How can a policy foster local pharmaceutical production and still protect public health? Lessons from the health–industry complex in Brazil

ABSTRACT

The global health community is increasingly advocating for the local production of pharmaceuticals in developing countries as a way to promote technology transfer, capacity building and improve access to medicines. However, efforts to advance drug manufacturing in these countries revive an old dilemma of fostering technological development versus granting access to social services, such as healthcare. This paper explores the case of Brazil, a country that has developed large-scale health-inspired industrial policies, but is, yet, little understood. Brazil’s experience suggests that progressive healthcare bureaucrats can create innovative practices for technology and knowledge transfers. It also demonstrates that highly competitive pharmaceutical firms can collaborate with each other, if a government provides them the right incentives. Reforming regulatory policies is crucial for guaranteeing high-quality products in developing countries, but governments must play a crucial role in supporting local firms to adapt to these regulations. These findings send a strong message to global health policymakers and practitioners on the conditions to create a suitable environment for local production of medical products.

KEYWORDS:

• Local pharmaceutical production
• pharmaceuticals
• industrial policy
• health policy
• Brazil

Acknowledgements

I thank Nilson do Rosário Costa and Ken Shadlen for their comments on an early version of this article.

Disclosure statement

I declare no conflict of interest.

ORCID

Elize Massard da Fonseca http://orcid.org/0000-0003-3847-3105

Notes

1. Compulsory license is a flexibility of TRIPS that allows countries to override intellectual property protection of a patented drug or process, without the consent of the patent owner.

2. In Brazil, state bureaucrats are usually civil servants, but higher posts in public administration are political appointments. The country has a history of appointing health professionals to higher echelons of the health ministry (Falleti, 2010). Other scholars have also discussed the role of health bureaucracy in promoting AIDS policies (Nunn, 2008). Fonseca et al. (2017) discuss the incremental policy process of institutionalising health, science and technology, as well as the crucial period of the creation of SCTIE.

3. The consortium took nearly 2 years to deliver the first batch of EFV to the Ministry of Health and received some criticism over this lengthy process (Agencia Estado, 2009).

4. See detailed graphical analysis and methodology in https://goo.gl/69Kng7 (accessed June 19, 2017).

5. https://goo.gl/q34F4q, https://goo.gl/VrTKvu, https://goo.gl/GjYrMg (accessed June 19, 2017).

6. See a discussion on opportunity costs for AIDS treatment in Nunn, da Fonseca, Bastos, and Gruskin (2009).

Additional information

Funding

This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo Research Foundation (Fapesp) under grants number 2014/07725-3 and 2015/18604-5.