilian technology and expertise as it seeks to find sustainable alternatives to HIV/AIDS care in developing world.