The Unified Health System (SUS), which regulates the public health service in Brazil , has as one of its main features the basic health care, which foresees the performance of teams of professionals closest to the population, establishing a link with them and increasing their commitment and responsibility with patients and communities.

But the actions and services of this system are also determined by the implementation of health programs and campaigns, created by the federal government and structured to meet Brazilians' needs and specific health needs.

Some of them are Brazil Smiling Program, in oral health; Donate Organs, Donate Life, which encourages the donation of organs; Popular Pharmacy program, which provides essential medicines at lower cost; Samu 192, which organizes and speeds up the assistance provided to people in emergencies; Combating Dengue, among others. One of these measures that most stands out is the National Program of STD (sexually transmitted diseases) and AIDS, which began to be built before the creation of the SUS in 1988.

In 1986, there were still many doubts, mistakes and fear in relation to AIDS, but the scientific information about it was already starting to be gathered and both government and civil society were articulating and organizing themselves to act. In this context the National Program was created with the mission of reducing the incidence of HIV and of the disease, improving the quality of life of individuals and fighting for their rights.

So the guidelines began to be established for the improvement of public services offered to patients with AIDS and other STDs: reduction of HIV transmission and syphilis from mother to baby during the gestation; increasing the coverage of diagnosis and treatment of STDs and of HIV infection; preventive actions for women and people with greater vulnerability; fighting stigma and discrimination, among others.

Access to medicines

In 1996, the National Program of STD and AIDS took one of the most important steps in the creation of the federal law that provides universal and free distribution, through the SUS structure, of specific medicines, the antiretroviral, to HIV-positive patients and to AIDS patients throughout the country. This was an "early" measure of Brazil in relation to other countries in fighting HIV and AIDS, and it became the reference program all over the world.

In parallel to this, clinical examinations also began to be offered by the public service, both to check the contamination by the virus or not, and to monitor HIV positive patients. These developments - political, social and scientific - have caused a significant reduction of deaths by AIDS. According to the Ministry of Health, with the time, the antiretroviral distribution strategy was effective not only in improving and extending patient's life, but also in saving resources.

The Brazilian program is also considered reference for its steady action before large antiretroviral manufacturing laboratories. On several occasions the federal government ordered the compulsory licensing of these drugs, which determines the breakdown of the patent by the country and allows the import of generic versions of the product, which cost much less.

Another important feature of the program is the active participation of the civil society. Before its creation, the first non-governmental organizations dedicated specifically to this question were founded, in São Paulo and Rio de Janeiro . And up to now organizations and movements of the civil society work in partnership with the government in the development of projects and campaigns, as well as addressing demands of patients and of general population.

Further information on the National Program of STD and AIDS: www.aids.gov.br

Further information on SUS: www.saude.gov.br