South America: Access to AIDS Meds Drives Down Mortality

AIDS mortality in Brazil, Chile, and Argentina has decreased greatly in the past decade due to programs providing universal free access to antiretroviral medications (ARVs). However, such programs may soon have to contend with rising prices for new drug formulas patented by large pharmaceutical companies.

Between 1996 and 2004, free ARVs in Brazil helped lower AIDS mortality by 27.5 percent; AIDS-related hospital admissions fell by 80 percent between 1996 and 2003. Chile initiated universal ARV coverage in 2003, and AIDS-related health indicators have improved, according to Patricio Novoa of Vivo Positivo, an umbrella group of HIV organizations.

Argentina's Health Ministry said that in 1996, before ARVs were available, AIDS mortality was at 60 percent. By 2004, mortality had dropped to 38 percent, said Kart Frieder of the nongovernmental organization Fundaciún Huesped.

UNAIDS considers Brazil's program, which offers 17 drugs, one of the most successful in the world. Generic drug production reduced the average annual cost of treating one patient from $6,240 in 1997 to $1,336 in 2004, said Mariangela Simao of Brazil's National Program on STDs and AIDS. The savings were achieved through government funding for manufacturing generic drugs and vigorous negotiations with transnational pharmaceutical companies to bring prices down.

The challenge now is to provide new, increasingly expensive drugs that are heavily protected by patents, according to Veriano Terto of the Brazilian Interdisciplinary AIDS Association. Frieder said the same obstacles may affect the Argentine program.

Doctors Without Borders, which provides ARVs for more than 80,000 HIV patients in 30 countries, is also concerned. An article on the group's Web site said spending on ARVs will double in the next two years as more patients have to move on to more expensive, second-line treatments.

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