You have probably already seen the news that Brazil will start producing the main medication used in HIV treatment by the NHS. But perhaps you thought: "So what? What does this really change?"

Actually, this is much bigger news than it seems.

It means that the country will become less dependent on importing an essential medication for thousands of Brazilians. In other words, treatment gains more security, the risk of medication shortages decreases and the NHS strengthens its capacity to care for people living with HIV.

And this matters greatly.

Today, living with HIV is completely different from what it was 30 or 40 years ago. The diagnosis, which was once surrounded by fear and few treatment options, can now be accompanied by a long, healthy and quality life. Much of this change has happened thanks to advances in medications.

HIV and AIDS: are they the same thing?

Many people still use both terms as if they were synonymous, but they mean different things.

  • HIV is the virus
  • AIDS is the disease that can arise when this virus severely weakens the body's defence system

Having HIV does not mean having AIDS. Today, a person who discovers HIV early and receives correct treatment may never develop AIDS.

Why is this medication so important?

The medication that Brazil will start to produce is called dolutegravir.

It is part of the treatment most currently used by the NHS because it manages to prevent the virus from continuing to multiply within the body.

With this, the amount of virus in the blood gradually decreases until it becomes so low that tests can no longer detect it. This is what we call undetectable viral load.

Undetectable = Untransmittable (U = U)

When a person takes medications correctly, maintains medical follow-up and remains with an undetectable viral load for at least six months, they do not transmit HIV through sexual contact.

This concept became known worldwide as Undetectable = Untransmittable (U = U) — and completely changed the way we view HIV.

How does treatment work in Brazil?

In Brazil, treatment is completely free.

After a positive test, the person is referred to a specialised NHS service, undergoes tests, starts medications and receives regular follow-up care.

In addition to medications, the NHS also offers:

  • consultations;
  • tests to monitor viral load;
  • guidance from a multidisciplinary team.

All of this at no cost to the patient.

Why does manufacturing this medication in Brazil make a difference?

Imagine depending on another country to receive a medication that needs to be taken every day.

If there are problems in global production, delays in imports or international crises, there is a risk of drug shortages.

By producing dolutegravir in the country itself, Brazil gains more autonomy. This helps to:

  • ensure that the medication continues to reach patients on a regular basis;
  • strengthen one of the world's largest public HIV treatment programmes.

Is treatment still difficult?

Fortunately, not as it was in the past.

At the beginning of the epidemic, it was common for people to need to take several tablets throughout the day, with many side effects.

Today, for most patients, treatment is much simpler. In many cases, just one tablet a day is enough to completely control the virus.

When treatment is followed correctly, life expectancy can be very close to that of a person who does not live with HIV.

How is transmission transmitted?

HIV can be transmitted mainly through:

  • sexual intercourse without condoms;
  • sharing syringes and needles;
  • transmission from mother to baby during pregnancy, childbirth or breastfeeding, when there is no treatment;
  • contact with contaminated blood.

HIV is NOT transmitted through:

  • hugging;
  • social kissing;
  • handshake;
  • sharing glasses, plates, cutlery;
  • swimming pools;
  • bathrooms;
  • mosquito bites.

These myths still exist and end up fuelling prejudice.

Is it possible to prevent?

Yes. Today there are several forms of prevention.

Condoms continue to be a great ally.

PrEP is a medication used before exposure to the virus by people at higher risk of infection.

PEP is indicated after a risky situation. It should be started within 72 hours and can prevent infection from occurring.

Testing is another very important strategy. Getting tested when there has been exposure or doubt means that the earlier diagnosis is made, the sooner treatment can begin.

What does this news represent?

Producing dolutegravir in Brazil goes far beyond the manufacture of a medication.

It is investing in public health, reducing import dependency and ensuring that thousands of people continue to have access to safe and effective treatment.

But perhaps the most important message is another.

Today, HIV is no longer a death sentence.

With early diagnosis, appropriate treatment and regular follow-up, it is possible to work, study, start a family, have children and live many years with quality of life.

Correct information, access to treatment and combating prejudice continue to be the most important tools in this story.

This content is for informational purposes and does not replace a consultation. For a better assessment, please see a doctor.

Dr. Rebeca Soares Andrade CRM - GO 39335