We can think about eliminating AIDS in Brazil, says doctor chosen to lead the fight against HIV in Health


Doctor Draurio Barreira, manager of tuberculosis at Unitaid (International Center for the Purchase of Medicines against AIDS, malaria and tuberculosis), a global agency linked to the WHO (World Health Organization), was invited to take over the new STI Surveillance Department /Aids and Viral Hepatitis of the Ministry of Health.

“I want to return to Brazil and contribute to the reconstruction process”, says the doctor, who worked in surveillance programs for sexually transmitted diseases in the country in the 1990s.

“I am thinking of articulating an inter-ministerial agenda that can raise the agenda for the elimination of Aids and viral hepatitis among the government’s priorities”, he adds.

For Barreira, “elimination” is a possible and achievable term by 2030, according to the target proposed by the WHO. “We could be the first developing country to eliminate tuberculosis. I am very clear about the feasibility of this goal of eliminating the disease as a public health problem and we can think of viral hepatitis and AIDS in the same way”.

He knows that the actions in the coming years can return to Brazil the role of protagonist in the fight against Aids and he hopes that the post will be regained.

“Brazil has conditions like few others to lead the health movement in a very bold way because, unlike almost all countries, it has a health system that provides universal access. This is very rare”, he concludes.

Doctor Fábio Mesquita was even considered for the position, but in the end Barreira was chosen.

Coordinator of the National Tuberculosis Control Program until 2016, Barreira resigned from the Ministry of Health to take up his position at the agency in Geneva (Switzerland), focused on innovation in health and the provision of new tools for the prevention, diagnosis and treatment of diseases, mainly AIDS, tuberculosis and malaria.

“My cycle now, returning from the global to the national, focuses on the affected individual, on providing access to innovation for the most vulnerable and needy populations”, he says.

One of the challenges, he says, is to guarantee access to new technologies in the area. He mentions, as an example, the quick tests for HIV that can be done by the person himself — which in Brazil do not advance because the diagnosis in the country is based on the doctor. “It is necessary to decentralize, within health protocols, so that not only professionals but the population in need can make their own diagnosis”, he defends.

The pandemic has demonstrated the crucial importance of diagnosis and prevention. We must take advantage of these lessons in the case of AIDS, tuberculosis and hepatitis.

“When prevention is feasible, it is better to prevent than to treat. When treatment is the solution, it should be accessible to everyone. Today, there are test strategies as the best form of prevention, in the sense of testing and providing treatments. There is pre-prophylaxis and post-exposure. We have an arsenal, now we need to impact especially the most vulnerable populations”, says

Barreira recognizes, however, that offering options is not enough. You need to know what people need and what best fits their reality.

“The first step of any national response to a disease is to have as interlocutor those who will benefit from the actions, then listen to civil society, affected communities and academia in order to offer what people need, not what we imagine to be needed. Magic bullets don’t exist”.

Another challenge is the need to secure more resources. In this sense, one of the actions envisaged by Barreira is to propose tackling these diseases as an intersectoral agenda, mobilizing financial and human resources from other areas.

“I am very convinced that it is possible to create this agenda. For this, there is a need to recreate the participatory management bodies as they traditionally were and that each commission can transcend the specific field of a department, of a ministry, so that it is a truly agenda. transversal and government”, comments the doctor.

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