Health Surveillance & Disease Prevention & Control — Communicable Diseases: 
Acute Respiratory Infections - Anthrax - Antimicrobial Resistance - Campylobacter - Chagas -
Cholera - Dengue - Diarrheal/Enteric Diseases - Disease Outbreak News -
Emerging/Reemerging Diseases - Filariasis - Hantavirus - Influenza: Avian |  Pandemic |  Seasonal - International Health Regulations - Leishmaniasis - Leprosy - Malaria -
Neglected Diseases - Parasitic Diseases - Rabies - Research - Salmonella - Shigella - Smallpox -
Tuberculosis - West Nile Virus  - Yellow Fever  -
Health Analysis & Statistics - Chronic Diseases - Veterinary Public Health

Hansen's Disease in Brazil: PAHO Activities

Introduction

Anchored in the 13^th Technical Cooperation Agreement (TCA) between CONASEMS, PAHO/WHO, and the Ministry of Health (Ministério da Saúde / MS) of Brazil, together with MORHAN and Child Pastoral Services, the objective of this collaboration agreement is to help the MS increase access to diagnosis and treatment through decentralization of basic care in its drive to eliminate the disease at municipal level.

For 2003-2005, PAHO/WHO will face one of its greatest challenges regarding elimination and its sustainability in Brazil, and epidemiological surveillance: maintenance, monitoring, and dissemination of information on Hansen's disease.

Activities 2000–2002

Proposal 2003–2006

The objective of the 13^th Technical Cooperation Agreement will be to continue to support the MS in its goal to eliminate Hansen's disease in Brazil. Until 2003, activities will focus mainly on the following lines of action:

1. Technical cooperation with DATASUS in developing and participating in the implementation of four information technologies: a new application to update registries, TabNet, Notebooks for Elimination Profiles, and an Observatory with systematic analysis. These products will permit the following:
1. Analysis associated with data produced by SINAM, co-validating indicators for detection and stopping the disease through cure by cure, to test the adequacy of bonus transfer.
2. Preparation of epidemiological alerts on the situation in endemic municipalities considered priority areas for decision-making.
3. Preparation of elimination profiles at three managerial three levels.
4. Joint preparation with ATDS of situation reports on the evolution of the elimination of Hansen's disease in Brazil.
2. Coordinate carrying out Leprosy Elimination Monitoring (LEMs) in the states of the country.
3. Support MORHAN and Pastoral Child Services in local advocacy activities.
4. Contribute in the implementation of multidrug therapy (MDT) in areas of geographical priority.
5. Promote, together with the MS, a national evaluation meeting on advances made in the area of elimination.
6. Maintain momentum in advocacy activities.

Conclusions and Recommendations for the Execution of the 13^th Technical Cooperation Agreement

It should be pointed out that the government of Brazil has been incorporating into its policies the initiatives generated by this cooperation. The MS, recognizing the success of the strategy—extension of universal and unrestricted access of MDT/WHO treatment and advances in advocacy—is utilizing the method of action recommended by GT/HANSEN/CONASEMS, which is expanding its actions into tuberculosis as well. The MS will incorporate the application SINAN for updating of registries, and it will add prestige to the initiative by disseminating the information on the Internet. Cooperation with the Pastoral Child Services and the TV station Globo has also contributed much to meeting the objectives laid out in the TCA.