Changing global essential medicines norms to improve access to AIDS treatment: Lessons from Brazil

Abstract

Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today.

Keywords:

• HIV
• AIDS
• treatment
• Brazil
• human rights
• trade
• access
• drugs
• essential medicines

Notes

1. The WHA is the World Health Organisation's decision-making body and has 192 member delegates from each of the world's nation states.

2. Article 27:1 of the TRIPS Agreement reads ‘Patents shall be available and patent rights enjoyable without discrimination as to the place of invention, the field of technology and whether products are imported or locally produced’.

3. The UN Commission on Human Rights’ historical mandate was to examine, monitor and report on human rights situations and violations worldwide. The institution was historically comprised of 53 member states elected each year. The UN Commission on Human Rights (UNCHR) was replaced by the Human Rights Council in 2006.

4. The Sub-Commission on Human Rights was a subsidiary body of the Commission on Human Rights, comprised of 26 experts representing the world's different regions.

5. The prequalification process is a quality assessment and bioequivalence testing process designed to enhance access to high-quality drugs for AIDS, malaria, tuberculosis and reproductive health. To gain official WHO prequalification status and to be used in any programmes funded by UN agencies, both patented and generic drugs must meet bioequivalence, good manufacturing, laboratory and clinical practices.

6. Developing countries included a group of African nations, which called itself the ‘Africa Group’, Bangladesh, Barbados, Bolivia, Brazil, Cuba, Dominican Republic, Ecuador, Haiti, Honduras, India, Indonesia, Jamaica, Pakistan, Paraguay, Philippines, Peru, Sri Lanka, Thailand and Venezuela.

7. Parallel importation occurs when patented drugs are produced and sold in one market and then imported into a second market without authorisation of the patent holder in the second market.

8. Although several developing countries tried to include clauses stating that the right to health takes precedence over commercial interests into the resolution, the movement ultimately failed.