Abstract
We posit that an innovation system developed in Brazil’s health industry during the AIDS epidemic, from the 1990s onwards, and based on universal access to treatment, the local production of generic medicines, and public and citizen-based regulation of intellectual property and the markets. This model inspired the World Health Organization (WHO) in the early 2000s and continues to inspire humanitarian organizations such as the Drugs and Neglected Diseases Initiative. It does nevertheless have weaknesses and disparities: there has not been a sufficient increase in public health spending, and the shortcomings of the pharmaceutical raw materials industry are still evident. We posit, however, that the institutions, technological capacities and health democracy underpinning this innovation model are likely to withstand the economic and political crisis, and may even provide resources to overcome it. In December 2017, during a time of stagnant growth in Brazil, the Ministry of Health decided to set up 25 additional Product Development Partnerships to supply the public health system and learn new technologies.
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Notes
- 1.
“Brazil’s health system woes worsen in economic crisis”, Jonathan Watts, The Lancet, 16 April 2016.
- 2.
ANVISA : Agencia Nacional de Vigilancia Sanitaria.
- 3.
Tina Rosenberg, “Look at Brazil”, The New York Times Magazine, January 28, 2001.
- 4.
Law 742, Ministry of Health, November 2007; Laws 374 and 375, February 2008; Presidential Decree, 12 May 2008; list of strategic products that justify the creation of the health industrial complex, 16 May 2008.
- 5.
“Ministerio da Saude anuncia novas PDP destinadas a fabricaçao de medicamentos e equipamento de saúde”, INVESTE SAO PAULO, 8 octobre 2015.
- 6.
The BNDES has a special programme, Profarma, for funding the pharmaceutical industry.
- 7.
A synthesis report on Brazil, published by the OECD in November 2015, highlighted both the progress made in access to treatment, with the implementation of the unified health system (SUS) in 1988, and the persistent insufficiency of public spending on health (OECD Economic Surveys, Brazil, synthesis, 51 pages).
- 8.
- 9.
Interview with Jaime Rabi, April 2003.
- 10.
Interview with Eloan Pinheiro, April 2005.
- 11.
FACT: Fixed-Dose Artemisinin Combination Therapy.
- 12.
- 13.
The federal government did finally renew the compulsory license decree for the remainder of the process patent’s validity, until 2014.
- 14.
Our interviews with Jaime Rabi in April 2003, November 2014 and December 2016. Jaime Rabi sat on the Pharmasset Board in the late 1990s.
- 15.
“Structure and innovation in pharmaceutical industry in Brazil: the impact of generics drugs”, Thiago Caliari and Ricardo Ruiz, 2010, 16 pages. These authors took into account the following indicators to measure the innovation rate: 1- product innovations; 2- process innovations; 3- patent applications filed at the national patent office; 4- ongoing R&D activity; 5- employees’ above-average education; 6- the firm’s exports; 7- the firm exports and get a premium price.
- 16.
The results of a survey of 16 biotechnology and pharmaceutical firms in 2008 likewise indicated the positive impact of the ARV copying programme on innovation: “Another recent example includes the partnerships between public pharmaceutical laboratories and private national pharmo-chemical firms for the national production of anti-retroviral medication to supply the national program to care for AIDS patients. Partnerships of this sort show the importance of joint action by system players to promote innovation and development in the country”, Innovation in Brazil: Public policies and business strategies, Ricardo Sennes, 46 pages.
- 17.
In this volume, see the Chap. 2 by Cristina D’Almeida: “Knowledge Generation and Laboratory Capacity Building in the Fight against HIV/AIDS in Brazil: Experiences on the Development of a Heat-stable Formula tion Comprising Rito navir”.
- 18.
- 19.
“I’MAK is a team of lawyers and scientists increasing access to affordable medicines by making sure the patent system works” (I-MAK).
- 20.
“National Drug Policy”, Ministry of Health, Brazil, February 2001, 21 pages.
- 21.
The recent report “The Brazilian Innovation System: a Mission-oriented Policy Proposal”, Marianna Mazzucato, Caetano Penna, 2016, Cgee, 114 pages, also highlights the emergence of an innovation sub-system in the health sector, p. 12 and 82.
- 22.
See the WHO study “Local Production and Technology Transfer to Increase Access to Medical Devices. Addressing the Barriers and Challenges in Low and Middle-income Countries”, 2012, on the development of new technological firms in Brazil, p. 34.
- 23.
Thiago Caliari, Roberto Mazzoleni and Luciano Martins Costa Povoa (2013) point out the growing role of Brazilian universities and public research organizations in patenting, and their importance in the chemicals, biotechnology and pharmaceutical sectors: “Innovation in the pharmaceutical industry in Brazil post-TRIPS” in TRIPS Compliance, National Patent Regimes and Innovation, edited by Sunil Mani and Richard R Nelson, Edward Elgar, pp. 29–30; see also “University and Patenting in Brazil”, Ana Lucia Vitale Torkomian, Marli Elisabeth Ritter dos Santo, Helice, volume 2, 2013, Issue 1; Rosana Ceron di Georgio: “From University to industry: Technology Transfer at Unicamp in Brazil”, Handbook of best practices, 2007, pp. 1747–1752; OECD 2008, Science and Innovation Outlook, country notes, p. 164.
- 24.
Joseph Fortunak and Octavio Antunes, 2006, “ARV Production in Brazil: an evaluation”, Report for the Brazilian Interdisciplinary AIDS Association (ABIA ) and MSF Brazil.
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Cassier, M., Correa, M. (2019). General Introduction. In: Cassier, M., Correa, M. (eds) Health Innovation and Social Justice in Brazil. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-76834-2_1
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