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Brazil Active in Effort to Widen Global Access to Medicines

Fabíola Ortiz

RIO DE JANEIRO, Oct 20 2011 (IPS) - Brazil is keen to take part in the international effort to expand access to medicines and to produce its own drugs, and will start by becoming the world supplier of medicines to treat Chagas disease.

The announcement was made by Health Minister Alexandre Padilha at the World Conference on Social Determinants of Health, which opened Tuesday Oct. 19 in Rio de Janeiro.

Brazil plans to double its production of medicines to treat Chagas disease, in response to requests from multilateral aid organisations.

This South American country “will take on the commitment of guaranteeing worldwide production of medicines for Chagas disease. This is possible only because of our strategy of partnerships with public and private laboratories,” the health minister said.

Brazil already manufactures 1.2 million tablets a year of the medicine, according to estimates by the Pan American Health Organisation (PAHO).

“We were about to fill all the demand, but now we will increase production by 113 percent and also deliver 225,000 tablets to Médecins Sans Frontières, who made an urgent request,” Padilha said.

Production of benznidazole, the drug in question, will reach 3.4 million tablets by the end of this year.

In 2008, Brazil became the world’s only producer of the medicine, when the state LAFEPE laboratory in the northeastern state of Pernambuco purchased stocks of ingredients from Swiss pharmaceutical company Roche, which ceased to manufacture it.

Chagas disease is a potentially fatal infectious, fever-inducing disease caused by Trypanosoma cruzi, a parasite transmitted by direct contact with the faeces of the blood-sucking “vinchuca” bug, its carrier.

In Brazil, insect transmission has virtually been eliminated, but cases of chronic infection still abound.

Chagas disease occurs mainly in Latin America. According to the World Health Organisation (WHO), close to eight million people are infected in the 21 countries where the disease is endemic, half as many people as were infected in 1990.

Access to medicines is a key aspect of the right to health, Padilha said. “Partnership with domestic industry is essential to maintain the Unified Health System (SUS), which is publicly funded and offers universal care,” he said.

According to Padilha, Brazil has made progress over the past 23 years since the SUS was created, offering free health services to the entire population.

“But we still need to improve the quality of care, and increase accountability and control over public health resources. The nearly 40 percent decline in tuberculosis cases over the last 10 years has only been possible because of poverty reduction,” said the minister, referring to the 36 million Brazilians who have been lifted out of poverty in that period.

However, Brazil today is still an extremely unequal country, and access to health services reflects this reality.

One way of ensuring equity in access to treatment is to expand the production of medicines.

The minister took the opportunity to announce that a regulatory system will be implemented for the registration and production of biotech drugs for treating cancer and a number of infectious diseases.

“The idea is to have clearer rules, so that industries here in Brazil can produce these medicines,” Padilha said.

The National Health Surveillance Agency (ANVISA) in Brazil has approved two compendiums of rules for biotech products, which represent a new frontier in medicines.

According to Padilha, the measure is an important stimulus for national production of biotechnological pharmaceuticals, which will bring down prices and expand treatment and care of the population by the SUS.

Only one percent of the medicines used by SUS are the products of biotechnology. However, that small proportion uses up 34 percent of the SUS budget.

But “these products are a new frontier for safer and more effective treatments,” Padilha said.

“In recent Health Ministry negotiations for the purchase of cancer medicines, we managed to cut the cost by almost half. When we start to produce them here in Brazil, we will bring down the price even further,” he said.

The World Conference on Social Determinants of Health, organised by the WHO, is the largest to be held outside WHO headquarters in Geneva in the last 30 years.

Until Friday Oct. 21, representatives from more than 80 countries will be analysing strategies to combat social inequality, which has serious health consequences for their populations.

At the end of the meeting, the Rio Declaration will be adopted, formalising the political commitment of signatory countries to widen access to health services.

WHO Director-General Margaret Chan said Brazil was the most appropriate country for hosting this conference, because it has overcome many barriers that blocked universal access to public services.

Chan warned that without good access to social services, job opportunities, health, education, water, drainage and adequate housing, there would be growing inequality within and between countries.

Faced with the serious effects of the global financial crisis, the WHO wants governments to commit themselves not to cut spending on health.

The director-general said the mistakes of the 1970s should be avoided, referring to the multiple oil, food and financial crises, which resulted in a decline in investment in social services, health and education.

In 2008, when the financial crisis broke out, the WHO called on the relevant ministries to recognise the importance of counter-cyclical social investment.

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