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Since the beginning of its work in Brazil, UNODC has supported the Brazilian government in the construction of a comprehensive response to HIV, especially among drug users and imprisoned populations. The partnership between UNODC and the STDs, Aids and Viral Hepatitis Department of the Health Ministry started in 1994, when approximately 25% of Brazil's AIDS cases were associated with the use of injecting drugs. Data from the Health Ministry shows a constant decline of this percentage. From 1996 to 2006 there was a 72% reduction in AIDS cases among users of injecting drugs.
The partnership between UNODC and the STDs, Aids and Viral Hepatitis Department of the Health Ministry always prioritized the damage reduction strategy for drug users, seeking to stimulate the civil society's extensive participation in their activities. Through the years, the complexity of new standards of drug use started to require different work strategies for each type of use, including non-injecting drugs, such as crack and stimulants.
Concerning the imprisoned population in Brazil, UNODC works on the implementation of the National Health Plan for the Penitentiary System, in partnership with the Health Ministry and the Justice Ministry's National Penitentiary Department (Depen).
National survey on HIV/AIDS in prison settings
As in many other countries, the prevalence of HIV/AIDS in the imprisoned population in Brazil is higher than that of the general population. In prison settings, overcrowding and violence realities, combined with precarious conditions of hygiene, food and medical services, aggravate the vulnerability situation of this population in relation to some diseases, among them HIV, hepatitis C, other STDs and tuberculosis.
It was in this context that, in 2009, UNODC supported the initiative by Brazil's Justice Ministry and Health Ministry for the promotion of the National survey on HIV/AIDS in prison settings. The survey brought together representatives of the states' health and prison management services, federal agencies, organized civil society and international agencies that work on HIV/Aids in prison settings, working with a view to promote an extensive discussion and the proposition of strategies to enhance actions of combat against HIV/Aids and the co-infections tuberculosis and viral hepatitis within the penitentiary system population.
At the end of the survey, a set of recommendations based on five axes was agreed upon by the participants:
1) Inter-sector health and justice policies: legal, financial and operational aspects.
2) HIV and co-infections tuberculosis and hepatitis risk and vulnerability factors.
3) Organization of the health services and system management network.
4) Access to technologies and materials for prevention, diagnosis, assistance and treatment of STDs, HIV/Aids and co-infections tuberculosis and viral hepatitis.
5) Attention to more vulnerable social groups and combat against stigma and prejudice.
Latin America and the Caribbean regional survey on HIV/AIDS in prison settings
The Latin America and the Caribbean regional survey took place in Brazil, in May 2008, with the purpose of promoting technical cooperation and discussing the common bases for holistic policies on health in prison settings, tackling prevention, attention and treatment for HIV/AIDS in different countries.
The participant countries were able to share their experiences in prison management, presenting the institutions responsible for each country's system and their connections with justice, health and the civil society, in relation to local programmes for HIV prevention.
The diagnosis presented on vulnerability and health conditions in prison settings revealed the need for urgent action. Moreover, the importance of improving the epidemic's registration system, so as to refine the diagnosis of health inside prisons, was common ground among the participants. The need for coordinated action among various social players for a prison system's reform that covers health and quality was also stressed.
The event extended technical cooperation among countries in the field of HIV epidemic control. At the same time, an agenda on human rights was established encompassing the spheres of justice, health and civil society, built on political, normative, epidemiologic, technical and evaluation axes. By the end of the event, 21 recommendations were agreed upon, each indicating the players responsible for their implementation.
Participant countries: Argentina, Brazil, Bolivia, Belize, Chile, Colombia, Costa Rica, Cuba, El Salvador, Guatemala, Ecuador, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Dominican Republic, Uruguay and Venezuela.
Final document of the Latin America and the Caribbean regional survey on HIV/AIDS in prison settings (in Spanish).
School Award
The School Award is a joint initiative involving five United Nations agencies - UNESCO, UNODC, UNICEF, UNAIDS and UNFPA - the STDs, Aids and Viral Hepatitis Department of the Health Ministry and the Education Ministry, with the purpose of stimulating STD/AIDS and drug use prevention among children, adolescents and youngsters at primary and secondary schools across Brazil.
