[A2k] Intervention of Brazil to the WTO TRIPS Council (March 2011) providing details about the Brazilian HIV treatment program
thiru at keionline.org
Thu Mar 3 03:14:23 PST 2011
Intervention of Brazil to the WTO TRIPS Council (March 2011) providing
details about the Brazilian HIV treatment program
On Tuesday, 1 March 2011, Brazil made the following intervention at
the WTO Council for TRIPS during discussions of the paragraph 6 system.
Brazil welcomes the opportunity for this follow-up to the review on
the implementation of the paragraph 6 system. Our aim here is to
assess whether this system is indeed an expeditious solution for
countries lacking manufacturing capacity and to address any
shortcomings for the system’s effective operation.
As we have mentioned last meeting, the TRIPS Council and other fora
should analyze whether the economic and political incentives provided
by the system are adequate to secure investment in the production of
generic medicines at affordable prices. The fact that in seven years
there has been only one case of use of the system is strong evidence
that they are not.
The paragraph 6 system as well as other TRIPS flexibilities are tools
to help ensure access to medicines at affordable prices. This is
particular important in Brazil for our Constitution guarantees to all
citizens universal and equal access to health at no cost.
We would like to take this opportunity to present some aspects of our
HIV/AIDS program that may be of interes for our discussions today.
In Brazil, all persons living with HIV/AIDS are entitled to receive
free treatment, which includes the exams needed to monitor their
health and all the medicines for HIV and opportunistic diseases.
There are currently 201 thousand patients under treatment for HIV/AIDS
in Brazil. The number of patients increases by 30 thousand annually.
The estimated cost for the HIV/AIDS program in 2011 is 500 million
dollars, which means an annual cost per patient of 2500 dollars.
Advances in drug development have provided more effective treatment,
resulting in significant gains in terms of patients longevity. This is
an important achievement but also entails increased costs. As patients
develop resistance, more research and investment are needed to develop
next generation drugs. As a result, new generation drugs come at a
higher cost. The Brazilian government thus acts to reach a balance
between the rights granted to IPR owners and the interests of society
as a whole.
Currently, 57% of Brazil’s HIV/AIDS patients use second and third
generation antiretroviral drugs. The use of these new generation drugs
increase annually as the life expectancy of HIV patients in Brazil has
increased from 58 months in 1995 to 108 months in 2007.
In order to maintain the sustainability of the program, Brazil
continuously negotiates with drugmakers to reduce the price of anti-
retroviral and makes full use of the flexibilities provided at the
TRIPS Agreement. One example of such use is the issuance of a
compulsory licensing of the anti-retroviral drug Efavirenz, in 2007,
which is one of the most used medicines in the anti-retroviral
therapy. In 2007, 38% of the Brazilian patients were making use of it.
Because of the increase in costs due both to an increase in the number
of patients and to the use of new generation drugs, the costs related
to Efavirenz risked jeopardize the viability of the Program.
At US$ 1.59 a dose, the purchase of Efavirenz cost approximately US$
42.9 millions to the Brazilian Government, or US$ 580 per patient/
year. As a result of the compulsory licensing, the cost per dose was
reduced to US$ 0,43.
Let me conclude by saying that we remain committed to make the
necessary changes so that the paragraph 6 system can perform the
function it was designed to perform.
In this regard, we consider it is time to include other stakeholder in
this discussions so that we can better undertand why the system is no
being used and agree on ways to improve it."
Knowledge Ecology International (KEI)
thiru at keionline.org
Tel: +41 22 791 6727
Mobile: +41 76 508 0997
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