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 The BRICS Health Ministers met in Brasilia on December 5, 2014, at the Fourth Meeting of Ministers of Health of the BRICS.

 2. The Ministers underscored that the Declaration of Fortaleza and its Action Plan, adopted at the Sixth BRICS Summit, inaugurated a new cycle of BRICS coordination. The focus on social inclusion and sustainable development will contribute to the strengthening of intra-BRICS partnership, including cooperation in health.

3. Considering the impact of tuberculosis in the BRICS countries and in many developing countries, the Ministers approved the development of a cooperation plan, that includes a common approach to:

- universal access to first line anti-tuberculosis medicines for all patients with TB in BRICS countries, as well as in low- and middle- income countries;

- scientific research and innovations on diagnostics, treatment including drug resistance and service delivery of TB;

- sharing technologies, identifying manufacturing capacities and means of financing;

- to aspire towards a 90-90-90 TB target (90% of vulnerable groups screened, 90% diagnosed and started on treatment with 90% treatment success);

- and other issues of common interest.

In this context, the Ministers approved the setting up of a working group to develop the operational framework of the aforementioned plan, in the first half of 2015.

4. The Ministers expressed grave concern about the impact of the Ebola outbreak in West African countries and their sadness at the loss of lives and the suffering it had inflicted. They called for urgent and comprehensive international support to the efforts coordinated by the UN, and particularly to the actions undertaken by the WHO, to accelerate the response to the Ebola outbreak. The Ministers commended the setting up of the UN Mission For Ebola Emergency Response (UNMEER) and expressed their support for its strategic objectives, namely to stop the outbreak, treat the infected, ensure essential services, preserve stability and prevent outbreaks in countries that are currently unaffected. They committed to continue efforts through bilateral, regional and multilateral channels to help ensure a robust and effective response to the outbreak. In dealing with the ongoing outbreak, they urged other countries, to act in line with recommendations of the World Health Organization, including avoiding imposing general trade and travel restrictions on the affected countries.

5. The Ministers declared their intention to strengthen cooperation on the prevention and control of the Ebola disease in their territories and neighboring regions, in line with efforts coordinated by the United Nations and the World Health Organization (WHO), in accordance with the International Health Regulations (2005) and with particular emphasis in the areas of surveillance, diagnostic technologies, methods and health solutions and workforce training.

6. The Ministers recognized the importance of the end of HIV/AIDS as proposed by UNAIDS` targets. They recalled the Joint Communiqué of the BRICS Health Ministers Meeting in Cape Town in November 7, 2013, where the BRICS countries committed to collaborate on the development of medicines and the delivery of quality healthcare. In Brasília, they committed to deepen the discussion thereon. The Ministers endeavor to achieve the 90-90-90 HIV treatment target 2020, which is to rapidly reduce new HIV infection and AIDS related deaths including from tuberculosis and put us on the Fast Track to ending AIDS by 2030.

7. Concerned with sustainable access to new drugs and their impact on health budgets, especially concerning Hepatitis C, HIV and non- communicable diseases, the Ministers reiterated their support to the effective implementation of the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property and to the demonstration projects selected under the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) of the World Health Organization (WHO). They also reaffirmed their support to initiatives and experiences aimed at overcoming barriers in access to medicines, including the full use of TRIPS flexibilities, by means of promoting local production and using other price-reduction mechanisms, as well as fostering innovative and sustainable models for R&D and transfers of technology.

8. Considering the Global Plan to Combat Neglected Tropical Diseases 2008-2015, WHA Resolution 66.12, the World Health Organization's 2020 Roadmap for Neglected Tropical Diseases, the Ministers recognized the progress made by their governments regarding the fight against neglected diseases. They highlighted that many of these diseases are related to poverty and to the lack of access to information, and the suffering of millions of people can be prevented by the implementation of simple measures. The Ministers agreed to the promotion of cooperation between countries, including the establishment of intersectoral policies to improve access to medicines.

9. The Ministers acknowledged that antimicrobial resistance is a severe threat to global health that could undermine decades of progress in combating infectious diseases, in particular those brought about through the health-related Millennium Development Goals. They emphasized that the Global Action Plan on Antimicrobial Resistance should take into account the rational use of antimicrobials and the differences between health systems, cultures, ecologies, epidemiology conditions and economic situations, and that it should also provide guidance on how to implement mitigating actions.

10. Recognizing that 80% of premature deaths associated with chronic non-communicable diseases (NCDs) occur in developing countries and that the disproportionate incidence of these illnesses among the poorest populations highlight the need for a comprehensive response to NCDs, the Ministers reaffirmed the commitments made in the Political Declaration on the Prevention and Control of Non-communicable Diseases and in the General Assembly High-Level Meeting on Non-Communicable Diseases of July 2014. They also reiterated their efforts to implement the WHO Global Action Plan for Prevention and Control of Non-Communicable Diseases 2013-2020, adopt strategies to reduce risk factors (tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol), to strengthen their health systems and to promote research and development and access to medicines.

11. Recognizing that the rates of overweight, obesity and malnutrition-related chronic diseases have been increasing significantly in our countries, the Ministers expressed their interest in sharing strategies and policies. They reiterated their commitment to implement the Rome Declaration and Plan of Action, both resulting from the II International Conference on Nutrition, and agreed to jointly organize a side event during the 68th World Health Assembly with a view to proposing concrete progress to address this common challenge.

12. Considering the high number of deaths from tobacco-related diseases and the financial burden placed on public healthcare systems, the Ministers reaffirmed the commitments assumed under the Framework Convention on Tobacco Control (FCTC) as fundamental to strengthen tobacco control measures. They further recognized the results achieved during the Sixth Session of the Conference of the Parties to the WHO FCTC and the Moscow Declaration as milestones in this challenging journey.

13. Considering that the WHO reform process is aimed at improving strategic decision-making of its governing bodies and at strengthening WHO leadership in global health, and also considering the Framework of engagement with non-State actors drafted by the WHO Secretariat, the Ministers commended the progress made so far and highlighted the importance of engaging Member States in the reform process.

14. Recognizing that healthcare provides a fundamental contribution to a more inclusive and sustainable development model, and highlighting the importance of ensuring universal access to healthcare, the Ministers welcomed the Report of the Open Working Group on Sustainable Development Goals (OWG-SDG), and expressed their commitment to combine efforts during the Intergovernmental Negotiating Process for the Post-2015 Agenda, to be concluded in September 2015.

15. The Ministers recognized the importance of WHA Resolution 67/20 and congratulated the World Health Organization (WHO) and the Government of Brazil for hosting the 16th International Conference of Drug Regulatory Authorities held in Rio de Janeiro in August 2014, and for offering an opportunity to strengthen ties, discuss trends and share solutions of common interest.

16. They recalled the commitments of the Decade of Action for Road Safety 2011-2020 and commended the inclusion of this subject in the Report of the Open Work Group on Sustainable Development Goals. They also welcomed the invitation to return to Brazil on 18 and 19 November 2015 for the Second Global High-Level Conference on Road Safety, an opportunity to review commitments and to discuss new strategies to mitigate one of the leading causes of death among young people aged 15-29.

17. The Ministers of Health of Brazil, India, China and South Africa convey their appreciation to Russia for its offer to host the next Meeting of the Ministers of Health of the BRICS in 2015 and extend their full support to that end.

Brasília, 5 December 2014.