Being an encouragement and a reinforcement to the national policy consolidated by the Health and Prevention in Schools Project (SPE), the School Award is promoted through a national competition of essays on the subjects of STDs, AIDS, drug use and youth pregnancy. This activity does not have its own budget and every year new partners, committed to the promotion of preventive education, join the initiative. Important private institutions, such as CAIXA INSURANCE Group and Globo Television Network, have contributed to the promotion of activities.
Actions targeting the youth
In general, the youth is a priority population in the work of the United Nations agencies. UN is expressly committed to guarantee the development of this group. In respect to UNODC's mandate, it is recognized that youngsters are more vulnerable than adults to drug abuse and that this causes adverse social and health effects, including those related to HIV/AIDS. In addition to general issues concerning the youth, drug abuse has an additional impact in the life of young people living with HIV/AIDS, which relates to antiretroviral treatment, when the case requires.
From the need identified in the Meeting on Youth, which took place in Brasilia, in April 2008, UNODC has been promoting efforts with a view to closing the gap between the needs of young people living with HIV/AIDS and the Brazilian agenda on youth. Players from the civil society and different areas of government have been crucial to guaranteeing the effectiveness of the required actions, which are in their formulation process. One of the results of this joint effort was the formal establishment of the National Network of Young People Living with HIV/AIDS, during the 3rd National Meeting of Young People Living with HIV/AIDS. Later, UNODC started to encourage the widening of the National Network of Young People Living with HIV/AIDS' scope of action to include forums, such as the National Youth Council (CONJUVE), which assists in the formulation of public policies directed to this specific population.
Young leaders living with HIV/AIDS programme
Living with HIV/AIDS is a situation also experienced by adolescents and young Brazilians. 11.5% of all AIDS cases in Brazil are among people between the ages of 13 and 24. In general, these adolescents and young people acquired the virus through mother-to-child transmission (vertical transmission) or through sexual relations without protection. With a fast diagnosis and use of new medicine available, they will reach adult age and will have dreams and expectations just as anyone else.
As is the case with any young Brazilian, one of the main difficulties that young people living with HIV/AIDS face is to find their first job. To help them in this challenge, the STDs, Aids and Viral Hepatitis Department of the Health Ministry, the NGO Pact Brazil and the United States Agency for International Development (USAID) combined efforts, with the support of UNODC, UNICEF, UNAIDS, UNFPA and UNESCO, to promote a programme to train leaders living with HIV/aids.
The program is innovative because it has double meaning. On one side, it aims at bringing young people living with HIV/Aids closer to the execution of governmental and non-governmental actions that form the Brazilian response on the fight against the AIDS epidemic. On the other side, it seeks to extend the young people protagonism, offering them a job as a registered employee for 11 months within health services and NGOs based in their cities. The experiences accumulated are later used in their work within various services, also serving to encourage their involvement in their cities' mobilization spaces, apart from promoting a national coordination among the initiative's participants.
The street as prevention space
UNODC supported the STDs, Aids and Viral Hepatitis Department of the Health Ministry in the coordination of working groups in three cities (Rio de Janeiro, Salvador and São Paulo), aiming at developing an inter-sector and integrated response to the vulnerabilities of young people living in the street in relation to HIV/AIDS. This initiative also had UNICEF's support.
Some of the results observed were the extended coordination between NGOs and the health services, the increased awareness and qualification of health professionals and social educators to care for street children and adolescents, the formulation of common agendas and the training of prevention agents.
"Same as you" Campaign
Launched in the end of 2009 by five UN agencies, including UNODC, the "Same as you" campaign has as its basic concept equal rights between diverse populations, such as students, gays, lesbians, people living with HIV/AIDS, sex professionals, refugees, transgenders and transvestites, drug users and black populations. The campaign is composed of ten 30-second films broadcast in television channels across the country.
The campaign comes as an initiative against inequality and violations of human rights, especially in the areas of health, education, employment, safety and interaction. The campaign is about an opportunity to raise Brazilian society's awareness on respecting the diversity in each of the social groups featuring in th
e campaign, reaffirming equal rights.
Watch the campaign films:
www.youtube.com/user/UNAIDSBr