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

2. BRAZIL: MAJOR ASPECTS AREA: 8.500.000 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)

3. 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 9192939495969798990001 0 5000 10000 15000 20000 25000 30000 0 0,5 1 1,5 2,0 2,5 Cases reportedCases estimatedRate

4. Source: Ministry of Health Patients on ARV Therapy in the Public Health System - Brazil, 1997 - 2001* * preliminary data 113,000

5. Impact of MOH ARV Drug Policy (1994 - 2002) Mortality reduction  40 - 70% Morbidity reduction  60 - 80% 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 358.000 avoided admissions (1997- 2001) Estimated Savings  U$ 2.2 billions (Hospital and Ambulatory Care)

6. 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

7. SUPPORT FOR CIVIL SOCIETY ORGANIZATION PROJECTS ACCORDING TO MACROREGIONAL DISTRIBUITION 113 196 366 716 290 27 105 49 322 56 AIDS I Amount of Projects: 559 Amount of Resources: U$ 10 million AIDS II Amount of Projects: 1.681 Amount of Resources: U$ 30 million

8. 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 1992 - Consolidation of norms forbidding non voluntary testing;

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

10. PREVENTION & THE WORLD OF WORK 1998 - Creation of a “National Business Council” (NBC) on HIV/AIDS –Cooperation between government and NBC reach 10 million people per year; 1995 - Implementation of “workplace committees” – 3,000 enterprises and 3 million workers reached

11. EMPLOYEMENT CONTEXT 80 million people are in the 16-49 year age group

12. PREVENTION & THE WORLD OF WORK May 2002 - 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