In 2019 920,000 people were living with HIV which is 0.5 % of the population. 42,000 were new cases that year with 14000 deaths related to HIV. Compared with 2010 there were 640,000 cases. In the year 1991, there were more than 10,000 cases which grew to 250,000 in 1998. There was an exponential increase in HIV/AIDS cases in the 1980s. Brazil was in the midst of a transition from dictatorship to democracy when the first case of HIV/AIDS was reported. The newly formed government was influenced by protesters of the military regime, one of the influencing movements was the sanitary health movement called Sanitaristas, which comprised middle-class health workers who sought equal health services for all citizens. This built the framework for the policy of HIV/AIDS treatment and prevention in Brazil. The National AIDS Control Program was established in 1986. Until now there were many programs and measures set up to curtail HIV and also to treat the patients and due to this the prevalence and incidence have decreased and the epidemic is considered stable. But recently there has been an increase in the number of cases in the young population. Also, many issues need to be discussed such as discrimination faced by HIV patients and, usage of condoms as preventive measures. Other issues such as prostitution, HIV in the elderly, regional discrepancies in the availability of drugs and testing kits, and developing a complete cure for HIV also deserves attention.
The Brazilian model is considered far more successful compared to other developing countries by the United Nations. Brazil is one of the first 40 countries to provide free HIV treatment and self-testing kits which has increased the number of people aware of the disease and people taking Antiretroviral therapy. Brazil also buys a huge number of condoms and distributes them as a preventive measure. Brazil has decentralized its HIV testing centres and trained NGOs in the rapid testing of HIV. Brazil was one of the few countries that had a compressive approach to sex education that included knowledge about STIs, HIV, sexuality, gender identities, and sexual and reproductive rights. Outside the school environment, various awareness programs were initiated focusing on the use of condoms and HIV with the use of social media such as Tinder and Hornet. It provides free treatment to mothers irrespective of CD4 count and continued treatment after birth to reduce mother-to-child transmission. Brazil has also launched a free needle exchange program to reduce the incidence in the drug abusers population. A pre-exposure prophylaxis pilot program was initiated in which ART drugs were given to high-risk populations such as men who have sex with men and the transgender population.
The Joint United Nations Programme on HIV/AIDS unites and brings together efforts of the UNHCR, World Bank, UNESCO, UNDP, UN Women, UNFPA, WHO, World Food Programme, UNODC, and ILO for a coordinated response. The main role of UNAIDS is not to provide finance many of its sponsors do give out loans. Its function is policy formation, strategic planning, technical guidance, research and development, and advocacy within the framework of a global plan. The UN has enlisted eight objectives to be achieved by 2015 under the Millennium Development Goals in 2000. The result was a drop in incidence by 21% worldwide. Another goal was to reduce MTCT which resulted in a reduction in 50% of the incidence of HIV in children in Africa, much of it was due to antiretroviral programs designed for MTCT.UNICEF’s goal is to prevent new infections and treat children with HIV. UNICEF to achieve its goals works with governments and local partners to bring in the funds. UNICEF advocates a combination of biomedical, structural, and behavioural interventions. These include pre-prophylaxis, self-testing, HIV-sensitive protection services, and mobile communications to improve the availability of treatment to all. In 2014 UNAIDS set a target of 90-90-90 which targets 90% diagnosis of people who had AIDS, 90 % diagnosed people on ART, and 90% suppression of viral load in those who were treated. The result was that 81% of people knew they had HIV 82% were receiving treatment and 87% of people who were receiving treatment were virally suppressed, which is fairly close to achieving its goals.
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