Founded in 2003, CDC-Brazil works in close collaboration with the Ministry of Health’s (MOH) Secretariat of Health Surveillance to foster evidence-based decision-making and promote the use of new and innovative technologies to control the country’s concentrated HIV/AIDS epidemic.
Strengthening Public Health Systems
CDC provides technical leadership and direct assistance to the MOH to strengthen HIV programming, monitoring and evaluation (M&E), epidemiological surveillance, and laboratory services. CDC also leads and co-funds studies and trainings, and encourages two-way knowledge sharing. Recent examples are Brazil’s first ever estimation of HIV incidence, an ongoing investigation of the causes of AIDS-related mortality in southern Brazil, and knowledge transfer in respondent-driven sampling.
Expanding HIV Testing Among Men Who Have Sex with Men (MSM)
With support from the Key Populations Implementation Science (KPIS) fund, CDC-Brazil implements the “A Hora é Agora” (The Time Is Now) Program in a pilot site in southern Brazil. The program aims to expand HIV rapid testing among MSM, and to ensure linkage to care in partnership with the Curitiba Municipal Health Secretariat. Through this activity CDC will evaluate a high intensity, combined prevention strategy to decrease HIV infections among MSM. To achieve that, CDC utilizes innovative diagnostic expansion methodologies such as mobile, non-governmental organization-based, and e-testing outlets.
Building Public Health Workforce Capacity
In partnership with the MOH’s Oswaldo Cruz Foundation (FIOCRUZ), CDC provides technical support to on-site and online M&E programs at the certificate and Masters levels. As of 2014, these programs will be fully funded by the Brazilian MOH.
Key Activities and Accomplishments
Over 8,000 people trained in M&E with CDC technical assistance: The National AIDS Department (NAD) took ownership of the CDC-designed curriculum and now offers M&E training as part of Brazil’s biannual HIV/AIDS Prevention Congress. In addition, the CDC/FIOCRUZ M&E Master’s Program is being replicated in Angola and will soon be available in English in Ethiopia.
CDC transferred state-of-the-art sampling methodologies to Brazilian scholars who, in turn, are supporting the NAD in carrying out national surveys on key populations, thus overcoming critical sampling limitations that had been negatively impacting HIV monitoring.
CDC provided technical assistance to the NAD in developing the tools that outline the key stages of engagement in the continuum of HIV care, also known as the “cascade.” Results of this collaborative work were published in the 2013 National HIV/AIDS Epidemiological Bulletin which, for the first time, described the Brazilian continuum of care.
CDC supported the NAD in conducting the first estimation of HIV incidence in Brazil, based both on back calculation of the first CD4 count as well as on prevalence of recent HIV infection. CDC also supported the NAD in evaluating the causes of HIV-related mortality in the Southern region, which reports the highest AIDS-related mortality rates in country.