Brazil sustains HIV response during the COVID-19 pandemic
Authors: Gerson F Mendes Pereira
Journal: The Lancet HIV (2021)

Brazil is proud of its internationally recognised HIV programme, which was not discontinued or threatened because of the COVID-19 pandemic, as described in a Feature published in the December, 2020, issue of The Lancet HIV.1Parkin Daniels J COVID-19 threatens HIV care continuity in Brazil.Lancet HIV. 2020; 7: e804-e805Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar Brazil has strongly criticised the Rights in a Pandemic report by UNAIDS because of inconsistent data and statistics. Over the past 2 years, The Brazilian Ministry of Health has improved the bureaucratic structure that supports the national HIV programme. In May, 2019, considering the burden of the tuberculosis and HIV co-infection, the Department of Diseases of Chronic Conditions and Sexually Transmitted Infections was created that oversees the HIV, tuberculosis, and Hansen's disease national programmes. This new department has more human and financial resources available to respond to the diseases: the annual budget increased from R$1 719 214 056 in 2018 to R$2 446 639 943 in 2019 and to R$2 673 212 503 in 2020.2Government of BrazilPortal da Transparência.http://www.portaltransparencia.gov.br/orcamentoDate: 2020Date accessed: January 19, 2021Google Scholar The new department kept providing medication for HIV treatment and prevention in Brazil during the pandemic, thanks to its logistics expertise. Moreover, the number of services offering pre-exposure prophylaxis (PrEP) has grown steadily, with 26 764 people starting PrEP in the past 3 years (8108 people in 2018, 8536 people in 2019, and 10 120 people until October, 2020).3Departamento de Doenças de Condições Crônicas e Infecções Sexualmente TransmissíveisMinistério Da SaúdePainel PrEP.http://www.aids.gov.br/pt-br/painel-prepDate: 2021Date accessed: January 6, 2021Google Scholar An increase of new PrEP users is also noticeable since 2018. Brazil has also continued to answer requests for antiretrovirals and antiviral drugs donations from nearby countries (ie, Argentina, Ecuador, El Salvador, Guyana, Jamaica, Paraguay, Suriname, and Uruguay). Since the beginning of the pandemic, the Ministry of Health has been monitoring the effect of COVID-19 on people with HIV4Departamento de Doenças de Condições Crônicas e Infecções Sexualmente TransmissíveisMinistério Da SaúdePainel de monitoramento de dados de HIV durante a pandemia da COVID-19.http://www.aids.gov.br/pt-br/painelcovidHIVDate: 2019Date accessed: January 6, 2021Google Scholar and found there was no decrease in the number of people being treated for HIV in Brazil (which was 709 000 people as of September, 2020).4Departamento de Doenças de Condições Crônicas e Infecções Sexualmente TransmissíveisMinistério Da SaúdePainel de monitoramento de dados de HIV durante a pandemia da COVID-19.http://www.aids.gov.br/pt-br/painelcovidHIVDate: 2019Date accessed: January 6, 2021Google Scholar The proportion of multimonth dispensations increased between 2019 and 2020: a 26% increase in those for 60 days, and a 103% increase in those for 90 days. There was also an increase in the median of medication coverage from 30 to 60 days (the national average is 64 days) and a 3% increase in the number of people with HIV linked to health services.4Departamento de Doenças de Condições Crônicas e Infecções Sexualmente TransmissíveisMinistério Da SaúdePainel de monitoramento de dados de HIV durante a pandemia da COVID-19.http://www.aids.gov.br/pt-br/painelcovidHIVDate: 2019Date accessed: January 6, 2021Google Scholar Other measures implemented during the pandemic to continue the fight against HIV in Brazil include automatic 90-day extension of antiretroviral dispensing forms, 90-day extension of HIV treatment active forms, 120-day extension of PrEP active forms, HIV tests for inpatients with respiratory syndrome, reduction of appointments and follow-up examinations for people living with HIV with undetectable viral loads, and telemedicine services and digitally signed laboratory-examination requests, certificates, and prescriptions. Two calls for non-governmental organisation proposals were also published in August and December, 2020, worth R$5 million each.5UN EducationalScientific and Cultural OrganizationInvitation for partnershiips for the selection of Civil Society Organisations (CSOs) for the execution of projects related to surveillance, prevention and control of diseases of chronic conditions and sexually transmitted infections.https://fornecedor.brasilia.unesco.org/processes/2904Date: Aug 12, 2020Date accessed: January 6, 2021Google Scholar, 6Departamento de Doenças de Condições Crônicas e Infecções Sexualmente TransmissíveisMinistério Da SaúdePNUD apoia testagem de HIV em estratégia 'Viva Melhor Sabendo'.http://www.aids.gov.br/pt-br/noticias/pnud-apoia-testagem-de-hiv-em-estrategia-viva-melhor-sabendoDate: Dec 4, 2020Date accessed: January 6, 2021Google Scholar In conclusion, the Brazilian HIV programme is an institutional policy that has been kept strong through different governments and the COVID-19 pandemic. GFMP is an employee of the Brazilian Government. COVID-19 threatens HIV care continuity in BrazilA double-whammy of the pandemic and unsympathetic government threatens to undermine the HIV response in Brazil. Joe Parkin Daniels reports. Full-Text PDF