The rising costs of drugs is threatening Brazil's ability to provide free AIDS medication to all patients needing it, according to a study that will be presented at the UN next week.
Experts say Brazil's AIDS-treatment program has reached a crossroads due to the increased funding needs.
"There are two choices: Either the government spends more on AIDS and less on other diseases, or the quality of the AIDS treatment suffers," said Alexandre Grangeiro, a former director of Brazil's anti-AIDS program who helped develop the study.
The study will be presented at an Extraordinary Session of the UN General Assembly on HIV and AIDS running from tomorrow to Friday.
Brazil's AIDS treatment program has been praised by the UN as an example for other developing countries fighting to control the deadly epidemic.
Thanks to the treatment program and aggressive prevention efforts, Brazil has been largely successful in managing to stabilize the epidemic. The death rate among men has fallen from 15.1 deaths per 100,000 in 1995 to 8.8 per 100,000 in 2004.
Between 1980 and 2004 171,923 Brazilians have died of AIDS.
But as the virus becomes more resistant and patients require newer drugs, the program also has become more expensive.
According to the study, the cost per patient jumped 50 percent between 2004 and last year, from 4,000 reals (US$1,800) a year to 6,000 reals.
At the same time, costs for AIDS drugs -- all manufactured in the US or Europe -- grew to nearly 1 billion reals, up from 700 million reals the year before.
The Brazilian program was significantly cheaper in the 1990s, when the country produced generic versions of AIDS drugs patented before it signed its intellectual property law in 1996.
Since then, Brazil has occasionally threatened to break patents on the grounds it faces a national health emergency, which is allowed under WTO rules. But so far, the government has reached agreements for big discounts from producers and has not broken a patent.
Now Brazil has no generic equivalents ready to use, and its threats to break patents have lost their punch, said Grangeiro, who is now the director of the Sao Paulo state Health Institute.
Mariangela Simoes, the head of the government's anti-AIDS program, said the government had made a decision to contain costs solely through negotiation.
"The government is committed to following the law that says it will provide anti-AIDS medicines to people who need them," Simoes said. "Whether that affects treatment for other diseases is a question of the Health Ministry's priorities."