RESUMO
Resumo O sucesso do Programa Nacional de DST/Aids no Brasil se deve, em boa medida, à pluralidade de atores sociais engajados no combate à Aids. Este artigo visa analisar a dinâmica de mudanças ocorridas dentro do subsistema da Política Nacional de DST/Aids à luz do modelo de coalizões de defesa (MCD). Trata-se de um estudo que se vale da análise documental dos marcos normativos e de entrevistas com informantes-chave. Os resultados apontam para a formação de três coalizões: Coalizão A (engajamento social), Coalizão B (força governamental), e Coalizão C (parcerias internacionais), que, mediadas pelos parlamentares e instituições científicas, travam disputas traduzindo seus pontos de vista em ações governamentais. Os achados mostram que, embora bem-sucedida, a Política Nacional de DST/Aids enfrentou grandes dificuldades em estabelecer padrões que contemplassem as necessidades da população. Entretanto, mesmo que as coalizões contem com estratégias distintas, apresentam-se como convergentes, pois se direcionam para o mesmo objetivo. Vale ressaltar que, nos dias atuais, a onda conservadora atuante no Brasil apresenta tendência a inviabilizar novas políticas no campo da Aids e ameaça direitos humanos e sociais adquiridos. Tais impactos devem ser analisados em estudos futuros.
Abstract The success of the National STD/AIDS Program in Brazil is, to a great extent, associated with the multiplicity of social actors involved in the fight against AIDS. The scope of this article is to analyze the dynamics of changes occurring within the subsystem of national STD/AIDS policy in the light of the advocacy coalition framework (ACF) model. The study is based on documentary analysis of regulatory frameworks and interviews with key informants. The results point to the formation of three coalitions: Coalition A (social engagement); Coalition B (the force of governmental policies/actors); and Coalition C (international partnerships) which, mediated by the House of representatives and scientific institutions, wage disputes to translate their viewpoints into government actions. The data show that, despite being successful, the National STD/AIDS Policy faced great difficulties in establishing standards that addressed the needs of the population. However, although coalitions have different strategies, they are convergent, as they are directed towards the same objectives. It is worth mentioning that nowadays, the conservative wave in Brazil tends to preclude renewed policies in the field of AIDS and may threaten well-established human and social rights. Such impacts need to be analyzed in future studies.
Assuntos
Humanos , Síndrome de Imunodeficiência Adquirida Felina/prevenção & controle , Formulação de Políticas , Negociação , Governo , Política de SaúdeRESUMO
Zoonotic sporotrichosis caused by the fungus Sporothrix brasiliensis is usually severe in cats. This study investigated the associations between clinical features, fungal load, coinfections, histological skin changes, and response to itraconazole in cats with sporotrichosis caused by S. brasiliensis. Fifty-two cats with skin lesions and a definitive diagnosis of sporotrichosis were treated with itraconazole for a maximum period of 36 weeks. The animals were submitted to clinical examination and two subsequent collections of samples from the same skin lesion for fungal diagnosis and histopathology, as well as serology for feline immunodeficiency (FIV) and leukaemia (FeLV) viruses. Thirty-seven (71%) cats were clinically cured. Nasal mucosa lesions and respiratory signs were associated with treatment failure. Cats coinfected with FIV/FeLV (n = 12) had a lower neutrophil count in the lesion. A high fungal load in skin lesions was linked to young age and treatment failure, as well as to a longer time of wound healing, poorly formed granulomas and fewer neutrophils, macrophages and lymphocytes in these lesions. These results indicate that itraconazole is effective, but nasal mucosal involvement, respiratory signs and high fungal loads in skin lesions are predictors of treatment failure that will assist in the development of better treatment protocols for cats.