Getting fair treatment: Brazil faces new challenge in its fight against Big Pharma.(HIV AND AIDS)

Brazil has a success story to share with the world. It was the first developing country to provide free antiretroviral (ARV) drugs to its HIV-positive citizens, leading to a dramatic cut in AIDS deaths. By manufacturing its own cheap generic versions of branded medicines, it took on and defeated the big transnational drug companies.

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Dr Andre de Mello e Souza of the Pontifica Universidade Catolica do Rio de Janeiro played a pivotal role in developing Brazil's policy on HIV treatment. Its history of health activism started during the 1980s democratization process and led to healthcare being incorporated into the 1988 Constitution as the right of the citizen and the duty of the state.

'This was tremendously important,' he says. 'It gave the public a legal base to demand their right to treatment. In 1996 another law was passed to give people HIV treatment free of charge.'

Brazil's stand was controversial at the time. 'The World Health Organization, the World Bank, the Gates Foundation were all saying "look, you have scarce resources and you have to apply them where they are most cost-effective". They thought all the resources should be channelled towards prevention.' But Brazil's free-drugs policy proved to be surprisingly cost-effective. It made significant savings in hospitalization costs, saw 50 per cent fewer infections than the World Bank had predicted, and death rates from AIDS plummeted.