Inter Press Service - September 19, 2003
Mario Osava

The synthetic drug that would be appropriate in her case costs around 270 dollars, but her daughter, a nurse, with the help of university medical professors, obtained an alternative treatment that involves cheaper drugs made by pharmacies, and which include plant-based substances.

Angelina Oliveira, 80, is a retired public employee and her pension is five times more than Lucena's. She has to spend more than 67 dollars a month on medicines to control hypertension, vertigo and thyroid problems, and twice that on drugs for digestive ailments.

An understated Oliveira says she would like to see "reduced prices".

The high price of medicines brings with it a low regard for patents in Brazil, where advocates of a health system that is not tied to the market won some more allies this week.

The National Conference on Medications and Pharmaceutical Assistance, which drew nearly a thousand participants to Brasilia for sessions Monday through Thursday, approved a proposal for greater flexibility of the country's patents law.

Such flexibility is necessary if Brazil is to improve public health, says the initiative.

Patents represent a "monopoly that turns medicines into mere merchandise," makes them expensive and obstructs progress in public health, says Clair Castilhos, conference coordinator and professor of pharmacology at the Federal University of Santa Catarina, in southern Brazil.

Ideally, the Brazilian patents law would be revoked, she told IPS. "It is one of the strictest in the world," but it would be unrealistic to expect such a radical action, said Castilhos, who is calling for "an immediate revision" of the law, at the very least.

In 2001, Brazil played a leading role in the international community's adoption of the principle that public health emergencies take precedence over intellectual property protections.

Although the patents law is considered rigorous, the country had already suspended specific patent rights through the mechanism known as compulsory licensing -- as allowed under national legislation -- to lower the costs of the government programme for distributing free medications to people with HIV/AIDS.

Compulsory licensing, approved by the World Trade Organisation for certain cases, allows a government to temporarily override a patent and produce generic copies of a medicine, but must pay royalties to the patent holder. Nevertheless, generic copies are much cheaper to produce than brand-name drugs.

The conference-goers in Brasilia agreed on guidelines for a new national policy that assures the ill -- and particularly the poorest -- free access to essential medicines through the SUS health system, similar to the existing anti-AIDS programme, or at least to provide them with medications at the lowest market prices.

SUS, created a decade and a half ago with the intent of making medical assistance universally accessible, is facing implementation problems in a country where there is enormous demand -- Brazil is home to 170 million people -- and scant public resources. However, the system does function well in many parts of the country.

One of its greatest weaknesses is the precariousness of its assistance for the sectors of the population who cannot afford to purchase medicines.

The conference recommended, that in order to better supply the hospitals and SUS posts, there must be greater support for research and the use of medicinal plants, but also greater efforts to fight bio-piracy and strengthen the national pharmaceutical industry.

Bio-piracy can be defined as the appropriation and patenting of natural genetic resources, which in many cases have been used for centuries by indigenous peoples and are considered part of their traditional knowledge.

This week's conference rounded up a debate of several months, begun in municipal meetings and continued in conferences in each of the 27 Brazilian states. This process "of broad participation could serve as a model in other Latin American countries," noted Norberto Rech, director of pharmaceutical assistance at the Ministry of Health.

Half of the participants in the Brasilia meeting were representatives of health services users, a quarter were delegates from health workers' associations, and the rest were health administrators, including government officials and industry and trade representatives.

The proposals, said Rech, reinforce government plans to expand SUS's pharmaceutical activities and foment national production of medicines, as well as the sector's scientific and technological development.

Brazil imports 80 percent of the raw materials for its pharmaceutical industry. This dependence on foreign sources contributes to a trade deficit of 2.5 billion dollars annually in the pharma-chemical and drug product sector, he said.

That is why it would be a "strategic" move to enact a sector-specific industrial policy, with the important resource of 19 official laboratories -- linked to universities and research institutions -- that already produce a large portion of the generic medications in Brazil.

Generic drugs, generally identified by their active ingredients, are copies of patented or name-brand drugs.

Investment in that network of laboratories this year totals some 13.5 million dollars, which ministry official Rech says is "very little", but that the budget for 2004 will be double that figure.

Brazilians consume around 3.5 billion dollars in medications each year. The problem is that 80 percent of these drugs are sold through the private network, at prices that are accessible for just 20 percent of the population, says conference coordinator Castilhos.

"Many people skimp on food in order to save money for the medications their lives depend on," she said.

The business is so profitable that there are 58,000 pharmacies in Brazil. For the sake of comparison, there are 54,000 bakeries, Castilhos noted. (END/IPS/LA/HE-DV/TRASO-LD/MO/MP/03)

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