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Intervention of Brazil to the WTO TRIPS Council (March 2011) providing details about the Brazilian HIV treatment program
01 มีนาคม 2554
Date: 1 March 2011
Source: www.keionline.org
Link: http://keionline.org/node/1086
Brazil made the following intervention at the WTO Council for TRIPS during
discussions of the paragraph 6 system.
"Mr.
Chairman,
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.
Mr. Chairman,
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.
Mr. Chairman,
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 understand why the system is no being
used and agree on ways to improve it."