Brazil's Bold Move
  
  By Kelly Hearn 
  AlterNet.| March 25, 2005.
  http://www.alternet.org/envirohealth/21586/

Determined to get affordable drugs for its citizens living with HIV/AIDS, the 
Brazilian government threatens to break some of Big Pharma's patents.

Bolstering its reputation as a world leader in price wars over AIDS 
medications, Brazil is threatening to break antiretroviral drug patents unless 
drug companies allow it to manufacture generic versions of four major AIDS 
drugs.
A spokesperson for the Brazilian health ministry offered no comment when 
reached by telephone Wednesday, but a recent report on the Dow Jones newswire 
said the government of President Ignacio Lula de Silva has given three U.S. 
drug companies â Abbott, Gilead and Merck â until April 4 to transfer 
technology that would let labs make generic versions of Abbott's Kaletra, a 
combination pill of Lopinavir and Ritonavir, Gilead Science's Tenofovir and 
Merck's Efavirenz. Brazilian health officials say the four drugs combined 
take up 67 percent of the government's funds for imported AIDS medicines.

A spokeswoman for Abbott, Michelle Johnson, confirmed in a telephone 
conversation that the company had received a letter from the government but 
added that it was too early to tell what its response will be. Merck and Gilead 
declined interview requests.
Approximately 600,000 Brazilian citizens are HIV-positive and more than 
one-third of the people living with HIV in Latin America are in Brazil, 
according to the United Nations.
Brazil's strategy is to ask for voluntary licensing but rely on"compulsory 
licensing" as a last resort, making generics without permission but paying 
royalties.

Dr. Jorge Bermudez, a former Brazilian health official now at the Pan American 
Health Organization, says the government's moves are completely legal under the 
World Trade Organization's Trade Related Aspects of Intellectual Property 
Rights agreement. The so-called TRIPS agreement lets poor countries break 
patents in health emergencies and is considered the developing world's primary 
tool for securing affordable medications.
"All of this is taking place within legal frameworks," Bermudez said in a 
telephone conversation from his office in Washington, D.C.. "It is the only way 
Brazil can sustain universal access to medication."
Bermudez, who has attended meeting with Brazil's ministers of health and 
foreign policy, said both officials regard the patent confrontations as a 
matter of domestic political will. "They recognized that Brazil has made a 
political decision to ensure universal care has been made and now the 
government must act."
Brazil's leftist government has one of the world's most progressive AIDS 
programs. Already the state makes generic retroviral drugs and distributes them 
for free.

For the last few years, observers say Brazil has pushed drug makers to lower 
prices with threats of breaking patents but did not follow through until now. 
In January 2004, officials negotiated lower prices with Roche, Gilead and 
Abbott, reportedly landing discounts up to 76 percent for the five most 
expensive antiretroviral medications. The deal was expected to extend treatment 
to 20,000 new patients in 2004. Abbott's Michelle Johnson did not offer 
statistics on the company's past pricing decisions but said Brazil receives the 
lowest price for Kaletra of any country.

Patent laws required for entering the WTO are seen as putting costly medicines 
out of the reach of poor countries and patients. In a nod to WTO conformity, 
India's lawmakers on Tuesday passed a sweeping new patent law that critics 
believe will place clamps on the country's generic drugmakers, which supply 
AIDS medication to millions of poor people in and beyond India.

AIDS activists have taken issue with transnational agreements such as NAFTA, 
arguing that patent protections designed to benefit multinational corporations 
hamper the ability of poor countries to apply compulsory licensing under TRIPS. 
Bermudez said PAHO officials and some health ministers from other Latin 
American are concerned that the Central American Free Trade 
Act will do the same. The agency is also concerned that health ministers in 
signatory countries in some cases do not even participate in the negation of 
trade agreements.

Brazil's move, experts say, could embolden other countries in Latin America, 
where last year 1.7 million adults and children were living with HIV. In 2003, 
10 countries bonded together to negotiate lower drug prices. Health ministers 
in Peru, Bolivia, Colombia, Ecuador, Venezuela, Chile, Argentina, 
Mexico, Paraguay and Uruguay negotiated an agreement in Lima, Peru that spelled 
a $120 million a year price reduction of drugs for HIV/AIDS.

At the time of the agreement, PAHO officials said antiretroviral drugs, which 
cost from $1,000 to $5,000, was a price impossible for the majority of 
developing countries to afford. After the Peru agreement, prices were slated 
to fall between $350 and $690, amounting to an increase of 150,000 annual 
treatments for the signatory countries. 
Kelly Hearn is a correspondent for the Christian Science Monitor and a former 
science and technology writer for UPI.






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