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Evolution of HIV/AIDS response in Brazil: Policy innovations and challenges in the fourth decade of the epidemic
Author(s) -
Fonseca Elize Massard,
Bastos Francisco Inacio
Publication year - 2017
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2452
Subject(s) - decentralization , human immunodeficiency virus (hiv) , corporate governance , political science , economic growth , civil society , development economics , medicine , business , virology , economics , finance , politics , law
Summary Brazil was the first low‐ and middle‐income country to provide universal treatment access to people living with the acquired immunodeficiency syndrome (AIDS), becoming a widely acclaimed model for best practice to managing this epidemic. However, we know little about important challenges to the key pillars of Brazil's response. This article discusses how the evolution of the country's health system institutions and international advancements in AIDS treatment and prevention affected the national response. Decentralization of health system resources and policy making brought fresh challenges to the centralized governance of the national AIDS program and to civil society, weakening their coordination and advocacy capacity. Regardless, AIDS treatment and prevention strategies in Brazil remain aligned with the current international protocols, but unfortunately have been restricted in some geographic areas and/or populations.