Dolutegravir becomes part of antiretroviral drugs used for treating HIV infection or AIDS patients in Brazil
"We have been coming since the year 2015," said Vando Oliveira, coordinator of RNP + Ceará (National Network of People Living with HIV / AIDS in Ceará, ).
Pedro Chequer, former director of the Department of AIDS, said, the measure brings to the country the prospect of sustainability of AIDS policy. Richard Parker, CEO of ABIA (Brazilian Interdisciplinary AIDS Association), stressed that Brazil decreases with the decision, the distance that separates rich countries in the area of antiretroviral therapy. See what most activists, experts and the two doctors who were at the forefront of drug study in Brazil, Ricardo Diaz and Jose Valdez Madruga, speak:
Pedro Chequer, MD, co-founder and former director of the Department of STD, AIDS and Viral Hepatitis:"One of the principles governing the law that established access to antiretroviral drugs is the continuous updating of the therapeutic cast. To the extent that there are new drugs, they should be included in the list in order to improve care and extend the life of the patient. The emergence of dolutegravir and its incorporation represent effectively compliance with the law and a clear demonstration that the policy adopted in relation to terapaia against AIDS remains. This creates us the prospect of sustainability of policy and ensuring that the patient in Brazil will have access to what is most modern, with fewer side effects. "
- Richard Parker, CEO of ABIA (Brazilian Interdisciplinary AIDS Association):"The advance to incorporate new drugs is a gain. We have a big risk now happening in Brazil and other countries that are not rich and are getting late in incorporating new antiretrovirals. That means we have access to two classes. First world and third world, which is bad. The principle of access to medicines is that all humans have the same rights. So it's a breakthrough to see the Ministry of Health starting to move in this direction. "
- Regina Bueno, facilitative activist Rio + Youth Network, the group For Vidda River and the Rio AIDS Ministry:"Today, our first line is in 3 1, which has been discontinued for a long time in the United States and Europe, because it causes serious side effects, especially through efavirenz. The youth of our network that use it complain of insomnia, somnolence. So the arrival of dolutegravir is good because it is a less toxic drug, according to international research centers. This allows for more accessibility and permeability to the accession. Because what you want is to stop the transmission of HIV, zeroing viral load. If there are fewer side effects, are adhesion. But you need to know about it, especially health professionals in primary care, which is being recommended by the Ministry of Health protocols such as primary care. "
- Veriano Terto Jr., project coordinator of ABIA"It is an important step to update the list of available drugs, especially for newly diagnosed people. We give very welcome because until last year was almost taboo to speak of this drug, which seemed to be impossible. In a first opinion of Conitec [National Commission of SUS Technology Incorporation], He was rejected. Then, in the workshops, when we talked about it, we were seen as visionaries or we were speaking ill of existing drugs in the first line. There was none of that, I just wanted to show that it was feasible and, with a little political pressure, dolutegravir could be adopted and improve the quality of life of many people. "
- Eduardo Barbosa, CRD coordinator (Diversity Reference Center) and CRT support area (Reference and Treatment Center for STD / AIDS SP):"With the arrival of dolutegravir, we have a significant advance in the perspective of seeking best therapy for the individual. It's a chance to break some barriers to treatment adherence and retention of patients in the service. So, this merger is super important. "
- Vando Oliveira, RNP + Ceará coordinator:"We have arrived late, as in other more advanced countries, the dolutegravir is adopted from 2013. We have record of several patients who are in need of this medication in Brazil. Even this week, we are following one. He is hospitalized and is nine months waiting for the medicine. We were aprrensivos with this case, even after legalization. I'm talking about a case, but they are many. So the arrival of dolutegravir is something cool for sociual movement. "
- Carlos Duarte, the NGOs / AIDS Forum of Rio Grande do Sul:"The incorporation of any first line drug is critical because it reduces the likelihood of side effects. The more tip, the better for everyone, for the person living with HIV for the health service that will have fewer complications. "
- William Amaral, activist of the Community Committee of Fiocruz IPEC Monitoring:"It is the result of a struggle that comes from last year due to lag our consensus. We need other advances to succeed even in the therapeutic consensus of the first world. the entrance of the TAF, new formulation of tenofovir is required. And there are others already in use out there that have not incorporated herein. There, they no longer use AZT, efavirenz. It is important to enter this new medicine? IT IS. But you can not lose heart. We have to keep charging the Ministry of Health and SBI (Brazilian Society of Infectious Diseases) that position publicly for the incorporation of new drugs.
