Cut forecast of R$ 407 million raises fears of lack of HIV medicine

The cuts in the Ministry of Health provided for in the 2023 Budget proposal raise concern among associations representing HIV patients. According to a survey by the IEPS (Institute of Studies for Health Policies), the project foresees a reduction of R$ 407 million for the prevention, control and treatment of HIV/AIDS, sexually transmitted infections and viral hepatitis.

The area is one of the 12 listed by the IEPS that may lose resources next year, with reductions ranging from 17.4% of the budget, as in the HIV/AIDS area, to 65.7%, as in the case of the research, technological development and innovation in health. Other areas that may lose resources are the data sector and the Doctors for Brazil program, which replaces Mais Médicos.

“It’s a disregard for health and the country’s recent history. Brazil had an exemplary response to AIDS in previous years. Why cut back on a program that is exemplary and that has repercussions on other pathologies?”, asks the deputy. president of Abia (Brazilian Interdisciplinary AIDS Association), responsible for the National Observatory of AIDS Policies, Veriano Terto Junior.

According to the Ministry of Health, no public policy will be interrupted.

He fears for the addition of new drugs for treatment and prevention. “The ministry says it will buy carbotegravir for pre-exposure prophylaxis, PrEP. It is a drug that is very important and suitable for prevention, but it is expensive”, he exemplifies.

Another fear is that the cut in resources will affect the maintenance of the current drug program. Terto Junior cites the purchase of lamivudine, a drug used in different antiretroviral treatment regimens —including simplified regimens: lamivudine associated with dolutegravir; lamivudine combined with darunavir and ritonavir—and for which demand has increased in recent months.

He also mentions the need for resources for prevention campaigns, since the number of patients continues to be a concern. According to the latest epidemiological bulletin released by the Ministry of Health, in 2020, the country recorded 29,917 new cases of AIDS and 10,417 deaths associated with HIV.

From 1980 to June 2021, 1,045,355 AIDS cases were identified in Brazil, with a concentration in the Southeast (50.6%) and South (19.8%) regions, followed by the Northeast (16.5%), North (6.9%) and Midwest (6.2%).

“We don’t see prevention campaigns. There is the conservative context of our society, which ends up being a barrier because talking about prevention implies addressing the use of condoms and sex education, and the cut can fuel arguments such as ‘we are not going to campaign because we don’t have money’. “, says Terto Junior.

To prevent the cut from being approved, entities such as Abia have sought to mobilize the population, legislators and prosecutors. An example is the demonstration scheduled for the 21st, in front of the Municipal Theater of São Paulo.

“We try to bring to the public debate and show society the losses involved. Losing the place of reference in the fight against AIDS in the world is sad because it meant a huge financial, professional and life effort”, says the vice president of Abia.

In a note, the Ministry of Health stated that no public policy will be interrupted. “The ministry is attentive to budgetary needs and will seek, in dialogue with the National Congress, the necessary adjustments in the budget proposal for 2023”, he says.

In relation to lamivudine, the ministry says that there is no shortage. According to the ministry, in the month of September, there was a rapid and above-expected growth in the use of simplified treatment regimens and an attempt was made to expand the acquisition in the laboratory.

According to the ministry, the distribution of about 5 million units to the states began on Tuesday (11) to the states and new deliveries are planned by the end of the month.