Brasília, July 8, 2003 (Agência Brasil - ABr) - Starting in August, Brazil will make regular supplies of anti-retrovirus drugs available to ten countries chosen to serve as pilot projects for the treatment of HIV and Aids victims. The anti-Aids cocktails, which will be provided by the Brazilian government to one hundred patients in each country, for the period of one year, are estimated to be worth US$ 1 million. The governments of El Salvador, Guyana, the Dominican Republic, Colombia, and Paraguay, in the Americas, and Namibia, Burundi, Kenya, Burkina Faso, and Mozambique, in Africa, will assume responsibility for continuing the treatment of the patients, after the conclusion of Brazil's collaboration. The trip that President Luiz Inácio Lula da Silva will make to Africa, at the beginning of August, will serve to initiate the treatments that will be conducted in Mozambique and Namibia.
Nonetheless, children from the Nyumbani day-care center, in Nairobi, the capital of Kenya, have already begun treatment. Since 2001, 70 orphans who are bearers of HIV have been receiving vials of oral Zidovudina, which is part of the composition of the cocktail, through the aid of international solidarity movements. Donations began that year after a desperate appeal from Father D'Agostini, an Italian who has dedicated himself to the care of needy African children. The Brazilian donations, amounting to around 2,200 vials of Zidovudina, were made directly from the Pernambuco State Laboratory (Lafepe), but they have not been regular.
However, beginning in August, the supply will be regularized, since the Nyumbani day-care center was the Kenyan institution chosen by the Brazilian government to participate in the International Cooperation Program for Projects to Control and Prevent HIV-Aids in Developing Countries, launched last July by the Ministry of Health at the International Aids Conference, in Barcelona, Spain.
The shipment of the medications was preceded by a visit made by specialists from the National STD-Aids Coordination Office to these countries to help set up the projects, including the list of patients who will be helped. Currently, over 90% of the 40 million people who have contracted the disease virus live in poor or developing countries, and only 250 thousand have free access to anti-retrovirus drugs. Among them, 115 thousand are Brazilians, on whom the Ministry of Health spends around R$ 500 million per year.
PATENTS OR GENERICS?
Of the fourteen medications that make up the anti-Aids cocktail, Brazil produces seven. According to Alexandre Grangeiro, deputy-coordinator of the Brazilian Ministry of Health's STD-Aids Program, new drugs that arrive on the market cannot always be incorporated into the cocktail provided to disease victims, due to lack of means to pay the high prices charged by laboratories. The solution, therefore, is to make it easier to break patent rights, so as to permit the production or purchase of generic drugs from other suppliers. This applies both to the treatment of infected Brazilians and international cooperation prorams.
This is what Brazil is currently demanding in the medical sector of the World Trade Organization (WTO). The country demands the undisputed application of the WTO's Doha Declaration, signed in 2000, putting the interests of health above all commercial considerations. "The declaration goes into effect automatically, in this sense, without restrictions," Grangeiro affirmed. At the end of May, the 56th World Health Convention (WHO) decided that the debate over access to medications to treat diseases such as Aids is a question of public health. This proposal, formulated by the Brazilian government, with support from Africa and countries in Latin America and Asia, encountered stiff opposition. Representatives of developed countries, especially the United States, objected, offering proposals to establish strict measures to protect intellectual property.
The new position of the WHO may make it possible to introduce flexibility into the International Intellectual Property Treaty (Trips) for medications necessary for the maintenance of public health. In September, in Cancun (Mexico), the regulamention of the Doha Declaration's Article 6, which envisions trade in generic drugs among developing countries, will be determined.
Grangeiro explains that flexibility is different from breaking a patent, which is equivalent to ignoring industrial property. "Flexibility is temporary, in the public interest, and, eventually, royalties may be paid, but it makes it possible to combat monopoly - the exclusive use of the patent."
RESTRICTIONS ON BRAZIL
Countries like the United States, Switzerland, and Japan, want the Doha Declaration to be applied exclusively to diseases such as tuberculosis, malaria, and Aids, in developing countries, which should furnish a list of the diseases for which generic drugs can be produced. The coordinator argued that acceptance of this norm would greatly restrict the fight against other diseases that are seasonal or epidemic. "In Brazil, we have asthma as one of the big causes of hospitalizations, as well as diabetes and chronic kidney disease. To exclude any one of these diseases, as well as degenerative diseases in general, such as all kinds of cancer - highly profitable for the laboratories - would rule out the treatment of millions of people," he affirmed.
These issues will be decided at the WHO meeting in Cancun, in September. Prior to that, however, a preliminary meeting will be held in Egypt, in August, to prepare for the final debate. As these meetings grow closer, emotions heat up. Last week various American pharmaceutical companies requested that the American government include Brazil on a list of countries to be sent to the WHO, to prohibit them from importing generic drugs. "They fear that we can produce generics to compete on the international market. But they ignore the fact that the prices these industries charge are out of touch with our realities," he concluded. (DAS)
