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A study by Brown University and Harvard School of Public Health researchers has found that Brazil’s nearly two-decade effort to fight HIV/AIDS by making inexpensive generic medicines widely available, among other strategies, has been a success and could be emulated by others.
The study, published in the July/August issue of the journal Health Affairs, also involved Francisco Bastos, a well-known AIDS epidemiologist at the Oswaldo Cruz Foundation in Rio de Janiero, and Elize da Fonseca at the University of Edinburgh in Scotland.
It outlines how Brazil pursued controversial policies, starting in the early 1990s, such as passing a law guaranteeing free, universal access to drugs for AIDS treatment. The country also began producing generic AIDS medicines in public factories, and it pressured drug companies to sharply reduce their prices for patented medicines by threatening to produce generic versions well before the patents expired.
In addition, Brazil did extensive HIV education and prevention work, promoting HIV testing and widely distributing condoms. It targeted sex workers, drug users and gay men.
The United States and other countries originally opposed some of Brazil’s policies, but with Brazil’s help, the study found, global health and trade policies actually changed, and now former opponents invest millions to ensure continued access to generic AIDS drugs.
Brazil managed to keep its HIV/AIDS epidemic confined to 0.5 percent of the population; about 660,000 Brazilians now live with the disease.
“Brazil has proved it is possible to treat people with AIDS in developing countries,” said study lead author Amy Nunn, assistant professor of medicine at The Warren Alpert Medical School of Brown University. She added that the country saved more than $1 billion as a result of its pressures on the drug companies.
“Before Brazil’s efforts, as recently as the year 2000,” she said, “most people living with HIV/AIDS in developing countries died without receiving treatment.”
The research was funded by the U.S. Departments of State and Education, the National Institute on Drug Abuse and the National Institute of Allergy and Infectious Diseases.