- Jose Araujo Lima, the Mopaids and Epah (Humanized Care space):"It is impossible not to recognize the importance of the arrival of dolutegravir, a charge that the NGOs have been doing for a long time. But there are factors that should be highlighted: the entry of that product is far from making satisfactory Brazilian consensus because of their large outdated. When the director of the Department [Adele Benzaken] Reports that "delivery will be from January gradually" prevents social control make monitoring and collection in its implementation. The Ministry says that there will be no "financial impact" a misguided reasoning when it should be interpreted as a major impact on the lives of people living with HIV / AIDS. What moves the government is the economy and not life. "
- Rodrigo Pinheiro, president of Foesp (NGOs / AIDS Forum of São Paulo):"This government action is the result of a claim of civil society, which has long been demanding better treatments. Pautávamos remember when it last management, and were accused of irresponsible by the issue of costs and what we see now is that lacked political will. Our fight still continues for better access to treatment that is available. "
- Pedro Villardi, project coordinator of ABIA and coordinator of WGIP (Working Group on Intellectual Property):"It is almost two years ABIA and the WGIP are demanding the dolutegravir as an option to the first line. It is a well tolerated medication, have fewer side effects. Embed it in a context where we start to treat asymptomatic people is critical. Now, a concern is about sustainability in the treatment, because of the price. We demand that the government take the necessary actions so that the universality and comprehensiveness are guaranteed. "
Doctors / researchers
They are part of the Technical Chamber for New Antiretroviral Medicines, composed of the most respected infectious disease treatment centers in the state of São Paulo. They have been at the forefront of research on the dolutegravir and have always been defenders of their incorporation into the SUS. See what they say Ricardo Diaz, Unifesp, and Jose Valdez Madruga, CRT:
- Ricardo Diaz, a researcher from Unifesp (Federal University of São Paulo)"It is a breakthrough that brings the people of the developed world in the initial treatment of HIV. But still does not end with the gap as this class is the integrase inhibitors. We raltegravir, to rescue, but elvitegravir is still being registered at Anvisa. Also, we have no new tenofovir, it is less toxic, with fewer side effects. However, the more powerful the dolutegravir and I am happy for the incorporation of this. It will greatly improve the quality of life of people, especially the possibility of replacing efavirenz drug that, every day, is more proven its relationship with terrible effects. "
- Jose Valdez Madruga, CRT:"The arrival of dolutegravir the first line of treatment is a major breakthrough. This medicine is potent and well tolerated. The incorporation of integrase inhibitors in the first line was also a vindication of the SBI, we had asked the Ministry of Health to update the protocol. Recalling that research has shown that this is the best class of drugs, with fewer side effects in the short and long term. The drug is also the first line in the United States, the European Union and indicated by the International AIDS Society. However, we would like raltegravir was also in first-line treatment, so the doctor could examine a case. Studies have shown that raltegravir has fewer drug interactions and no data ten years of use. No data are, for example, for kidney and bone safety of dolutegravir. So it is important to have both options. I have nothing against the dolutegravir, I consider very important this step. Today has even received calls from patients wanting to change the scheme, they heard the pronouncement of the Minister. But one has to calm the drug will be available only in 2017 and the first time to those who are starting treatment. "
With information from the Drafting News Agency of AIDS Article: Incorporation of dolutegravir: Activists and experts welcome to antiretroviral and want other new drugs in the SUSoriginally published in 28 September 2016 - 18h20
I Claudio SouzaI would like to stress that there are also other drugs, better and with fewer side effects that MUST be made available to people living with HIV / AIDS in Brazil and, I admit, this was a major breakthrough. Not long ago, a person who lives in a "big city where health is literally yelling for help, start to cheap, a person who was in PEP with the" Three in one "was in imminent liver failure and all I could do was refer her to a private clinic where the doctor recommended immediate discontinuation of PEP, under penalty of not seeing the sun rise again.
Yet she made me and asked what to do.
I had not much to say, and, based on what the doctor said, advised her to follow the doctor's orders, since it was preferable to remain living with HIV or AIDS, to see her dead. It should be informed that PEP was in its fourth day and she was completely jaundiced, and even the eyes were yellow. I declare here that with a clear conscience; after the last time the window period it has re-examination and the result was presented as nonreactive.
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