For the age group of 15 to 26 years, the orientation of the Ministry of Health is the vaccination schedule with three doses, with interval of zero, two and six months. People who take the first dose in this period, exceptionally, will have the two subsequent doses guaranteed in the SUS. Double dose vaccination against HPV in boys prevents diseases and helps immunize girls. The ministry points out that it receives vaccines and medicines with a maximum of six months of manufacturing and that, from the national stock, no lot has maturity for this year. The routine use of this vaccine in the target population, which is for boys in the age group of 11 to 13 years and girls of nine to 14 years, must be maintained with two doses, being applied with interval of six months between them.

The HPV vaccine Quadrivalent is safe, effective and is the main form of prevention against the appearance of cancer of the cervix, fourth largest cause of death among the women in Brazil. In men, it protects against cancers of the penis, oropharynx and anus. In addition, it prevents more than 98% of genital warts, stigmatizing disease and difficult to treat. Transplant recipients of solid organs, bone marrow or cancer patients from nine to 26 years of age are also part of the targeted population. The services that serve this population must offer the HPV vaccine in the work routine. As per the MOH, from the beginning of the vaccination, in 2014, until June of this year, 18 million doses were given to the female population of the whole country. In the age group of nine to 15 years, in the same period, 10.7 million girls were immunized with the first dose, which corresponds to 74.7% of the total Brazilian population in this age group. They received the complete two-dose vaccination schedule recommended by the Ministry of Health, 7.1 million girls, which corresponds to 47% of the target population. Regarding boys, from January to June of this year, 853,920 adolescents aged 12 to 13 years were vaccinated with the first dose of the HPV vaccine, which corresponds to 23.6% of the 3.61 million boys in this age group.

Noticias; Agencia

In the Federal District, 1,068 people must undergo hemodialysis and 281 need peritoneal dialysis. The main causes for kidney disease in the country are diabetes and high blood pressure. The symptoms such as anemia, high blood pressure, swelling (edema), and tiredness go unnoticed. It is only the most advanced stage of the disease that patients are referred the renal replacement therapy. According to SBN, three types of treatment can be chosen: hemodialysis, peritoneal dialysis (performed at home) or kidney transplantation. People see dialysis as negative, and hence do not prefer it. As per the SBN, Brazil has 747 hemodialysis clinics, indicating 164 patients per clinic. The data indicates that the number of clinics is not meeting the demand, and the last resort for patients is home dialysis. In the Federal District, seven public hospitals treat patients with renal failure: Asa Norte, Sobradinho, Santa Maria, Gama, Taguatinga and Ceilândia; Base Hospital and University Hospital of Brasília.

To ease home treatments for patients, the company Baxter launched “HomeChoice Claria” in Brazil. The equipment allows physicians to remotely monitor and analyze patients undergoing peritoneal dialysis. The system works via a cloud data storage system, which facilitates the visualization of information related to the dialysis of each patient. Based on the information doctors can remotely and safely adjust the settings of each person’s home devices without having the need to move patients to clinics or hospitals. In Latin America, 2,234 patients already use the new equipment, it has shown significant improvements in treatment along with increased adherence to treatment.

Noticias

However, 96% of the cities allocate more than 15% to the financing of the health sector. Of the 5,570 municipalities in the country, 129 invested in health insurance in 2016, 2,260 invested close to 20% and another 2,716 spent from close to 30% in the sector. Brazil has 1,158 news units of the unified health system (SUS) that have not been opened due to lack of funds.

Municipalities do not have the capacity to invest more and open the new units. The federal government currently is granting one-fifth of the required funds for operating the current units. It is estimated that the Ministry of Health spent over USD 314 billion on services that have not been inaugurated.

The Ministry of Health had announced its intention to limit the number of Cubans travelling in this program. The reduction of the participation of foreign professionals, however, should be done gradually.

Medical care should not be disturbed especially in the regions where there is gap in permanent Brazilian doctors. The professionals arrive in Brazil through an agreement signed with the Pan American Health Organization (PAHO) and the Cuban government. However, plans are to gradually reduce the number to 4,000 Cubans and replace them with Brazilian medical professionals.

In 2016, 10,400 Cubans were working in the program, a 1,000 less from 2015. The agreement signed between the Brazilian and Cuban government and the PAHO provided that professionals recruited on the program would stay in the country for three years.

Although the law allowed the group to spend three more years in Brazil, new agreement signed in September 2016 states that professionals recruited in the first cycle (~4,000) should return to the country for circulation of new set of professionals. Permission to extend the term for these professionals for another three years would be granted in case of established families in Brazil.

