Health in Portugal
A monografia da Direcção-Geral da Saúde, Health in Portugal (Saúde em Portugal), sobre o sistema de saúde em Portugal e sobre a saúde dos portugueses já está disponível “on line”: link
Excelente trabalho da equipa da DGS.
Sobre o HIV/AIDS em Portugal, a monografia refere o seguinte:
The global pandemic of HIV infection is perhaps the first, but certainly not the last, of the new emerging diseases whose spread is inevitably associated with the accelerating processes of globalisation.
Since the HIV/AIDS epidemic began 25 years ago, the complexity and diversity of the social responses and policies generated by this epidemic have been the object of extensive research in several domains, such as medicine, public health and the social sciences.
In Portugal, according to the Communicable Disease Surveillance Centre of INSA, a total of 29,461 HIV/AIDS infection cases in different stages of disease had been notified by 30th June 2006.
Within the context of the 52 European countries, Portugal has the second highest incidence rate (251.1 cases per million inhabitants).
Although HIV transmission associated with injecting drug use represented 45.5% of the total worldwide number of notifications, a growing rate of sexually transmitted HIV has been reported since 2002. In 2002, the categories of heterosexual and homosexual transmission contributed 43.3% and 6.9%, respectively, whilst in 2005, these transmission categories were respectively reported to be 47.6% and 8.5% of the total cases notified.
In 1993, through the National Commission for the Fight against AIDS, in partnership with the National Association of Pharmacies, Portugal launched the national programme” Say no to a second hand syringe”, directed towards injecting drug users. This Programme provided the exchange of syringes and used needles which took place in pharmacies. Between May 1993 and 2001, approximately 25 million syringes were exchanged.
The evaluation of the results of this Programme, performed using studies of mathematical modelling in 2002, estimated that more than 7 thousand new infections by HIV were avoided during the almost eight years of the programme.
Combined anti-retroviral therapies contributed to the decrease in mortality, the reduction in the frequency and duration of admission episodes and to an increase in longevity and restoration of autonomy of a significant number of HIV-infected patients.
In order to prevent the further spread of the disease in Portugal, more than antiviral power of therapeutic regimes, it is essential to promote open-access to assistance projects.
The false dichotomies – prevention or treatment – and the inconsistent arguments about cost-effectiveness of anti-retroviral therapy continue to be common in Portugal.
Although many proposed intervention policies for the control of HIV/AIDS infection emphasise their distance from the early concept of “the unique nature of AIDS”. An analysis of the most recent strategies confronts us with surprising evidence that past trends are continuing. In Portugal, the situation of HIV/AIDS infection in prisons is the best example of that continuity with the “unique” concept of the past.
According to the National Programme for Prevention and Control of HIV/AIDS Infection, it is estimated that the prevalence of infection in the prison population is 10.2% and that infection with the hepatitis C virus is 29%, with it being known that 56.8% of the in-mates infected by HIV are co-infected by hepatitis C virus.
Although the evaluation of the syringe and needle supply programmes in some prisons in Spain, Switzerland and Germany, indicates that use of drugs in prisons has not increased. There has been a decrease in the sharing of materials used for the preparation and consumption of drugs as well as a decrease in the use of needles as aggressive weapons. The non-implementation of these infection control measures in Portuguese prisons, contributes to the perpetuation of the transmission risk of HIV, hepatitis C or hepatitis B within this population.
The debate over preventive measures, such as the supply of condoms or the exchange of the necessary paraphernalia for drug preparation and consumption in the prison environment, reflects philosophical differences as well as uncertainties regarding the frequency of HIV infection inside prisons.
Independently of personal opinions on this matter, the current epidemiologic reality requires the adoption of effective measures to reduce the risk of infection of HIV and other blood and STI among in-mates.
Epidemics such as HIV/AIDS infection are not simple medical events, but complex social processes that reflect underlying political, economic and cultural factors.
Health in Portugal, pag 77
Sobre o HIV/AIDS em Portugal, a monografia refere o seguinte:
The global pandemic of HIV infection is perhaps the first, but certainly not the last, of the new emerging diseases whose spread is inevitably associated with the accelerating processes of globalisation.
Since the HIV/AIDS epidemic began 25 years ago, the complexity and diversity of the social responses and policies generated by this epidemic have been the object of extensive research in several domains, such as medicine, public health and the social sciences.
In Portugal, according to the Communicable Disease Surveillance Centre of INSA, a total of 29,461 HIV/AIDS infection cases in different stages of disease had been notified by 30th June 2006.
Within the context of the 52 European countries, Portugal has the second highest incidence rate (251.1 cases per million inhabitants).
Although HIV transmission associated with injecting drug use represented 45.5% of the total worldwide number of notifications, a growing rate of sexually transmitted HIV has been reported since 2002. In 2002, the categories of heterosexual and homosexual transmission contributed 43.3% and 6.9%, respectively, whilst in 2005, these transmission categories were respectively reported to be 47.6% and 8.5% of the total cases notified.
In 1993, through the National Commission for the Fight against AIDS, in partnership with the National Association of Pharmacies, Portugal launched the national programme” Say no to a second hand syringe”, directed towards injecting drug users. This Programme provided the exchange of syringes and used needles which took place in pharmacies. Between May 1993 and 2001, approximately 25 million syringes were exchanged.
The evaluation of the results of this Programme, performed using studies of mathematical modelling in 2002, estimated that more than 7 thousand new infections by HIV were avoided during the almost eight years of the programme.
Combined anti-retroviral therapies contributed to the decrease in mortality, the reduction in the frequency and duration of admission episodes and to an increase in longevity and restoration of autonomy of a significant number of HIV-infected patients.
In order to prevent the further spread of the disease in Portugal, more than antiviral power of therapeutic regimes, it is essential to promote open-access to assistance projects.
The false dichotomies – prevention or treatment – and the inconsistent arguments about cost-effectiveness of anti-retroviral therapy continue to be common in Portugal.
Although many proposed intervention policies for the control of HIV/AIDS infection emphasise their distance from the early concept of “the unique nature of AIDS”. An analysis of the most recent strategies confronts us with surprising evidence that past trends are continuing. In Portugal, the situation of HIV/AIDS infection in prisons is the best example of that continuity with the “unique” concept of the past.
According to the National Programme for Prevention and Control of HIV/AIDS Infection, it is estimated that the prevalence of infection in the prison population is 10.2% and that infection with the hepatitis C virus is 29%, with it being known that 56.8% of the in-mates infected by HIV are co-infected by hepatitis C virus.
Although the evaluation of the syringe and needle supply programmes in some prisons in Spain, Switzerland and Germany, indicates that use of drugs in prisons has not increased. There has been a decrease in the sharing of materials used for the preparation and consumption of drugs as well as a decrease in the use of needles as aggressive weapons. The non-implementation of these infection control measures in Portuguese prisons, contributes to the perpetuation of the transmission risk of HIV, hepatitis C or hepatitis B within this population.
The debate over preventive measures, such as the supply of condoms or the exchange of the necessary paraphernalia for drug preparation and consumption in the prison environment, reflects philosophical differences as well as uncertainties regarding the frequency of HIV infection inside prisons.
Independently of personal opinions on this matter, the current epidemiologic reality requires the adoption of effective measures to reduce the risk of infection of HIV and other blood and STI among in-mates.
Epidemics such as HIV/AIDS infection are not simple medical events, but complex social processes that reflect underlying political, economic and cultural factors.
Health in Portugal, pag 77
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