Brazil Solves HIV Puzzle

Brazil's ability to identify the AIDS virus was the result of genetic
mapping. The country has a unique AIDS program in which
everyone with the disease gets treated for free. At the moment,
there are 310,000 registered cases of AIDS in Brazil. The number
of "expected" cases in 2004 was supposed to be 1.2 million.

Irene Lobo

Brazil will inform the 15^th World Conference on AIDS, which is taking place in Thailand, that the country is able to solve the puzzle of the HIV type 1 virus, and can detect and specify with precision variants and subtypes found in people who are infected by the disease. All told, Brazil will present 25 papers at the conference.

The ability to identify the AIDS virus was the result of genetic mapping at the Federal University of São Paulo (Unifesp). Mapping the genetic sequence is important in finding a cure (in the form of an antiretroviral vaccine), as well as formulating public policy in dealing with and controlling the disease.

Brazil, as is well-known, has a unique AIDS program, which basically consists of government assistance, free of charge, for anyone with the disease. The country provides AIDS drugs, now mostly cheaper, generic, domestic-made versions of brand-name medicines.

Brazilian representatives at the AIDS conference will report that the program is a success, having cut the expected number of cases in the country significantly. At the moment, there are 310,000 registered cases of AIDS in Brazil. The number of "expected" cases in 2004 was supposed to be 1.2 million.

AIDS Vaccine

In June, a trial of a preventive AIDS vaccine began in Brazil. With 14,000 new AIDS cases every day around the world, the danger of an epidemic is real and must be dealt with, says José Valdez Madruga, who coordinates part of the research on the vaccine and is connected to a worldwide network of researchers. He says that although the vaccine is still in an embryonic stage, he hopes it will work and be available in a few years.

Most HIV positive patients in Brazil have a variant B subtype. However, researchers are concerned with the appearance of other subtypes, such as the C subtype, which has been found in the southern part of Brazil.

Biologist Maria Cecília Araripe Sucupira of Unifesp reports that a study of AIDS in the city of Santos (state of São Paulo), where there has been a high rate of the disease, has found that drug resistant strains have appeared.

Sucupira points out that various factors can cause the appearance of such strains. People do not take their AIDS drugs correctly, for example. There is also the poverty factor, especially in the Northeast region, she says. And finally, there has been a worrisome spike in cases of AIDS among women.

UN Commends Brazil

The 2004 Report on the Global Aids Epidemic commends the advances made by Brazil in the area of preventing the disease. Released yesterday July 6 in Brasília by the United Nations HIV/Aids Program (UNAids), the document cites the increase in condom consumption as a positive item.

According to the Ministry of Health's National STD/Aids Program, condom consumption grew from 150 million in 1994 to over 600 million in 2003.

The report also highlights Brazil's progress in the treatment of carriers of the disease. Of the 400 thousand people around the world who have access to anti-retroviral medicines, 140 thousand live in Brazil.

The Brazilian government spends US$ 229.6 million (700 million reais) annually on Aids treatment; 60 percent of this total is used to purchase medications.

"This policy of furnishing universal treatment to carriers of the virus made it possible to reduce mortality by 50 percent and enabled the National Health System (SUS) to save around US$ 2 million (6.1 million reais) in the past five years," affirms the Director of the Ministry's STD/Aids Program, Alexandre Grangeiro.

The report also underscores Brazil's leadership in cooperative efforts among Southern hemisphere countries, especially those in Latin America and Portuguese-speaking countries in Africa, which receive donations of medicines from Brazil to treat the disease.

"Brazil's example to the world is the big contribution made by civil society in controlling Aids. The partnership between governments and non-governmental organizations (NGO's) and the innovative perspective of the NGO's in terms of making new technologies available permitted the country to make very significant progress, especially in the area of prevention," proclaims the Director of UNAids in Brazil, Pedro Chequer.

HIV and Drugs

The Global Report on Drugs, released June 25 by the United Nations Office on Drugs and Crime (UNODC), cites Brazil as an international model in the fight against HIV virus infections among users of injectable drugs.

Around 13 million people all over the world use injectable drugs. Approximately 78 percent of these users live in developing countries, and the sharing of syringes and needles is the principal factor of transmission in these cases. In Brazil, the incidence of HIV among injectable drug users dropped from 24.5 percent to 12.1 percent between 1994 and 2002.

In comparative terms, the UNODC study reveals that, among this population, the disease "easily affects 50 percent, reaching 90 percent in some parts of the world." Opium and heroin consumption is considered the most troublesome.

The report indicates that 67 percent of the treatments resulting from drug consumption in Asia stem from the consumption of opium derivatives. In Europe this index is 61 percent, according to the UNODC representative in Brazil, Giovanni Quaglia.

Condoms Thai Style

The Coordinator of the National STD/Aids Program, Alexander Grangeiro, revealed at the end of June that Brazil may import technology developed in Thailand to produce condoms.

"The condoms manufactured there are 40 times less expensive than the ones sold here," observed Grangeiro, who participated in a meeting, June 21, with representatives of the Thai government.

"They are willing to share the know-how and transfer this technology for Brazil to obtain better results, when it installs a condom factory."

Thailand and Brazil are members of a seven-country group with plans to establish a technology exchange network for combating the HIV virus. China, India, Russia, and South Africa also belong to this group.

Representatives from these countries are currently engaged in a diagnosis of each country's potential. The partnership can help the group deal with new challenges in fighting the disease.

One such challenge will arise next year, when developing countries will adhere to a World Trade Organization (WTO) agreement that sets rules for protecting intellectual property.

To comply with this agreement—known as Trips—these countries will patent the anti-retroviral drugs produced by their industries. The prices of these medications will tend to rise as a result.

This change disturbs representatives of international organisms. The director of the French Aids Research Agency, Michel Kazatchkine, is afraid that the price increase will decrease the number of people benefited by the Global Fund to Fight Aids, Tuberculosis, and Malaria. Two years ago this fund, fed by the developing countries, established a war chest of US$ 3 billion.

"Over half this money is used for the treatment of Aids in African countries," according to Kazatchkine, one of the members of the Global Fund's management committee.

"The Fund currently makes it possible to treat 1.3 million people. This in places where, until recently, only the high-income population had access to medications."

Irene Lobo works for Agência Brasil (AB), the official press agency of the Brazilian government. Comments are welcome at lia@radiobras.gov.br.

Translated from the Portuguese by David Silberstein