Profile of the Brazilian projects for technical cooperation on Aids in the world : a look into potential study hypotheses

Há algumas décadas o Brasil inseriu-se nas discussões técnicas sobre a resposta mundial à epidemia de aids e destacou-se como importante ator de cooperação e como formador de opinião pública global sobre o tema. Apesar desse movimento, o perfil predominante desses projetos permanece desconhecido e inexplorado, dificultando análises sobre esse potencial correlação. Pretende-se começar a suprir essa lacuna a partir de um levantamento de projetos de cooperação técnica internacional brasileira em aids, no período de 2002 a 2009, utilizando a base de dados da Assessoria de Cooperação Internacional do Departamento DST, Aids e Hepatites Virais do Ministério da Saúde do Brasil. Para a análise desses dados recorreu-se à técnica de análise de conteúdo para identificar o perfil predominante dessa cooperação e propor hipóteses norteadoras de futuras pesquisas. O levantamento apresentou a distribuição dos projetos de cooperação do Brasil em aids no mundo e a análise de conteúdo possibilitou formular duas hipóteses: que no período em questão a cooperação do Brasil buscou fortalecer as respostas dos países à epidemia de HIV/aids e conferir maior visibilidade às políticas brasileiras de combate à doença no cenário global. Essas observações, por sua vez, indicam a necessidade e pertinência de novas pesquisas amparadas pela hipótese de um forte alinhamento do perfil técnico desses projetos com a política externa nacional, a diplomacia da saúde brasileira e o fortalecimento da governança global em aids. _________________________________________________________________________________ ABSTRACTA few decades ago Brazil became involved in technical discussions about the global response to the Aids epidemics, and assumed an important role for its cooperation and as global public opinion maker on the subject. Despite this characteristic, the predominant profile of these projects remains unknown and unexplored, making it difficult to analyze this potential correlation. This gap will be bridged by means of a study on Brazil’s international technical cooperation projects on Aids between 2002 and 2009, using the database of the International Cooperation Advisory of the Department of STD, Aids and Viral Hepatitis of the Brazilian Ministry of Health. The technique used to analyze these data was content analysis, in order to identify the predominant profile of the cooperation, and to propose hypotheses that will provide guidelines for future research. The study presented the distribution of Brazil’s cooperation projects on Aids in the world, and the content analysis made it possible to devise two hypotheses: within the given period, Brazil’s cooperation attempted to strengthen the responses of other countries to the HIV/Aids epidemic, and to project Brazilian policies for fighting the disease at a global level. These observations, on the other hand, point toward the need for and pertinence of new studies supported by the hypothesis of a strong alignment between the technical characteristic of these projects and the national external policy, the diplomacy of the Brazilian health, and the strengthening of global governance on Aids

AVASUS’ Contributions to Promoting Lifelong Learning in Health: Toward Achieving the SDGs and Strengthening Global Health Security

The Virtual Learning Environment of the Brazilian Health System (AVASUS) was developed by the Laboratory for Technological Innovation in Health (LAIS) and the Secretariat of Distance Education (SEDIS) at the Federal University of Rio Grande do Norte (UFRN) in partnership with Brazil’s Ministry of Health (MoH). AVASUS provides open educational resources in the health field and has emerged as the third largest platform for massive health education globally, with more than one million students. Among the various learning pathways AVASUS offers, some specifically focus on meeting the educational needs to address public health emergencies and overlooked health contexts. The main argument in this study is that technology-mediated lifelong learning in health is an effective strategy for achieving the Sustainable Development Goals (SDGs) of the 2030 Agenda. This chapter analyzes the pathways related to COVID-19, syphilis, and prison health, focusing on the contributions towards achieving SDGs 3, 4, 5, 10, 11, 16, and 17 and fulfilling the Global Health Security Agenda. Our analysis revealed two key findings. Lifelong learning in health (i) prompts decision-making on public health policies and (ii) contributes towards implementing the SDGs. Ultimately, AVASUS should be recognized as a tool to improve health services and support policy-making

Use of Interrupted Time Series Analysis in Understanding the Course of the Congenital Syphilis Epidemic in Brazil

To fight against the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) launched the “Syphilis No!” Project (SNP), with specific resources funded by a parliamentary amendment. Then, in 2018, a national rapid response started to be implemented on the Brazilian Unified Health System (SUS, Sistema Único de Saúde) in two strategic lines (1) to reinforce SUS's universal actions and (2) to implement specific ones to 100 municipalities chosen by the MoH as priorities for syphilis congenital response. In 2015, such localities represented 6895% of congenital syphilis cases in Brazil. In this context, SNP has implemented actions to strengthen epidemiological surveillance of acquired syphilis and congenital syphilis by instituting an integrated and collaborative response through health services networks and reinforcing interstate relations. Methods: A quasi-experimental study using time series analysis was conducted to assess immediate impacts and changes to the trend in national congenital syphilis before and after the project, from September 2016 to December 2019. Data were assessed considering rates of congenital syphilis per 1,000 live births in all priority municipalities (n=100) covered by the project and in non-priority municipalities (n=5,470) from all five macro-regions of Brazil. Findings: Priority municipalities showed a greater reduction (change in trend) in comparison to non-priority. The linear regression model revealed trend changes after the intervention, with both groups of municipalities showing a drop in the average monthly number of cases per 1,000 live births, with a reduction of -0·21 (CI 95% -0·33 to -0·09; p=0·0011) in priority municipalities and of -0·10 (CI 95% -0.19 to -0.02; p=0·0216) in non-priority municipalities. Interpretation: The study using ITS provides important evidence on the direction, timing, and magnitude of the effects of interventions introduced as part of the SNP on congenital syphilis in Brazil. Our results suggest that the Syphilis No! Project influenced the trends of congenital syphilis in Brazil from 2018, with higher reductions achieved in the priority municipalities. Funding: The research is funded by a grant to the Syphilis No! Project from Brazilian Ministry of Health (Project Number: 54/2017). The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript