Global TB Caucus Country Spotlight: Brazil
Brazil is the world’s fifth largest country in the world, both in terms of population and geographical area. With approximately 210 million people, Brazil has the 8th biggest economy in the world. Despite that, studies have shown that poverty has increased over the last few years due to the political and economic crises the country is facing.
And with the recent increase of poverty, the number of tuberculosis (TB) cases has also increased. The country had been reducing TB rates over the past 15 years, having achieved the TB targets set by the Millennium Development Goals a few years in advance. This year, national data shows that TB rates have increased for the first time since 1990.
Brazil is one of the 20 countries in the world with the highest number of TB cases, and also ranks as the top 20 countries with the highest number of TB-HIV coinfection. The World Health Organization estimates 87 thousand cases, of which only 72 thousand were found and notified by the health system. That means that 15 thousand patients aren't being officially diagnosed and treated, which contributes to maintaining the transmission chain.
TB is also concentrated amongst the most vulnerable populations, people who often face barriers to access health services. The government develops specific activities for four vulnerable groups: indigenous populations, people living with HIV/AIDS, prisoners and homeless populations. Those groups are proven to be at a higher risk of developing TB: indigenous peoples have 3 times higher risk than the general population, whilst people living with HIV/AIDS and prisoners are 28 times more at risk, and a study from the city of Sao Paulo shows alarming data for the homeless population, who have 56 times higher risk of getting TB than the general population.
It is clear that Brazil needs to address challenges related to inequality, poverty and access to public services. TB is a huge part of that challenge. And while the government struggles to develop more inclusive health and social protection policies, the legislative is putting pressure to make sure no TB patient is left behind.
One recent initiative launched to raise the political profile of the disease and discuss issues related to access to diagnosis and treatment, but also social protection schemes is the National TB Caucus, led by Congressman Antonio Brito. Along with other members such as Congresswomen Benedita da Silva and Erika Kokay and fellow congressman Chico D’Ângelo, Members of Parliament are calling their ministries to step up in the response against TB and commit to investing in better public policies and innovative tools to help ending the disease.
The Brazilian TB Caucus was launched in May 2012, and has been re-established for the new legislatures that came ever since. The Caucus has made legislative changes to benefit NGOs working with TB and other poverty-related diseases, created a Subcommittee to assess public policies related to TB and published recommendations to be followed by the different ministries regarding policies and measures to be taken jointly. They also established a Monitoring & Evaluation framework to review the implementation of the End TB Strategy in Brazil and constantly push the government on the different actions related to the disease nationally and internationally.
In addition, the Caucus works closely with civil society representatives and organisations to make sure the voices of the communities are in the center of all activities conducted. This platform has helped drive forward positive dialogues with the government's’ executive branch, focusing on the needs of affected communities.
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