THE RESPONSE TO HIV/AIDS AND THE WORLD OF WORK IN BRAZIL Paulo R. Teixeira, MD Brazilian STD/AIDS Program Ministry of Health

BRAZIL: MAJOR ASPECTS AREA: sq. KM POPULATION (2000): 169,500,000 ECONOMIC PRODUCTIVE FORCE: 80,000,000 GNP PER CAPITA (2001): US$ 2,914 LIFE EXPECTANCY (2001): 68 YEARS HDI RANK (2000): 74 th (0.747)

AIDS cases(notified and estimated) and incidence rate by year of diagnosis. Brazil, 1991 to 2001*. *Cases notified up to 30/06/01. Source: CN-STDT/AIDS/SPS/MS ,5 1 1,5 2,0 2,5 Cases reportedCases estimatedRate

Source: Ministry of Health Patients on ARV Therapy in the Public Health System - Brazil, * * preliminary data 113,000

Impact of MOH ARV Drug Policy ( ) Mortality reduction  % Morbidity reduction  % Occurence of new AIDS cases  58,000 avoided cases Occurence of AIDS related deaths  90,000 avoided deaths Survival Improvement after AIDS diagnosis  12x (5  58 months) Reduciton in Hospitalisation needs Seven fold reduction avoided admissions ( ) Estimated Savings  U$ 2.2 billions (Hospital and Ambulatory Care)

FRAMEWORK TO FIGHT AGAINST AIDS IN BRAZIL Early governmental response Strong civil society participation in all decision levels Multisectorial mobilization Prevention & treatment approach with human rights perspective Support for community projects

SUPPORT FOR CIVIL SOCIETY ORGANIZATION PROJECTS ACCORDING TO MACROREGIONAL DISTRIBUITION AIDS I Amount of Projects: 559 Amount of Resources: U$ 10 million AIDS II Amount of Projects: Amount of Resources: U$ 30 million

AIDS & WORLD OF WORK: AN EARLY PARTNERSHIP 1987 – Adoption of guidelines on HIV+ workers rights and norms on AIDS prevention at workplace; 1988 – mandatory prevention activities for companies with more than 100 employees Consolidation of norms forbidding non voluntary testing;

PREVENTION & THE WORLD OF WORK: VULNERABLE GROUPS  TRUCK DRIVERS  SEAPORT WORKERS  MINE WORKERS

PREVENTION & THE WORLD OF WORK Creation of a “National Business Council” (NBC) on HIV/AIDS –Cooperation between government and NBC reach 10 million people per year; Implementation of “workplace committees” – 3,000 enterprises and 3 million workers reached

EMPLOYEMENT CONTEXT 80 million people are in the year age group

PREVENTION & THE WORLD OF WORK May in co-operation with International Labour Organization, distribution of the Brazilian translation of the “Code of Practices on HIV & the World of Work” and creation of a tripartite committee to implement its recommendations