Brazil's approach to its HIV/AIDS epidemic has emerged as a model for developing countries. Brazil's own health officials credit much of their success to the early adoption of a policy of universal access to antiretroviral drugs. As early as 1991, the country was providing AZT (zidovudine) to AIDS patients, and almost as soon as triple therapy became available in 1996, it was added to the national HIV/AIDS drug arsenal.
"The results were impressive," says Ricardo Pio Marins, deputy director of Brazil's National Program for Sexually Transmitted Diseases and AIDS. "From 1996 up to now, we have observed a striking reduction in mortality, morbidity and hospitalization rates of HIV-positive patients, with major savings in economic terms. In big cities such as Rio de Janeiro and São Paulo, we have seen up to a 70 percent reduction in AIDS-related deaths between 1995 and 2000. Nationally we've had declines of 60–80 percent in opportunistic infections and a fourfold reduction in hospitalization rates. The overall savings to the government add up to more than $700 million between 1997 and 2000."
To share its success, Brazil has initiated more than 30 cooperative projects with other developing countries, providing technical support and capacity building in such fields as prevention, treatment, community participation and institutional development. Brazil has also maintained an open-ended offer to transfer to other countries—at no cost—technology to manufacture generic antiretrovirals.
"There are strong arguments in favor of widespread treatment access," says Marins. "We have seen that reducing the prices of antiretroviral drugs can dramatically alter the economics of HIV/AIDS treatment, and possible obstacles to adequate treatment, such as poor infrastructure, can be overcome through a well-designed and internationally supported effort."