RIO DE JANEIRO, July 30, 2008 (AFP) - Brazil, long considered a model country in the fight against AIDS, depends on cheap retroviral treatments secured from the big drug companies after fierce struggle.
That fight goes on today, with Brazil also manufacturing its own generic anti-AIDS medicine.
The strategy has created friction with the pharmaceutical groups investing billions in new anti-virals -- but it has also proved successful in this vast country, population 190 million, which has a third of Latin America's HIV-positive patients.
Around 32,000 new HIV/AIDS carriers are detected every year, a proportion that has stayed roughly the same for the past two decades.
That in itself is a triumph for a nation which was once predicted to be on the same path as parts of Africa where AIDS transmission has exploded, creating a veritable crisis.
The director of the Brazilian health ministry's AIDS program, Mariangela Simao, told AFP that in 2002, the prevelance rate of HIV/AIDS per 100,000 people was 22.2 cases. In 2006, it was 17.5, "which confirms a slightly lower trend," she said.
The government, though, is determined to push back further against the disease, said Simao, who will be attending an international AIDS conference in Mexico next week.
There are currently 620,000 people with HIV living in Brazil, or 0.61 percent of the population between 15 and 49. Of those, 190,000 with AIDS receive free treatment.
The health ministry spent 820 million dollars last year on its AIDS program, of which 620 million dollars went to paying for retroviral medicine.
"Each year, 18,000 to 20,000 people are being treated for AIDS," Simao said, adding that Brazil has made 16 types of retroviral treatments available.
Seven of those treatments are non-patented generics made in Brazil by state laboratories.
The other nine are imported at prices negotiated every year by Brazil to fulfil its promise of providing universal access to the drugs.
Last year, Brazil failed to secure a deal with the US pharmaceutical Merck for the HIV retroviral efavirenz.
It decided to break the patent on the drug -- the first time it has done so -- and is importing it from India pending its own generic production.
The 30 million dollars per year it is saving by doing so is being reinvested in HIV prevention.
"Between our trade and our health, we have chosen to look after our health," President Luiz Inacio Lula da Silva said at the time.
Simao explained that 80,000 patients with HIV in Brazil were receiving efavirenz, and two Brazilian laboratories were developing the drug. "It should be for sale on our market in 2009," she said.
The official said the government was well-placed to buy other treatments for the one-third of AIDS patients who were in a more advanced stage of the disease.
"The government buys in bulk, so it has a good margin for negotiation," she said.
"But that's not the case for countries like Chile or Mexico, which are paying five to seven times more because they are reliant on trade accords with the United States," she noted.
At the AIDS conference, "Brazil and France will steer the discussion towards the fact that it is possible to achieve universal access for these medicines by 2010, and will look at the impact on patents this access would have," she said.
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