Brazil, EU Collaborate On Local Production Of AIDS Drugs In Mozambique

By Claudia Jurberg for Intellectual Property Watch
RIO DE JANEIRO – Brazilian President Luiz Inácio Lula da Silva, Health Minister José Gomes Temporão and the President of Oswaldo Cruz Foundation, Paulo Buss, recently inaugurated an office of the foundation in Maputo, Mozambique, to produce medicines and offer courses on public health.

The president, Lula, and the health minister reinforced Brazilian support to establish a pharmaceutical plant in Maputo that will produce HIV/AIDS drugs such as antiretrovirals (ARVs).

“Brazil has a political, moral and ethical obligation to do what you are doing with the African continent,” Lula said during the visit. “Certainly we are not the largest debtors to the African continent, but we are certainly the most thankful for being as we are.”

“We have a goal to comply with a deadline,” he continued. “We need give to them the opportunity to not die prematurely because of AIDS and other diseases.”

The project has been developing in Mozambique since July 2005 under a partnership between the Mozambique Health Ministry and Farmanguinhos, the unit of the Oswaldo Cruz Foundation (Portuguese abbreviation Fiocruz) that produces medicines.

Fiocruz is one of the biggest public health institutions in Latin America and is dedicated – in addition to the production of drugs – to vaccines and kits to diagnose diseases. It also is responsible for the training of human resources for the public health system.

Farmanguinhos press officer Taís Motta told Intellectual Property Watch that the plant in Africa will be inaugurated in the first semester of 2009 and is expected to begin production in the same year. The plant will produce ARVs and drugs against malaria and other diseases. The factory location is being adapted for the necessary equipment. The project is not expected to result in medicines being shipped to Brazil, but rather is intended to represent a commitment to helping Africa.

The investment is aimed at advancing science and technology in Mozambique, lessening economic dependence and, specifically in this case, dependence on the development of ARVs. Currently, they are purchased from other countries at higher costs.

Estavudina and Nevirapina will be the first ARVs under production. After one or two years, the plant will introduce another ARV, the combination of zidovudine/lamivudine/nelfinavir. At first, it will be distributed only in Mozambique.

Last week, the final planning for the project was taken in the Brazilian capital of Brasília. The first phase will take place on 20 November with professional training of Mozambicans who will work at the pharmaceutical plant. The first two modules of training are quality control in Rio de Janeiro, and project management in Mozambique in February 2009, when the plant will be operational. In the future, Farmanguinhos will transfer the production technology to that country.

The total resources for the project are on the order of US$21.5 million but less than US$5 million will be given by Brazil; the rest will be donated by the European Union. The goal of the plant is collaborate on assistance in Africa because the high prevalence of HIV/AIDS there.

Nowadays, Mozambique receives medicine through donations or buys them from elsewhere. The government estimated that 110,000 people receive antiretrovirals every month in the country. UNAIDS and the World Health Organization (WHO) set the number lower: 90,000 are receiving antiretroviral therapy, while they estimate that the number of people in need is 370,000. But there is an upward trend in coverage over the last three years.

Most new infections occur in young people, according to data from UNICEF. In 2000, the prevalence among people between 15 and 49 years was estimated at 12.2 percent. Mozambique´s population is estimated at more than 20 million inhabitants, and around 70 percent live in rural areas. Some 10 million are between 15 and 49 years old and life expectancy is 50 years, according to WHO.

In 2007, WHO estimated 1.5 million people are living with HIV/AIDS in Mozambique. Around 58 percent of Mozambicans infected with HIV are women. Girls between 15 and 19 years old are three times more infected than boys in the same age group. And the number of orphan children who lost their parents to HIV/AIDS was 400,000 in 2007.

Official data from National Statistics System from in 2005 show that there were 1,256 health units, including hospitals and health centres spread across the 11 provinces to give assistance to people.

Mozambique Health Minister Ivo Garrido recently told the official news agency that the main problem in Mozambique is not the lack of medicine but lack of information. Literacy in 2006 was only 43 percent of adults.

“Most people infected with the HIV virus do not know,” said Minister Garrido, adding, “They do not associate their health problems with AIDS. So they constantly visit health centres to treat other disorders.”

For him, “it would be nice and easy if the problem was just limited to the availability of ARVs. If that was the case, we would simply buy medicines and the problem would be solved.”

However, said the minister, “the problem is more serious and deeper, and is related to society. It’s false to claim that people don’t have access to ARVs because the drugs are not available. The main reason is that most people are unaware that they are ill.”

He believes that the problem associated with access to ARVs in Mozambique is not going to be solved by the new pharmaceutical plant alone. For him, the situation is more complex.

On the other hand, he said that a country which produces medicines locally has advantages. There are a number of barriers removed when there is a pharmaceutical plant in the country.

Brazilian Minister José Gomes Temporão explained that Fundação Oswaldo Cruz’s office in Maputo also will offer courses at the masters, doctoral and postgraduate levels on infection diseases, public health, planning of health systems and strategy to human resources to the health system. The idea is that the Mozambicans could resolve the main public health problems that afflict society.

Claudia Jurberg may be reached at info@ip-watch.ch.