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Ministry of Health National STD/AIDS Programme

Universal Access to Antiretroviral Therapy: The Brazilian Experience. Ministry of Health National STD/AIDS Programme. BRAZIL FEDERATIVE REPUBLIC POPULATION (2000): 169,500,000 GNP PER CAPITA (1998): US$ 6,625 HDI RANK (1999): 74 th ( 0.747 )

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Ministry of Health National STD/AIDS Programme

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  1. Universal Access to Antiretroviral Therapy: The Brazilian Experience Ministry of Health National STD/AIDS Programme

  2. BRAZIL • FEDERATIVE REPUBLIC • POPULATION (2000): 169,500,000 • GNP PER CAPITA (1998): US$ 6,625 • HDI RANK (1999): 74th ( 0.747 ) • CUMULATIVE AIDS CASES (Dec/2000): 203,353 • ESTIMATED NUMBER OF HIV+ INDIVIDUALS (1998): 536,000 • AIDS INCIDENCE RATE (1999): 11/100,000 in hab.

  3. BRAZILIAN ARV ACCESS PROGRAM: MAJOR ASPECTS • UNIVERSAL AND FREE OF CHARGE ACCESS TO ARV DRUGS • NUMBER OF PATIENTS ON ARV TREATMENT (DEC/2000): 95,000 • NATIONAL ARV TREATMENT GUIDELINES • NATIONAL ARV LOGISTIC CONTROL SYSTEM: 424 DISPENSARY UNITS • NATIONAL NETWORK ON VIRAL LOAD: 70 LABORATORIES • NATIONAL NETWORK ON CD4+ CELL COUNT: 63 LABORATORIES

  4. Impact of Antiretroviral Therapy(1995 - 2000) • Reduced Mortality 40-70% • Reduced Morbidity  60-80% • Reduced Hospitalization • 234,000 avoided • Cost Savings U$ 711 million

  5. Multinationals Local Companies 5 4 1996 1997 1998 1999 2000 2.90 3 2.00 1.85 2 1.72 1.55 1.31 Cost per capsule or tablet (US $) 1.04 0.83 1 0.56 0.51 0.18 0.08 0 Indinavir cap 400 mg Saquinavir cap 200 mg Lamivudine tabs 150 mg Zalcitabine 0.75 mg Didanosine (ddi), 100 mg Zidovudine(ZDV), 100 mg Brazil: ARV Price Reduction According to the Source of Production 9% 72 % Source: MOH

  6. Cost Impact of the ARV Therapy generated by drugs between 1997-2000 • Net savings of US$ 200/250 million, between 1997 and 2000, considering as a basis 1997 prices and increase in the number of patients from 27.000 to 92.000; • Only in the year 2000 savings of US$ 80 million (approximately 30% of the total cost) with the beginning of the National Production of Nevirapine and Indinavir. • Savings of US$ 40 million in 2001 as consequence of the Agreement with Merck Sharp Laboratory

  7. Brazilian MoH & Merck Agreement on ARV Price Reduction (March, 2001) • 64,8 % Price Reduction on Indinavir U$ 1.33/capsule  U$ 0.47/capsule • 59,0 % Price Reduction on Efavirenz U$ 2.05/capsule  U$ 0.84/capsule

  8. Global Agreement for an Equitable Access to AIDS Treatment • Protection of local production of AIDS drugs legislation; • International funding for developing countries acquisition of AIDS drugs • Differential price policy of AIDS drugs for developing countries (equitable basis); • Incentives and subsidies to the researche and development of new drugs for public and private institutions. • International technical support to adequate use of antiretroviral drugs.

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