AIDS Drugs: U.S. vs. the World

Paulo Rebêlo
Wired News
May 2001

The Brazilian health system is a model to the world when it comes to fighting AIDS. But it faces the wrath of labs in the United States, which want to regain control of their patents on generic medicines used to fight the disease.

Brazil is the only Latin American nation providing free triple therapy, which almost pays for itself by reducing the costs for hospitalization and drugs.

Nevertheless, U.S. labs are trying to stop the production of the generics used in Brazil — known as antiretroviral drugs — since they derive from formulas developed and patented in the United States. The Brazilian manufacturers do not pay royalties.

In 1998, moved by the high cost of AIDS-fighting drugs, Brazil’s government decided to analyze trademarked drugs and produce its own generic antiretroviral drugs.

From the standpoint of being an effective strategy, it worked. According to Far-Manguinhos lab, located in Rio de Janeiro, Brazil imports the ingredients from Asia and produces 12 drugs that keep AIDS under control for 200,000 Brazilians.

“Our task is purely social,” says Eloan Pinheiro, director of Far-Manguinhos. The lab produces dozens of drugs used against diseases, like malaria, that have largely vanished from developed countries.

Reports from Brazil’s health ministry say that the current program has reduced AIDS deaths by half. It has improved the quality of life for thousands of people living with the disease, from the richest to the poorest.

“Brazil can only afford the producing expenditures because we don’t pay market prices,” says Health Minister José Serra. Actually, drugs produced in Brazil are 79 percent cheaper to make, according to Far-Manguinhos.

The trademark issue flared when the United Nations encouraged other countries to follow Brazil’s example and begin manufacturing their own drugs based on patented formulas. The move was opposed by the United States.

Brazilian patent law recognizes the primacy of compulsory license over trademark in cases deemed national emergencies, and AIDS fits that description easily.

The ethical issue — whether labs should refuse to lower the cost of their drugs for developing countries — also strikes a deep chord in Brazil.

In April, the United Nations agreed with Brazil’s position, with 52 of 53 nations voting to accept the notion of ignoring patents in favor of developing badly needed drugs. The lone holdout was the United States, which voted to protect the patents of pharmaceutical products. While the vote was not an official resolution, “it has a very strong political, moral and ethic appeal,” said Celso Amorim, Brazil’s ambassador to the World Trade Organization in Geneva.

Researchers argue with the WTO that they need worldwide patent protection to recoup the millions spent on research and development of the anti-AIDS drugs.

But Brazil’s president, Fernando Henrique Cardoso, chooses ethics over profits: “We’re not trying to challenge anyone. We don’t want to overstep patents at any price. But for the health of our nation, we won’t hesitate.”

Replies Robert Zoellick, U.S. trade representative: “Certain countries try to justify the use of protectionist measures by associating these issues with the AIDS crisis when no such linkage exists.”

According to Zoellick, “the U.S. won’t hesitate in using its total strength and international laws to modify the situation.”

Dr. Paulo Teixeira, head of the Brazilian program on AIDS, said it would be disastrous if the USTR is left to call the shots, to the point of being able to dictate to other countries how to conduct their AIDS strategies.

“If that happens, we’re doomed,” he said.

According to Teixeira, USTR reports defend some anti-AIDS programs, such as those in Thailand, Senegal and Uganda. But those countries don’t insist upon wide access or the self-production of antiretroviral medicines.

Brazil, it seems, is No. 1 leper at the USTR, says Teixeira.

“They exclude Brazil when it comes to anti-AIDS programs.”