The Political Economy of HIV/AIDS in Developing Countries
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The Political Economy of HIV/AIDS in Developing Countries

TRIPS, Public Health Systems and Free Access

Edited by Benjamin Coriat

The book is based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa. Focusing on the issue of universal and free access to treatment (a goal now taken to heart by the international community), it assesses the progress made and presents a rigorous diagnosis of the obstacles that remain, especially the constraints imposed by TRIPS and the poor state of most public health systems in Southern countries. In so doing, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where it continues to spread with devastating social and economic consequences.
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Chapter 6: Scaling Up and Reverse Engineering: Acquisition of Industrial Knowledge by Copying Drugs in Brazil

Maurice Cassier and Marilena Correa


6. Scaling-up and reverse engineering: acquisition of industrial knowledge by copying drugs in Brazil Maurice Cassier and Marilena Correa The Brazilian HIV/AIDS programme combines the local production of ARVs by public and private sector pharmaceutical laboratories with the free distribution of these drugs to patients. This was the case for firstgeneration ARVs, which were not under patent in Brazil before 1996, and currently applies to decisions concerning compulsory licences on secondgeneration ARVs, which are patented. By mobilizing public pharmaceutical laboratories to produce these generic drugs, the Brazilian state has gone beyond its role of protecting patients and the population; it has (again) become an entrepreneur and pharmaceuticals manufacturer (Cassier and Correa, 2003). At the same time it has mobilized private laboratories producing active pharmaceutical ingredients (API), with a view to creating industrial complementarity with public laboratories specialized in drug formulation – even if competitive situations between public and private laboratories have sometimes existed in the final drug market. Local production of ARVs and initially of AZT, launched in 1993 by Lafepe, a public laboratory in Recife, and Microbiologica, a private laboratory in Rio de Janeiro, has become a strategic element of both public health policy and industrial pharmaceutical policy. Local production is seen as the way to reduce the cost of ARVs for the Health Ministry (the argument was used to support calls for compulsory licences on Kaletra in 2005 and on Efavirenz in 2007). It was also hoped that ARV production would boost the Brazilian chemicals and pharmaceuticals industry, including...

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