According to official data around 12,000 people from Venezuela have entered the country since 2014. Hospitals in Roraima indicate that majority of the patients are Venezuelans. This is burdening the medical supplies of the region leading to critically low stock. According to Brazilian health professionals, Venezuelans usually arrive at hospitals in severe conditions requiring immediate medical attention.

Increase in incidence of diseases like HIV, tuberculosis and malaria has been observed. The hospitalization rate of Brazilians in the general hospital is 7% while that of Venezuelans reaches to 20%. Other countries in the region have also registered a significant increase in immigrants from Venezuela.

In addition, a significant increase in the number of asylum requests for Venezuelans has increased in the country reaching 2,595 in the first 11 months of 2016, against 54 in 2013. Despite the shortage of medicines and food in the Venezuela, bureaucratic obstacles hinder import of products.

It is of opinion that Brazil and other countries must press for Venezuela to accept international aid to minimize the impact of economic problems and the political crisis on the population.

Estimates by the Ministry of Health (MoH) show that prevalence of obesity has increased by 60%, rising from 11.8% in 2006 to 18.9% in 2016. Percentage of overweight population increased from 42.6% to 53.8%.

Experts attribute the weight gain of Brazilians not only to economic and cultural factors but also genetic and hormonal. Studies have highlighted the change in eating pattern over the last few decades. With little time to eat, people have reduced home-cooked meals and opted for faster, higher caloric foods.

Surveys have observed a change in the regular consumption of beans which considered a staple diet for Brazilians, decreased from 67.5% in 2012 to 61.3% in 2016. Additionally, only one in three adults consume fruit five days a week. Increase in purchasing power can also be attributed to the growth of obesity prevalence.

Middle-class income which represents currently 56% of the population grew by 71% between 2005 and 2015, with the income of the poorest 25% increasing the most. It has also been observed that percentage of overweight population significantly increased in the age group from 18 to 24 years (30.3%) and 50% in 25 to 44 years.

Other contributing factors include genetics, disturbed sleeping patterns and lack of healthy diet. Obesity can lead to increased risk of other metabolic diseases such as diabetes, cardiovascular disease and hypertension. Cardiovascular diseases, chronic respiratory diseases, diabetes and cancer account for 74% of annual deaths in Brazil.

OTCs in Latin America have long competed against prescription drugs that were commonly sold “under the counter” without the necessary prescription. It is a common tale that if a consumer felt a sore throat coming on, they could stop by their local pharmacy to pick up antibiotics without a confirmed diagnosis, leading to mounting concerns in the region over bacterial resistance.

However, this began to change in 2010 when both Brazil’s National Health Surveillance Agency (ANVISA) and Mexico’s Ministry of Health stepped up enforcement by requiring prescription duplicates and imposing hefty fines on noncompliant pharmacies.

Download the complete report for more information.

The aim of the plan is to reduce the incidence to 10 per 100,000 cases by 2035. This plan reaffirms the country’s commitment to the World Health Organization (WHO) and marks the World Tuberculosis Day, celebrated on 24^th March. The plan defines the indicators to be monitored by states and municipalities in the health care network.

The objective of the plan is early diagnosis, continuous treatment and reducing abandonment before the recommended period. The national plan is divided into three pillars. First is integrated and patient-centered prevention and care, second is strong public policies and support system and third is strengthening of research and innovation.

Disease control will be made based on indicators such as detection, diagnosis, TB-HIV co-infection, completion of treatment and cases of latent, sensitive and drug-resistant tuberculosis. To raise public awareness about tuberculosis, the MoH is running campaigns.

The campaign emphasizes that responsibility for treatment should be shared by patient, health care team, family, and friends. In addition to people with HIV, lower income population who have difficulty in accessing health services are prone to tuberculosis.

According to the MoH, 9.7% of confirmed tuberculosis cases had HIV in 2015. In 2016, 66,700 new cases and 12,800 relapse cases were registered in Brazil. The mortality coefficient for tuberculosis reduced by 15.4%, from 2.6 per 100,000 inhabitants in 2006 to 2.2 per 100,000 in 2015. Brazil registered 4,500 deaths from tuberculosis in 2015. Incidence in Rio de Janeiro is 5 per 100,000 people and Pará is 2.6 per 100,000 people.

According to the WHO, tuberculosis was the leading cause of mortality globally in 2015 and may have killed more than 1.8 million people. Six countries accounted for 60% of all new cases in 2015 namely India, Indonesia, China, Nigeria, Pakistan and South Africa. In 2014, the Ministry of Health Rapid Test Network for Tuberculosis (RTR-TB), a diagnostic test which detects the presence of the bacillus causing the disease in two hours and identifies rifampicin resistance. For 2017, the MoH has planned to distribute 70 new equipments with the capacity to do 250,000 tests.