A recent agreement between Latin American governments and global drug companies to reduce the price of AIDS medicines is another step forward in treating those diagnosed with the disease, say AIDS activists.
But Brazilian health officials continue to push international drugmakers to reduce prices. And regional AIDS activists say authorities must be more pro-active in identifying carriers of the HIV virus if they want to reduce hospitalizations, save on drug expenditures, and help destigmatize the disease.
Early diagnosis of the virus allows physicians to prevent full-blown AIDS from developing quickly, says Jaime Galindo, a doctor with the Fight Against AIDS Corporation, a Colombian nongovernmental organization. It benefits all taxpayers, because it can substantially reduce the cost of healthcare over the long term and negotiate for volume discounts from the makers of antiretroviral drugs.
Early diagnosis, Dr. Galindo says in a telephone interview from Cali, Colombia, "can not only improve their quality of life but they also save money in hospitalizations down the road. On top of that, the more people who are identified with having the disease, the easier it becomes to negotiate for price reductions with drug companies." Galindo says governments should offer free testing and be more aggressive in explaining to people why it is in their best interest to know if they have the disease.
Two weeks ago, health ministers from Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, Paraguay, Peru, Uruguay and Venezuela signed a landmark agreement with 26 drug companies in Buenos Aires to lower the cost of antiretroviral medicines by between 15 and 55 percent.
The deal sets a ceiling price for AIDS medicines sold in the region, and was achieved largely because of the negotiating power of Brazil, the regional powerhouse that has half of South America's GDP and population, plus around two-thirds of the HIV/AIDS cases.
Drugmakers say that Brazil's economic size means it can afford to pay for the cost of the drugs, which includes years of expensive research work. And Brazil has signed international treaties that say it will honor intellectual property rights and patents.
Brazil took the regional lead in the fight against AIDS in 1996 with an ambitious program that sought to distribute anti-retroviral drugs free of charge. By making its own generic drugs - and then by wrestling concessions from international pharmaceutical giants - Brazil dramatically reduced the amount it spends on antiretroviral medicines.
In 1997, the government spent about $139 million to give medicine to 36,000 people. In 2004, it spent 621 million reais ($220 million) to ensure four times as many people got free treatment.
Brazil's AIDS mortality rate has fallen by 50 percent in less than a decade, and the average survival time for someone diagnosed with the disease has risen from six months to nearly five years. Although the World Bank predicted the number of AIDS cases in Brazil would hit 1.2 million by 2000, the number today is around half that, says Pedro Chequer, the director of Brazil's AIDS treatment program.
Mr. Chequer complains that the major pharmaceutical companies still overcharge for the retroviral drugs used to treat AIDS patients. Last month negotiated better rates for Kaletra, an antiretroviral drug made by the US firm Abbott Laboratories. But Brazil is again threatening to break the patent and produce the drug itself because it says it can make a pill for 76 cents cheaper than the $1.17 charged by the Abbott Park, Ill. firm.
Today, the nine imported AIDS drugs use up 80 percent of the drug budget, Brazilian officials say. A bill allowing the breaking of drug patents is working its way through Brazil's legislature.