Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.

Reuters NewMedia - November 29, 2004
Carlos A. DeJuana

Given the high cost of the medicines it hands out free to HIV and AIDS patients, Brazil's internationally-recognized anti-AIDS program is unsustainable in the future if it does not start to manufacture the drugs at home, said Pedro Chequer, the coordinator for the Health Ministry's sexually transmitted disease and AIDS department.

"The decision for Brazil to become self-sufficient in that which is technically possible has already been taken," he said by telephone from Brasilia.

Brazil has a history of talking tough with multinational pharmaceutical companies when it comes to its anti-AIDS program, which has been hailed as a model for poor nations.

In the past, it has threatened to break their patents or import cheap copies in order to force companies to cut prices.

This time, however, the question is not just about price, but about the program's long-term viability, Chequer said.

The increasing reliance on foreign medicines means the Health Ministry now spends some 80 percent of its anti-AIDS budget on imported drugs, compared with 50 percent in 1999.

"When we're at 50 percent the situation is more favorable. But the situation is getting increasingly harder so that we are on the road to becoming hostages to multinational industry," Chequer said.

He added that the government was conferring with state laboratories and local pharmaceutical companies to asses which drugs it will be able to manufacture locally, but he expects production for some drugs to start next year.

Under Brazilian law, the government can declare a state of emergency and start local production of any drug, regardless of who holds the medicine's patent. The company, however, would receive royalties on production.

Chequer said any local production would comply with domestic and international laws.

"Brazil is not going to mock the law," he said. "But we also understand that any law, be it national or international, that interferes with our ethical interests, with the Brazilian government's commitment to universal access for patients, cannot be seriously considered."

Chequer declined to name the drugs it is planning to produce. In the past, it has negotiated drug prices with companies like Roche Holding AG, Gilead Sciences Inc., Abbot Laboratories, Bristol-Myers Squibb and Merck & Co. Inc.

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