ࡱ> npoK(7 l/ 0|DTimes New Romanh2bbv 0b( 0DArialNew Romanh2bbv 0b( 0" DArial Blackmanh2bbv 0b( 0"0DWingdingskmanh2bbv 0b( 0@DArial Narrowanh2bbv 0b( 0" ` .@  @@`` @n?" dd@  @@`` p   f       QT  i  bb PObiObii i        0e0e     A@ A1 8c8c     ?1 d0u0@Ty2 NP'p<'pA)BCD|E||S" ff ff3@g43d3dv 0bppp@  <4BdBd4b 0bb<4!d!d4b 0bbuʚ;2Nʚ;<4dddd4b{ 0 bbF>___PPT9 / 0z? %O =D }j+BRAZILIAN ARV ACCESS PROGRAM: MAJOR ASPECTS$,+$ 1UNIVERSAL AND FREE OF CHARGE ACCESS TO ARV DRUGS NUMBER OF PATIENTS ON ARV TREATMENT (DEC/2000): 95,000 NATIONAL ARV TREATMENT GUIDELINES NATIONAL ARV LOGISTIC CONTROL SYSTEM: 424 DISPENSARY UNITS NATIONAL NETWORK ON VIRAL LOAD: 70 LABORATORIES NATIONAL NETWORK ON CD4+ CELL COUNT: 63 LABORATORIES27"<151ffyCCost Impact of the ARV Therapy generated by drugs between 1997-2000,DC  D Net savings of US$ 200/250 million, between 1997 and 2000, considering as a basis 1997 prices and increase in the number of patients from 27.000 to 92.000; Only in the year 2000 savings of US$ 80 million (approximately 30% of the total cost) with the beginning of the National Production of Nevirapine and Indinavir. Savings of US$ 40 million in 2001 as consequence of the Agreement with Merck Sharp Laboratory XZF$      ` FBrazilian MoH & Merck Agreement on ARV Price Reduction (March, 2001)&GF$ Z <64,8 % Price Reduction on Indinavir U$ 1.33/capsule U$ 0.47/capsule 59,0 % Price Reduction on Efavirenz U$ 2.05/capsule U$ 0.84/capsule$($'#$$$$#$$$$,)+"";Global Agreement for an Equitable Access to AIDS Treatment $<:* 6   Protection of local production of AIDS drugs legislation; International funding for developing countries acquisition of AIDS drugs Differential price policy of AIDS drugs for developing countries (equitable basis); Incentives and subsidies to the researche and development of new drugs for public and private institutions. International technical support to adequate use of antiretroviral drugs. 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( 5TqmeS1T{uc_QINGKD/D<+q ||a  q  & 9 o D   o 1     N)GbZ+sZXv)4S@Kx m @  : 0 = = R j      y x  @@f  B'CDEF %" &' @d7 y   BCDEF%"   @   BCDEF%" @2 ?   B&C0DE$F,%" #% !0.&#@ # &  B?@0  .Ministry of Health National STD/AIDS Programme,/.6 Q  6D?`   EUniversal Access to Antiretroviral Therapy: The Brazilian ExperienceVF(2+00f$ 0f,H  0޽h ? ̙33 % IA0(     B C DE<FBeB% dQ9gU2+nnW*?- CJYYCX=_T}ewy/$& sj)52.7e# (murY31 P~<7^p-5-e3)477!-C>ohG_o(}FrJ- +Hk!"X!2u ")7)2]qzo0/ F0 Y# f% H a a V s   0 : Y D A H h    ? ( 5TqmeS1T{uc_QINGKD/D<+q ||a  q  & 9 o D   o 1     N)GbZ+sZXv)4S@Kx m @  : 0 = = R j      y x  @@f@   B'CDEF %" &' @d5 w    BCDEF%"   @~    BCDEF%" @0 =    B&C0DE$F,%" #% !0.&#@ !   0  /BRAZIL FEDERATIVE REPUBLIC POPULATION (2000): 169,500,000 GNP PER CAPITA (1998): US$ 6,625 HDI RANK (1999): 74th ( 0.747 ) CUMULATIVE AIDS CASES (Dec/2000): 203,353 ESTIMATED NUMBER OF HIV+ INDIVIDUALS (1998): 536,000 AIDS INCIDENCE RATE (1999): 11/100,000 in hab. 0}20}2e% 2%0}20}20}2,  mfffffH  0޽h ? ̙33  ( nW l  C    l  C ̛  H  0޽h ? ̙33 6.@( w   63  .Impact of Antiretroviral Therapy (1995 - 2000)*/.( /   H8 ?P   Reduced Mortality 40-70% Reduced Morbidity 60-80% Reduced Hospitalization 234,000 avoided Cost Savings U$ 711 millionU 2 2 2$$$$$$$$$ $$$$$ $$$$$Z    H  0޽h ? T3f3f9 i9a9Phh8(  v  N1?P7   `Oxaxa=1 ? ABrazil: ARV Price Reduction According to the Source of Production&BA &A  e4L   # `CTB  c $?l TB  c $?l m l  <8c? 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"  3 <[dO   N1.31   4 <h   N2.90   5 6k^ a  N1.55   6 6o]  N1.85   7 6m'   N0.56   8 6Du?0  N1.72   9 < 6L I  K1   ? 6L(  K2   @ 64L  K3   A 6,L K4   B 6pLo K5   C 0h   nIndinavir cap 400 mg      D 0 O  oSaquinavir cap 200 mg      E 0b 6  pLamivudine tabs 150 mg      F 0 XO  mZalcitabine 0.75 mg      G 0$ O  Didanosine (ddi), 100 mg 8       H 0Ԩ   ~Zidovudine(ZDV), 100 mg &     N = R I i vN  6 J = RT K c $8c WA  L 6( 6 N1996  pN 6 M r RRN N S [58cWw O 66 N1997  vN H6' P  RT Q c $8cHW R 66' N1998  vN ~6a S  RT T c $H6H6H68c~W U 6̸P6a N1999  pN 6 V  RN W S ̙8cW X 66 N2000  < Y # R  g  Z N< ? J9 Local Companies6( w2   [ N ? / eMultinationals $( w2  \ <1?ikG  P2.00 2   ] <\1?t P  P0.18 2  N 75 ^ 7 5B _ TD1???rB ` BDf31?7'rB a BDf31?E5N 75 b + :u8B c TD1???rB d BD1?7'rB e BD1?E5 f Tt1?]} J9% 2  g T<1?f J L72 % 2  h Tp1?s  _ Source: MOH" 2     N  6޽h ? 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