Dolutegravir becomes part of antiretroviral drugs used for treating HIV infection or AIDS patients in Brazil
"We had been since the year 2015vínhamos claiming that the integration of this new drug to drug list used to our health system, SUS
"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 antiretrovirals is the ongoing updating of the therapeutic cast. As new drugs emerge, they should be included in the cast to improve attention and extend the life of the patient. The emergence of dolutegravir and its incorporation effectively represent compliance with the law and a clear demonstration that the policy adopted in relation to AIDS therapy remains. This creates the perspective of the sustainability of the policy and the guarantee that the patient in Brazil will have access to the most modern, with fewer side effects. "
- Richard Parker, CEO of ABIA (Brazilian Interdisciplinary AIDS Association): "The breakthrough to incorporate new drugs is a gain. We have a great risk happening now in Brazil and in other countries that are not the richest and are lagging behind in the incorporation of 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 is a step forward to see the Ministry of Health starting to walk in that direction. "
- Regina Bueno, facilitative activist Rio + Youth Network, the group For Vidda River and the Rio AIDS Ministry: "Today, our first line has 3 in 1, which has long been discontinued in the United States and Europe because it brings serious side effects, especially through efavirenz. The young people in our network who use it complain of insomnia, drowsiness. So the arrival of dolutegravir is good because it is a much less toxic remedy, according to international research centers. This allows more accessibility and permeability for adhesion. Because what we want is to stop HIV transmission by zeroing the viral load. If there are fewer side effects, there is more adherence. But it is necessary to inform about this, especially the health professionals in basic care, which is being recommended by the protocols of the Ministry of Health as the first care. "
- Veriano Terto Jr., project coordinator at 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], it was rejected. Then in the workshops, when we talked about him, we were seen as visionaries or we were talking badly about the drugs already in the front row. It was nothing like that, we just wanted to show that it was viable and, with a little political pressure, the dolutegravir could be adopted and improve the quality of life for 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 better therapy for the individual. It is one more possibility of breaking some barriers in adherence to the treatment and in the retention of the patients in the service. So this incorporation is superimportant. "
- Vando Oliveira, RNP + Ceará coordinator: "It's already late, because in other more advanced countries, dolutegravir has been adopted since 2013. We have registered several patients who are in need of this medication in Brazil. Even this week, we're following one. He is hospitalized and has been waiting for the drug for nine months. We were apprehensive with this case, even after a judicial process. I'm talking about one case, but there are several. So the arrival of the dolutegravir is something cool for the sociual movement. "
- Carlos Duarte, the NGOs / AIDS Forum of Rio Grande do Sul: "Incorporating any first-line medication is critical because it reduces the likelihood of side effects. The more cutting-edge, the better for the whole world, for the person living with HIV, for the health service that will have less intercurrence. "
- William Amaral, activist of the Community Committee of Fiocruz IPEC Monitoring: "It is the result of a fight that has been going on since last year due to the lack of consensus. We need other advances to be able to match the therapeutic consensus of the first world. TAF, a new formulation of tenofovir, is required. And there are others already in use out there that are not yet incorporated here. There, they no longer use AZT, efavirenz. Is this new drug important? IS. But we can not fade away. We must continue to charge the Ministry of Health and SBI (Brazilian Society of Infectious Diseases) to publicly position themselves for the incorporation of the new drugs.
- Jose Araujo Lima, the Mopaids and Epah (Humanized Care space): "You can not deny the importance of the arrival of dolutegravir, a collection that NGOs have been doing for a long time. But there are factors that must be emphasized: the entry of this drug is far from making the Brazilian consensus satisfactory because of its great outdatedness. 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 civil society claim that has been charging for better treatments for some time. I remember when we set the record, past management, and we were accused of being irresponsible over the issue of costs and what we see now is that there was a lack of political will. Our struggle will continue for the better access to whatever treatment is available. "
- Pedro Villardi, project coordinator of ABIA and coordinator of WGIP (Working Group on Intellectual Property): "It has been almost two years since ABIA and GTPI have been demanding dolutegravir as an option for the first line. It is a well tolerated remedy, it has fewer side effects. Incorporating it into a context in which people start treating asymptomatic people is critical. Now a worrying factor is about sustainability in treatment, because of the price. We demand that the government take the necessary actions so that universality and completeness are guaranteed. "
Doctors / researchers
They are part of the Technical Chamber for the Evaluation of New Antiretroviral Medications, composed of infectologists from the most respected treatment centers in the state of São Paulo. They have been at the forefront of research on dolutegravir and have always been proponents of its incorporation into SUS. See what Ricardo Diaz of Unifesp and José Valdez Madruga of CRT say:
- 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 to the first line of treatment is a major breakthrough. This medicine is potent and well tolerated. Incorporation of integrase inhibitors in the first line was also a claim of SBI, we had already asked the Ministry of Health to update the protocol. Recalling that research has proven that this is the best class of drugs, with fewer short and long term side effects. The drug is also the first line in the United States, in the European Union and indicated by the International AIDS Society. However, we would like raltegravir to also be in the first line of treatment, so the doctor could analyze case by case. Studies have shown that raltegravir causes fewer drug interactions and there are data from ten years of use. There is no data, for example, on renal and bone safety of dolutegravir. So it is important to have both options. I have nothing against dolutegravir, I consider this step very important. Even today, I have received calls from patients wanting to change the scheme, they have heard the minister's statement. But it takes calm, the drug will be available only in 2017 and in the first moment for those who will be starting the 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 SUS published, originally 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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