Hopkins program sends journalists to Brazil during health policy breakthrough

CNN's Roy Wadia, one of the 12 U.S. journalists selected to participate in the Pew Gatekeeper Fellowship program at Johns Hopkins, reports on a major policy breakthrough on the world market, concerning AIDS drug therapy.

In an effort to combat the growing problem of AIDS, Brazil has enacted a policy to manufacture generic AIDS drugs for its own use. Brazil's Health Minister Jose Serra saw this policy as the best method available to distribute the AIDS medication free, under the public health system, to the patients suffering from the disease.

The World Trade Organization has estimated that Brazil would reach nearly 1.2 million HIV/AIDS cases by 2000, however government predictions place the number of cases at about half that amount.

Several large U.S. pharmaceutical companies have disputed the policy due to fears that Brazil could force foreign companies to manufacture AIDS medications in Brazil if the country declared a state of HIV/AIDS emergency.

These companies wanted to bring the case before the World Trade Organization. In response, Serra sent off Paulo Teixeira, Brazil's AIDS policy chief, to Geneva, Switzerland, to testify before a WTO panel in defense of Brazil's policy. Brazilian diplomats and U.S. organizations that support Brazil's policy lobbied the Bush Administration to repeal the WTO hearing. Brazil has also initiated a media campaign, in an effort to spread awareness of its AIDS policy.

One ad shows a picture of a mother holding a child and reads, "Local manufacturing of many of the drugs used in the anti-AIDS cocktail is not a declaration of war against the drugs industry. It is simply a fight for life."

Confronted with international pressure and the public relations problems that might result, Washington gave in and conceded not to bring the case before the WTO.

The U.S. Embassy in Brazil said in a statement, "This dispute was not about health or access to drugs. The United States never sought or intended to undermine Brazil's successful anti-AIDS effort. Let there be no mistake; we applaud this effort."

In addition to this victory Brazil was selected as a poster-child of health care policy at the United Nation's special session on HIV/AIDS, because it is the only developing nation currently employing an effective strategy to help combat AIDS.

In response to questions from U.S. journalists who were part of the Pew Gatekeeper program, Serra said, "Frankly, I'm surprised there is an international dispute at all, and we're surprised at the United States taking up the issue."

Speaking to the finances reasons for the policy, Serra highlights the high costs of brand-name AIDS therapies, "The drugs' prices are about 10 times their cost. Is this necessary to finance investment and research as their manufacturers claim? I don't think so."

Many different private organizations and government sectors have pulled together to support Brazil's health policy.

"Our politicians have taken a lead in the anti-AIDS campaign for many years now," said Rosemeire Munhoz, a top adviser on AIDS issues to Brazil's health ministry. "As important, the private sector is involved - we have a business council of 22 top companies who work together on AIDS awareness programs. And, thankfully, many religious leaders and NGOs (nongovernmental organizations) are very interested in working with the government."

Brazil's social openness towards the subject of sex has helped in the fight against HIV/AIDS. Sex education begins in school at an early age.

Even parts of the Catholic Church are assisting, "The church is divided, but there are some sectors that cooperate with the government," Munhoz said. "We know of priests and nuns who advise people to use condoms. And there's a church in Fortaleza where they've distributed condoms in the church itself."

Brazil's social liberalness towards sex does not extend to gay men, many of whom keep their sexuality secret.

"So you do find that men who have sex with other men hide behind marriages to women," said Dr. Artur Olhovetchi Kalichman. "Many of these men don't take precautions - they get infected; they infect their wives."

Brazil's strategy may serve as a model for other counties in their efforts to combat AIDS.

"Our example," Serra said, "could serve as a model for other countries in Latin America, the Caribbean, even Africa. Everyone in the world has the right to access these therapies."

Serra has plans to keep the generic drugs updated with advances in AIDS therapies through partnerships with U.S. companies.

The humanitarian organization, Doctors Without Borders, has already announced that it plans to implement AIDS treatment plans modeled after Brazil's in countries in Africa, Asia and Latin America.

Well, negotiations are under way with Merck and other companies to work more closely together hopefully," Munhoz said. "We've already achieved significant price reductions for two of the recent therapies. But in the future, we frankly want more flexibility when it comes to licenses and other legal issues. Are we going to talk about this in terms of breaking a patent or saving lives?"

The Pew International Journalism Program, which sponsored the journalists to go on this fact-finding trip to Brazil is part of the School of Advanced International Studies (SAIS) at Johns Hopkins University.

Founded in 1998 on a grant from the Pew Charitable Trusts, the program selects two groups of U.S. journalists to participate in a 15-week program based at Johns Hopkins. Journalists with at least three years of experience are eligible for the program which consists of seven weeks of daily seminars with speakers from SAIS and other leading institutions in the nation's capital, as well as participating in SAIS classes, and 5 weeks spent traveling to the country of the student's choice to gather research for an important global story. Deadlines for applications are April 1 and Oct. 1 each year.