Galvão Jane
Fogarty International AIDS Training Programme, School of Public Health, University of California, Berkeley, CA, USA.
Lancet. 2002 Dec 7;360(9348):1862-5. doi: 10.1016/S0140-6736(02)11775-2.
Since 1996, the Brazilian Ministry of Health has guaranteed free and universal access to antiretroviral treatment for people living with HIV/AIDS. Implementation of this policy has had political, financial, and logistical challenges. I have investigated the history and context of antiretroviral policy in Brazil, the logistics of the drugs' distribution, and the government's strategies for acquisition of the drugs. Many antiretrovirals used in Brazil are produced domestically; the remainder, including some of the most expensive drugs, are purchased from abroad. Although the Brazilian policy of antiretroviral distribution has had notable success, it remains threatened by the high cost of acquisition of drugs, which has led to disputes with international pharmaceutical companies over prices and patents. Whether or not the Brazilian model of guaranteeing access to antiretroviral treatment for people living with HIV/AIDS can be applied in other countries or regions, much can be learnt from the country's experience.
自1996年以来，巴西卫生部一直保障艾滋病毒/艾滋病感染者能够免费普遍获得抗逆转录病毒治疗。这项政策的实施面临政治、财政和后勤方面的挑战。我研究了巴西抗逆转录病毒政策的历史和背景、药物分发的后勤工作以及政府获取药物的策略。巴西使用的许多抗逆转录病毒药物是国内生产的；其余药物，包括一些最昂贵的药物，则从国外购买。尽管巴西的抗逆转录病毒药物分发政策取得了显著成功，但它仍然受到药物采购成本高昂的威胁，这导致了与国际制药公司在价格和专利方面的争端。无论巴西为艾滋病毒/艾滋病感染者保障抗逆转录病毒治疗的模式能否应用于其他国家或地区，该国的经验都有很多值得借鉴之处。
