2. 1988 Constitution: landmark for health The Unified Health System (SUS) UNIVERSALITY – as a fundamental right INTEGRALITY – from prevention to treatment EQUITY – no distinction with recognition of populations' specificities HEALTH AS A DEMOCRATIC ACHIEVEMENT

3. 80% 74% 61% 44% 33% HIV CONTINUUM OF CARE (Cascade) Brazil 2012

4. COMBINATION HIV PREVENTION

5. HARM REDUCTION CLASSIC PREVENTION STRATEGIES CONDOMS

6. Focus on Key Populations 33 supported projects - HIV Screening with Oral Fluid RT technology Trans Gays and MSM PUD SW STRUCTURAL INTERVENTIONS

7. Social Name Transgender and Transsexuals, you deserve a friendly service “You can be served in public health system with the name you chose. Order SUS card with your name that you decide to use and exercise your right.” STRUCTURAL INTERVENTIONS

8. President Dilma Roussef receives the LGBT Movement June, 2013 STRUCTURAL INTERVENTIONS

9. Keila Simpson, Human Rigths Award, by President Dilma Roussef December, 2013 International Drug Simposium: “From Coersion to Cohesion” STRUCTURAL INTERVENTIONS

10. “The results have galvanized efforts to eliminate the global AIDS epidemic” Dr. Bruce Alberts, Science’ Editor TREATMENT AS PREVENTION

11. NEW GOVERNMENT DIRECTIVE (DECEMBER 2013)  Introduces 5 new algorithms aimed at increasing access to testing and diagnosis  Algorithms 1 screening + confirmation - > RT finger prick  Algorithms 2 - screening RT finger prick + confirmation Oral Fluid  Algorithms 3 screening 3 rd generation immunoassays + confirmation VIRAL LOAD quantification FIRST STEP: NEW TESTING ALGORITHMS

12.  Algorithms 4 - 4th generation immunoassays as screening + confirmation VIRAL LOAD quantification  Algorithm 5 - combines 3rd generation immunoassay screening followed by Western Blot/Imunoblot confirmatory test. FIRST STEP: NEW TESTING ALGORITHMS

13. The new Clinical Protocol and Therapeutic Guidelines (CPTG) for Treatment of HIV Infection in Adults was discussed with an Advisory Board of experts, submitted to a public consultation for 30 days, and published in a Government Directive no. 27, of November 29, 2013. * SVS: Health Surveillance Secretariat Both the complete document (in Portuguese) and the Quick Consultation Guide are available in PDF and in an on-line version at www.aids.gov.br/pcdt SECOND STEP: NEW TREATMENT PROTOCOL

14. A highlight among the main new items of the CPTG is the recommendation to start antiretroviral therapy for all HIV positive people, regardless CD4, based on the possible impact on morbidity and mortality, but also in the reduction of HIV trans mission. A Public Health Approach. SECOND STEP: NEW TREATMENT PROTOCOL

15. TREATMENT 2.0 Adapt delivery systems Mobilize communities POC and other simplified monitoring Optimize drug regimens Reduce costs TREATMENT 2.0

16.  IOS (Apple) and Android platforms  Smartphones and Tablets  Free of charge  Offline access to national guidelines  Updates – downloadable new contents and modifications  New functionalities will be added: ie: interactions of ARV and other drugs. PCDT HIV TREATMENT PROTOCOL - APP

17. We are customizing the response working in the concept of Hot Spots (two initial Task Forces: RGS and Amazon) ; Starting a National Study on PREP in Public Health Services in 4 different sites (2 SP, 1RJ and 1 RGS); Intensifying PEP at least in the hot spots; Enhancing the universal and free of charge access to Hepatites B and C Treatment (including triple therapy with first generation of antivirals); Has lead the 2014 WHO/WHA resolution on universal treatment for Hepatites. WHAT ELSE?

18. 80% 74% 61% 44% 33% HIV CONTINUUM OF CARE (Cascade) Brazil 2012

19. 20 578 HIV CONTINUUM OF CARE (Cascade) Brazil 2012

22. Community of Portuguese Language Countries - CPLP Thematic Research and Development Networks (Rides CPLP ) are part of the CPLP Strategic Plan in Health, focusing the following themes: Network in STI - AIDS Network in Malaria Network in Tuberculosis

23. Community of Portuguese Language Countries - CPLP Brazil was elected to be the executive secretary of the “STI, AIDS Rides/CPLP” for the 2014-2016 period. Joint Work Plan (STI/AIDS Rides; Rides Mal ; TB Rides): “Elimination of MTCT transmission by 2017”. Implementation of national PMTCT plans under the perspective of the B + Recommendation (WHO). This initiative also includes HIV/TB co-infection diagnosis and treatment, as well as malaria testing and treatment (as a risk factor for HIV transmission during pregnancy).

24. Fabio Mesquita – Director fabio.mesquita@aids.gov.br Marcelo Freitas – Treatment Coordinator marcelo.araujo@aids.gov.br Cristina Raposo – Head of International Cooperation cristina.raposo@aids.gov.br OBRIGADO!