US embassy cable - 05BRASILIA1188

UNCLAS SECTION 01 OF 02 BRASILIA 001188 
 
SIPDIS 
 
PLEASE PASS TO HHS FOR VGIDI 
PLEASE PASS TO NIH FOGERTY CENTER REISS 
 
STATE FOR OES/IHA KBLISS 
STATE FOR WHA/BSC 
STATE FOR WHA/ESPC 
 
E.O. 12958: N/A 
TAGS: TBIO, TPHY, KSCA, BR 
SUBJECT: BRAZIL HEALTH NEWS UPDATE 
 
REF: (A) BRASILIA 000804; (B) BRASILIA 001045 
 
SENSITIVE BUT UNCLASSIFIED 
 
1.  Summary:  Brazil's Ministry of Health has made headlines 
both domestically and internationally, primarily regarding 
HIV/AIDS programs and drugs. The GOB has demanded 
negotiations for voluntary licensing for key HIV/AIDS 
"cocktail" drugs; refused approximately US DOL 24 million in 
potential future USAID HIV/AIDS program funds for domestic 
programs and promised countries in Africa and the Caribbean 
support for their HIV/AIDS programs.  CDC support enabled 
the GOB to contain an outbreak of Chagas. (End of Summary). 
 
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Brazil Negotiates Voluntary Licensing To Produce HIV/AIDS 
Drugs 
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2.  As reported in reftel, on March 14, 2005, the GOB 
announced that it had sent letters to several multinational 
drug companies asking that they agree to the voluntary 
licensing of anti-retroviral drugs to allow the drugs to be 
produced in Brazil.  The Ministry of Health said the request 
was made because the cost of these drugs had reached 
unbearable levels, reportedly spending US DOL 217 million in 
2004. Brazil reportedly produces eight of the 16 drugs used 
in the AIDS "cocktail" and the Ministry believes local 
laboratories will be ready to produce others next year. 
 
In Brazil, HIV/AIDS medications are distributed at no charge 
to the 154, 000 patients treated by the public health 
network.  The Ministry of Health estimates it will care for 
180,000 patients in 2005. 
 
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Brazil Refuses USAID Funds To Fight HIV/AIDS 
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3.  On April 28, 2005, the GOB announced that its national 
HIV/AIDS program decided not to accept USAID funds to 
support their program because recipient NGOs would be 
required to have written policies opposing the promotion of 
prostitution, a USAID requirement that they believe goes 
against their national polices on health and human rights. 
Brazil's HIV/AIDS Program's Director, Pedro Chequer, 
dismissed the possibility of cooperation contracts between 
USAID and Brazilian non-governmental organizations, if it 
would require them to sign anything stating their opposition 
to prostitution. 
 
Chequer told the media that there is no way Brazil would 
give up its established policy of allowing access to 
condoms, syringes, and needles. Nor would the government 
allow Brazilian NGOs to be subject to foreign legislation, 
he said.  In Chequer's opinion, even though USAID financing 
is directed at NGOs, the involvement of the Brazilian 
government is fundamental. The approximately US DOL 24 
million in question is the remainder of a grant, that began 
in 2003 and was to run through 2008. 
 
Although an infraction, prostitution is not a punishable 
crime in Brazil.  There are programs aimed at promoting 
HIV/AIDS awareness among what Brazil refers to as 
"professional sex workers."  Brazil has the world's largest 
program of free distribution of drugs against HIV/AIDs and 
it is considered a model by many international institutions. 
Recently, however, the Brazilian HIV/AIDs program has 
undergone problems such as lack of condoms and drugs. 
 
Press guidance has been provided by S/GAC 
 
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Brazil Partners With Less Developed Countries On HIV/AIDS 
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4.  Media reports indicate that Brazil plans to share with 
less developed countries its expertise in fighting HIV/AIDS. 
Brazil's Foreign Minister Celso Amorin announced on March 
16, 2005, while on a visit to Mozambique, Brazil's intention 
to help the country fight HIV/AIDS by building a 
pharmaceutical plant there. On April 8, 2005, while visiting 
Nigeria, President Lula said that Brazil was in negotiations 
with the government of Nigeria to transfer technology for 
the production of anti-retroviral medicines. On April 11, 
Brazil announced an agreement with CARICOM to provide for 
the transfer of technology to manufacture HIV/AIDS drugs, to 
be operational later this year. 
- - - - - - - - - - 
CDC Supports GOB In Chagas Disease Outbreak 
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5.  Since February 2005, a total of 3 deaths and 25 persons 
with illness due to Chagas's Disease have been confirmed in 
Santa Catarina state, in southern Brazil.  Supervisors and 
epidemiologists in training from the U.S. Center for Disease 
Control (CDC) - sponsored Field Epidemiology Training 
Program in Brazil's Ministry of Heath are conducting a field 
investigation in collaboration with local and state public 
health experts. Nearly all the persons with Chagas's Disease 
who have been identified and interviewed reported drinking 
fresh sugar cane juice produced by one local vendor on the 
same day, and a high rate of illness was documented in 
employees in this location.  U.S. CDC experts (Atlanta) have 
provided technical assistance to the outbreak investigation 
team.  The Brasilia CDC office has provided supervisory and 
technical support for the field work and study design. CDC 
has offered laboratory and epidemiological collaboration, as 
part of their Field Epidemiology Training Office located in 
Brazil's Ministry of Health. 
 
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Comments 
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6. Health is just another area in which Brazil seeks a role 
for itself as a "leader" of the developing world. Ever since 
Brazil made its initial challenge in the WTO nearly five 
years ago over patent issues and the production of HIV/AIDS 
drugs, it has shown a willingness to challenge established 
norms.  In addition to the examples outlined in this cable, 
Brazil has recently implemented ethics regulations governing 
medical research involving human subjects. This may impact 
on those developed nations that chose Brazilian institutions 
as partners in medical research. Apparently, Brazil's health 
policies, as they relate to international collaborations, 
are going through a period of transition. 
 
DANILOVICH