May 04, 2007
Brazil To Break Merck Patent
SAO PAOLO, Brazil -- It is fascinating to be sitting here reading today´s news that Brazil has moved one step closer to breaking a patent on an important HIV/AIDS drug produced by Merck. Brazil doesn´t have much of a generic manufacturing industry, but its state-owned drug producers are quite adept at buying drugs from India and China and repackaging them for the state-run health service, which services most of the population.
There are two Brazils. Beyond the post-modern facade of this sprawling metropolis (second largest city in the world after Mexico City) lies a country where the extremes between rich and poor defy easy description. I spent most of this week in the wilds of Minas Gerais province, where two-thirds of the 19 million people are at risk of parasitic diseases like hookworm, schistosomiasis and Chagas disease.
The least well off among them still eke out a living as subsistence farmers. They live so remotely that a Ford 4x4 took two hours to traverse the 20 miles that separated the village I was visiting from the closest paved road. These poorest of the poor live in mud huts without running water or electricity. Sanitation -- toilets or outhouses -- is non-existent. Many are illiterate.
Even the relatively well-off in the 1000-person village and the better-off farms that have electricity (and thus lights, small refrigerators, and satellite dish-fed televisions) live without proper sanitation facilities. As a result, upwards to 60 percent of the population in the district I was visiting suffers from a half dozen parasitic diseases like hookworm, Chagas disease, and schistosomiasis.
AIDS is not much of a problem in rural Brazil. But in a country that is struggling to provide health care for all of its people, every real (pronounced hey-al) that the health ministry spends for Merck´s drug is a real that can´t be spent on the health care teams that travel between villages deworming the peasants. If left untreated, they suffer from the iron deficiency anemia, lost work days and intellectual impairment caused by the parasitic worms that have infected their bodies.
I´ll have lots more to say about Brazil´s health care system and the state of its economy and politics when I return from this week-long working vacation. But from this vantage point, the argument that Brazil or other developing countries have to contribute to the drug industry´s profits on AIDS drugs in order to sustain research and development rings hollower than ever. These companies invest almost nothing researching cures for the diseases that are causing the most harm in countries like Brazil.
Posted by gooznews at May 4, 2007 04:50 PMJeez, I feel soooo sorry for the pharmaceutical company execs, why their trophy wives will just have to suffer with last year's Mercedes 600 series. Oh the shame! Oh the horror! How unfair that the impoverished want to stay alive because they can't afford the extortionary pricing by the profiteering pharmaceutical companies. Shame on them! It seems like Brazil is making a move that puts the hipppocratic oath (dedication to healing the sick) above monopolisitc extortion. How dare they! What will become of medicine if these horrors are allowed to continue????
Posted by: Arne Paul at May 4, 2007 08:12 PMDear Mr. Goozner,
I appreciate your work a lot, your "800 million dollar pill" book has been a very important resource for me (I'm a researcher and postgraduate professor in public health in Brazil), and I appreciate a lot your website as well.
With regards to the current post, however, I'd take the statement that 2/3 of the population of Minas Gerais state (not province) live in rural areas with a grain of salt. 85% per cent or more of the Brazilian population live now in urban areas, and actually this compounds the problems of poverty, because a large part of the swelling of the big cities came from people fleeing the countryside, and they make up the most part of the population living in the "favelas" (shantytowns) of the big cities, where the situation is really dire as well.
I am posting in a hurry, but I'll check the official figures and will get the accurate info for you later.
Regards,
Ken
An update:
I checked an official document (http://www.cedeplar.ufmg.br/diamantina2002/textos/D56.PDF) from the Minas Gerais government (we have state governors, as in the US), based on the Brazilian Geography and Statistics Institute (IBGE), which states that the population in Minas Gerais is 82% urban. Whoever told you that two thirds of the population in that state live in rural areas was wrong.
Ken
Posted by: Ken Camargo at May 5, 2007 04:26 PMKen is right; I was mistaken in writing that two-thirds of the population makes its living from subsistence agriculture in Minas Gerais, and I've now changed it in the posting. I was told by an official in the state's ministry of health that two-thirds of the population are at risk of hookworm, schistosomiasis and other parasitic diseases.
But I want to quarrel with the idea that 85 percent of the state's population, or Brazil's population, is urban just because they are no longer farmers. The town I was visiting, for instance, had about 1,000 people. They were not farmers; from what I could see, they earned their living as day laborers, either on farms near town or in construction. Underemployment seemed pervasive. Virtually the entire town lacked indoor plumbing, and the favela (yes, even this rural village had its own slum) didn't even have outhouses.
Belo Horizonte, the capital of Minas Gerais, is a relatively well-off city of three million. But the bus that took me to the northeastern corner of the state passed through many towns that appeared quite poor. I think the health ministry official was suggesting that a sizable portion of this "urban" population is also susceptible to the parasitic diseases that are endemic in the farm areas.
Thanks, Ken, for helping me clear that up. I was writing hastily from my hotel on Saturday before rushing to the airport, and mistakenly conflated the idea that two-thirds of the population was at risk with the proportion of the population working in subsistence agriculture.