HIV This Week

Changing global essential medicines norms to improve access to AIDS treatment: lessons from Brazil. Nunn A, Fonseca ED, Gruskin S. Glob Public Health. 2009;4:131-49.

Brazil ’s large-scale, successful HIV treatment programme is considered by many to be a model for other developing countries aiming to improve access to HIV treatment. Far less is known about Brazil’s important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil’s interest in preserving its national HIV treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up HIV treatment. This paper analyses Brazil’s contributions to global essential medicines policy and explains the relevance of Brazil’s contributions to global health policy today.

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Editors’ note: This interesting chronological narrative traces the far-reaching impact of Brazil’s efforts to preserve its domestic HIV treatment policies, which are based on legal commitments to provide universal access to antiretroviral drugs to its people, and yet recognise intellectual property rights. Brazil acted through the United Nations Commission on Human Rights, the United Nations General Assembly, the World Health Assembly, and the World Trade Organisation to improve access to essential medicines. Improved transparency about drug prices, generic drug use to address public health needs, incorporation of antiretroviral drugs into the WHO Essential Medicines List, strengthened TRIPS flexibilities for developing countries, and the defining of access to medicines as part of the human right to health can all be traced to a strong Brazilian influence in shaping global policy.