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[e-drug] WHO 3x5 strategy on supplies management (cont'd)

E-drug: WHO 3x5 strategy on supplies management (cont'd)

The question Patrice has been raising has been discussed many
times in Brazil, both by representatives of NGOs and government
bodies. Why does Brazil have a universal approach for its AIDS
patients, and at the same time, it needs to implement a "hunger zero"
program because part of the population is still malnourished? By the
way, even the AIDS Program in Brazil is still far from perfect. Vertical
transmission is quite high, although decreasing, there is a lack of
hospital beds, etc.. . Nevertheless it is a leading example and other
diseases in Brazil don't have the same universal approach in terms of
free access to medicines. Patients suffering from Hepatitis C (1
million cases) have difficulties to get access to more expensive drugs,
and the list goes on.

The Aids Program emerged under very specific circumstances in
Brazil and this is not the object of this discussion, but what is
interesting to note is the boost that the AIDS program succeeded in
giving to other health programs. By focusing on one disease in a very
strong political, cultural and medical way, it highlighted the
deficiencies of the public health structures throughout country. By its
strength, the AIDS program succeeded in solving some of these
problems and somehow constructed a bridge that other public health
problems can benefit from. The possible synergy from a well
succeeded AIDS program is not to be neglected. If well planned by
the public health authorities, the channels used to confront the AIDS
crisis can be used to drain benefits for other diseases. The outreach
to AIDS patients will bring the rest of the diseases at glance and
eventually measures need to be taken to solve this questions as well.
Let's take the case of TB. It is not officially in Brazil part of the AIDS
programme, but it has of course to work very closely with it as one
depends upon the other. Although the TB programme is very old, the
AIDS programme certainly boosted the actions of it. 
One can wonder if this is the right way to promote changes and to
tackle the infrastructure and organizational problems Patrice was
talking about? I am not sure. But I do believe that when an
opportunity emerges to make things different, it should be considered
and the 3 by 5 is definitely a moment of positive shared international
energy that can drain all kinds of resources to areas forgotten from
the health care systems. The challenge is certainly huge and treating
AIDS may be the start of a new vision of public health in developing

Michel Lotrowska
Representative Brazil, MSF Essential Medicines Access Campaign
Tel office: +55-21-2220-3523
Tel Home: +55-21-2513-4140
Cel/Mobile: +55-21-8111-3-666
Rua Santa Luzia 651-11
Rio de Janeiro - Brasil
e-mail: access@msf.org.br

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