Summaries of health policy coverage from major news organizations
Brazil’s Manufacture, Free Distribution of AIDS Drugs Halves Death Rate, NPR Reports
Brazil has cut its AIDS death rate by about 50%, thanks to an "aggressive program" to distribute the latest AIDS drugs to "everyone who needs" them, NPR's "All Things Considered" reported yesterday. The treatment is "so effective" that patients "can lead relatively normal lives" and some even act "as though they don't even have the virus," including HIV-positive women who deliver healthy children. Triple-drug HIV combination therapies, "cutting-edge pharmaceutical product[s]" that cost over a thousand dollars per month in the developed world, are distributed free of charge under Brazil's official government policy. The government halved the cost of the program, which currently serves approximately 90,000 Brazilians, to around half a billion dollars per year by establishing a government-run pharmaceutical laboratory on the outskirts of Rio de Janeiro. Lab Director Dr. Eloan Pinero said, "Our goal here is to analyze the drug completely, to figure out the formula and how to develop it, including a cost analysis. Then we can go to the manufacturer and say, 'Look, we know how to make this, and we know you could cut the price 50%. So it would be a good idea to cut your price when you deal with the Ministry of Health." The lab's copies are legal under Brazilian law because the patents for older drugs predate Brazil's 1997 international patent protection law, and are therefore "grandfathered in." However, the newest AIDS drugs are patent protected and must be "purchased at high prices directly from the patent holders." Currently, 40% of Brazil's AIDS drug budget finances the purchase of only two
post-1997 drugs. The "loophole" will continue to close as pharmaceutical companies invent new drugs and pass on the cost of innovation. Brazil's public health officials acknowledge that their system "is much better at dispensing drugs than treating full-blown AIDS," but do not regret the choice to invest in the anti-AIDS "cocktail," which has "relieved the strain on the system by cutting AIDS hospitalization rates by up to 80%." Public health expert Dr. Beatriz Grinschtein is critical of developing countries such as those in Africa that took the "opposite route" from Brazil, "concentrating only on AIDS prevention under the assumption that their health systems would never be able to treat the disease." Grinschtein said, "If we were to wait until all of the problems in our health system were corrected before we dealt with HIV, then we'd never get started," adding, "I hope we Brazilians are able to help people around the world see that there's a way out of this that doesn't require being rich." To listen to the full report in RealAudio, go to http://search.npr.org/cf/cmn/cmnpd01fm.cfm?PrgDate=03/13/2001&PrgD=2I and scroll down to "Brazil AIDS" (Kaste, "All Things Considered," NPR, 3/13).
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