Generic antiretroviral manufacture has saved Brazil US$ 1 billion.

Brazil’s policy on AIDS drugs has saved the country around US$ 1 billion since 2001, a new study in PLOS medicine has found.

In 1996, Brazil became the first developing country to commit to universal access to antiretroviral AIDS drugs for all HIV positive Brazilians that needed them. To achieve this goal, the country significantly expanded its drug manufacturing capabilities, and today produces eight different antiretroviral drugs (ARVs) in ‘generic’ (i.e. copied) forms. For drugs that are still within their patent period and cannot be copied under intellectual property laws, Brazil has either broken the patent using a compulsory license (in the case of efavirenz) so it can import generic versions from abroad, or it has negotiated significant price reductions for the brand named versions.

The bold programme has proven controversial with major pharmaceutical companies and the US Trade Representative, as they see it as breaching the intellectual property rights of the original manufacturer. However, under World Trade Organisation guidelines, Brazil’s actions are completely legal.

The study, published by researchers at the Harvard School of Public Health in the United States, described Brazil’s efforts and the $ 1 billion saving as “remarkable”, yet they also warned that the relatively high cost of generic ARVs in Brazil, and the increasing HIV positive population may cause problems in the future. The lack of competition for generics manufactured in the country (all are produced on government orders) means that they are more expensive than generics found in other nations (such as in India). The country has an adult HIV prevalence rate of 0.5% and is currently treating around 180,000 people, with numbers growing all the time.

The study’s authors hope that their work will be of use to other developing countries facing an ever-expanding bill for antiretroviral treatment.

“The trends this study highlights provide important information about how AIDS treatment costs are likely to evolve in other developing countries as efforts are made to provide universal access to life-saving ARVs.” the researchers stated. “The specific application of the Brazilian model to other countries will depend, however, on the strength of their health systems, intellectual property regulations, epidemiological profiles, AIDS treatment guidelines, and differing capacities to produce drugs locally.”

AVERT.org has more about AIDS in Brazil and generic antiretroviral treatment.