Sustaining Access to Antiretroviral Therapy in the Less-Developed World: Lessons from Brazil and Thailand.

Hdl Handle:
http://hdl.handle.net/10144/19975
Title:
Sustaining Access to Antiretroviral Therapy in the Less-Developed World: Lessons from Brazil and Thailand.
Authors:
Ford, N; Wilson, D; Costa Chaves, G; Lotrowska, M; Kijtiwatchakul, K
Journal:
AIDS (London, England)
Abstract:
ANTIRETROVIRAL ROLLOUT IN BRAZIL AND THAILAND: Brazil and Thailand are among few developing countries to achieve universal access to antiretroviral therapy. Three factors were critical to this success: legislation for free access to treatment; public sector capacity to manufacture medicines; and strong civil society action to support government initiatives to improve access. LOCAL PRODUCTION OF AFFORDABLE, NON-PATENTED DRUGS: Many older antiretroviral drugs are not patented in either country and affordable generic versions are manufactured by local pharmaceutical institutes. EFFORTS TO ENSURE ACCESS TO EXPENSIVE, PATENTED DRUGS: Developing countries were not required to grant patents on medicines until 2005, but under US government threats of trade sanctions, Thailand and Brazil began doing so at least ten years prior to this date. Brazil has used price negotiations with multi-national pharmaceutical companies to lower the price of newer patented antiretrovirals. However, the prices obtained by this approach remain unaffordable. Thailand recently employed compulsory licensing for two antiretrovirals, obtaining substantial price reductions, both for generic and brand products. Following Thailand's example, Brazil has issued its first compulsory license. LESSONS LEARNED: Middle-income countries are unable to pay the high prices of multinational pharmaceutical companies. By relying on negotiations with companies, Brazil pays up to four times more for some drugs compared with prices available internationally. Compulsory licensing has brought treatment with newer antiretrovirals within reach in Thailand, but has resulted in pressure from industry and the US government. An informed and engaged civil society is essential to support governments in putting health before trade.
Affiliation:
Médecins Sans Frontières, 522 Mooban Nakorn Thai 14, Ladphrao Soi 101/1, Bangkok 10240, Thailand. nathan.ford@london.msf.org
Issue Date:
Jul-2007
URI:
http://hdl.handle.net/10144/19975
DOI:
10.1097/01.aids.0000279703.78685.a6
PubMed ID:
17620749
Language:
en
ISSN:
0269-9370
Appears in Collections:
Health Politics; HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorFord, N-
dc.contributor.authorWilson, D-
dc.contributor.authorCosta Chaves, G-
dc.contributor.authorLotrowska, M-
dc.contributor.authorKijtiwatchakul, K-
dc.date.accessioned2008-03-06T14:17:29Z-
dc.date.available2008-03-06T14:17:29Z-
dc.date.issued2007-07-
dc.identifier.citationSustaining Access to Antiretroviral Therapy in the Less-Developed World: Lessons from Brazil and Thailand. 2007, 21 Suppl 4:S21-9 AIDSen
dc.identifier.issn0269-9370-
dc.identifier.pmid17620749-
dc.identifier.doi10.1097/01.aids.0000279703.78685.a6-
dc.identifier.urihttp://hdl.handle.net/10144/19975-
dc.description.abstractANTIRETROVIRAL ROLLOUT IN BRAZIL AND THAILAND: Brazil and Thailand are among few developing countries to achieve universal access to antiretroviral therapy. Three factors were critical to this success: legislation for free access to treatment; public sector capacity to manufacture medicines; and strong civil society action to support government initiatives to improve access. LOCAL PRODUCTION OF AFFORDABLE, NON-PATENTED DRUGS: Many older antiretroviral drugs are not patented in either country and affordable generic versions are manufactured by local pharmaceutical institutes. EFFORTS TO ENSURE ACCESS TO EXPENSIVE, PATENTED DRUGS: Developing countries were not required to grant patents on medicines until 2005, but under US government threats of trade sanctions, Thailand and Brazil began doing so at least ten years prior to this date. Brazil has used price negotiations with multi-national pharmaceutical companies to lower the price of newer patented antiretrovirals. However, the prices obtained by this approach remain unaffordable. Thailand recently employed compulsory licensing for two antiretrovirals, obtaining substantial price reductions, both for generic and brand products. Following Thailand's example, Brazil has issued its first compulsory license. LESSONS LEARNED: Middle-income countries are unable to pay the high prices of multinational pharmaceutical companies. By relying on negotiations with companies, Brazil pays up to four times more for some drugs compared with prices available internationally. Compulsory licensing has brought treatment with newer antiretrovirals within reach in Thailand, but has resulted in pressure from industry and the US government. An informed and engaged civil society is essential to support governments in putting health before trade.en
dc.language.isoenen
dc.rightsPublished by Wolters Kluwer Lippincott Williams & Wilkins - Archived on this site by kind permission Wolters Kluweren
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshBrazilen
dc.subject.meshDeveloping Countriesen
dc.subject.meshDrug Costsen
dc.subject.meshDrugs, Genericen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Services Accessibilityen
dc.subject.meshHumansen
dc.subject.meshPatents as Topicen
dc.subject.meshThailanden
dc.titleSustaining Access to Antiretroviral Therapy in the Less-Developed World: Lessons from Brazil and Thailand.en
dc.contributor.departmentMédecins Sans Frontières, 522 Mooban Nakorn Thai 14, Ladphrao Soi 101/1, Bangkok 10240, Thailand. nathan.ford@london.msf.orgen
dc.identifier.journalAIDS (London, England)en
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