Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of the Implementation of Public Health Policies on HTLV-1 in Brazil

Abstract

Human T lymphotropic virus 1 (HTLV-1) is a public health issue for most countries and imposes important consequences on patients' health and socioeconomic status. Brazil is one of the global leaders of the public health response to these viruses. The country has challenges to overcome to implement meaningful policies aiming to eliminate HTLV-1/2. An analysis of strengths, weaknesses, opportunities, and threats (SWOT) for the implementation of public health policies on HTLV-1/2 was performed. The strengths identified were the Brazilian Unified Health System (SUS); Brazilian expertise in public health programs successfully implemented; currently available policies targeting HTLV; and strong collaboration with researchers and patient's representative. Lack of awareness about HTLV, insufficient epidemiological data, lack of reference centers for patient care, insufficient availability of confirmatory tests, lack of universal antenatal screening, and absence of cost-effectiveness studies were identified as weaknesses. Some interesting opportunities included the increased interest from international organizations on HTLV, possibility of integrating HTLV into other programs, external funding for research, available online platforms, opportunity to acquire data from HTLV-1/2 surveillance to gather epidemiological information, and HTLV policies that were implemented independently by states and municipalities. In addition to the COVID-19 pandemic, existing demands from different diseases, the country's demography and its marked sociocultural diversity and the volatility of the technical team working with HTLV-1/2 at the Brazilian Ministry of Health are threats to the implementation of public policies on HTLV-1/2. This SWOT analysis will facilitate strategic planning to allow continuous progress of the Brazilian response to HTLV-1/2 infection.

Evaluation of massive education in prison health: a perspective of health care for the person deprived of freedom in Brazil

“…Recent studies show the relevance of this platform as a tool to induce public health policies. It has been an important instrument in the process of education and learning of health workers in Brazil because it has directly contributed, and in scale, to the improvement and supply of health services in the country ( 41 , 51 , 52 ). This massive education process, through AVASUS, has resulted in changes in work processes at various levels of health care, which has promoted resilience in the system and timely response to health problems ( 32 , 41 , 47 , 51 , 53 ).…”

HTLV infection and cessation of breastfeeding: context and challenges in implementing universal prevention policies in Brazil

“…8 ),( 9 However, there is still a lack of knowledge among health professionals and policymakers on HTLV-1 and infection prevention measures. 10 ),( 12 …”

“…The Ministry of Health has included HTLV-1 in a training course on STIs and regularly conducts awareness campaigns. 12 Continuous work focusing on this subject is essential, as well as stronger collaboration with important stakeholders such as medical and nursing councils, and professional associations such as FEBRASGO and the Brazilian Society of Pediatrics. Collaboration with the Ministry of Education, for the inclusion of HTLV-1 in the curriculum of professional development courses, is another strategy to be take into consideration.…”

“…Many of these centers are associated with research groups, without government financial support. 12 It is necessary to reverse this situation in order to ensure universal and equitable access to healthcare services.…”

“…Implementation of a notification and surveillance system for the infection in pregnant women and exposed children is important for identifying priority areas, designing more effective interventions and monitoring the impact of existing policies. 10 ),( 12 The laboratory interface and greater coordination with the Digital Health and Information Secretariat of the Ministry of Health will be welcome, as well as the implementation of the dialogue with the state and municipal health departments, so that the three spheres of government are involved in this process.…”