"The end of AIDS is not free. It is not too expensive. It is priceless." This was the impassioned call of UNAIDS Executive Director, Michel Sidibé, at the opening of the International AIDS conference on 22 July (22 July-27 July). But at a time of a global recession, when industrialized countries are unlikely to increase their aid commitments and pharmaceuticals remains a profit-driven industry, how are the most affected countries - often also the world’s poorest - to pay for treatment?
The annual conference centers on the fight against a pandemic that knows neither cure nor vaccine. Halting the number of those infected with HIV - which affects over 40 million individuals worldwide - was listed as a priority for this year’s edition, which gathered policy-makers, researchers, doctors and patients in Washington DC.
One of the (recurring) issues highlighted during discussion panels was the accessibility of medications. Although it has been proven that early treatment of HIV-affected individuals limits the chances for the virus to spread - before HIV positive patients are affected by AIDS - access to medication remains a problem in many countries.
Mozambique is one. Records show it has one of the highest rates of HIV-AIDS contamination in the world. According to UNICEF estimates, AIDS accounts for nearly 25 percent of all deaths recorded. UNAIDS puts the prevalence rate in the adult population aged between 15-49 years at 11.5 percent.
During his last visit to Mozambique in September 2011, Sidibé worried that the government was relying too much on external partners, which funded up to 97 percent of its AIDS program in a country where only half of those affected had access to medication. Sidibé recommended “Mozambique need[ed] to develop an innovative transitional plan for sustainable financing, which includes increased national budgets, private sector contribution and social health insurance."
This weekend, a new pharmaceutical plant run by the Sociedade Moçambicana de Medicamentos (SMM - Mozambican Society of Drugs) launched its production of anti-retrovirals in the city of Matola, near Maputo. The new development could be an example of what the UNAIDS director was calling for.
The factory was launched on Saturday 22 July
The factory began packaging drugs provided by Brazil, including Nevaparine, an anti-retroviral drug that becomes stable after six months and will then be distributed to Mozambicans. More importantly, the facility will soon produce the drug itself (and others), enabling Mozambique to at last become self-sufficient.
The SMM is the first 100 percent public capital company of the pharmaceutical sector in Africa. It exists thanks to a Brazilian public-private partnership initiative.
This health partnership is supported by an inter-lusophone Health Cooperation Strategic Plan defined at a 2009 meeting of the Community of Portuguese Language Countries in Lisbon. More precisely, the Mozambican-Brazilian partnership dates back to 2003, when then Brazilian President, Lula Da Silva, and his counterpart, Joaquim Chissano, made a bilateral priority of public medication schemes. Indeed, Brazil has offered free ARV treatment to HIV-positive citizens since 1996.
On the Brazilian side, the consortium Fiotec - Fiocruz - Farmanguinhos (respectively Foundation for Scientific and Technological Development on Health - Oswaldo Cruz Foundation and its medication productive unit) was in charge of managing the cooperation. In 2008, Mozambique’s government purchased the land where the factory is now located. The project of launching the factory was then included in this year’s bilateral agenda by Brazil’s current president, Dilma Roussef, and immediately accepted by Mozambique’s President Armando Guebuza.
At the launch of the plant, Brazilian Vice-President Michel Temer praised the arrangement. "There is an excellent partnership between the Brazilian and the Mozambican people and there is an absolute integration between the two countries in both public and private sectors." Interviewed ahead of the opening of the plant, Licia de Oliveira, Associate Director of Fiocruz Africa, supported the statement. "This international cooperation, in the modality of structuring action, aims at sharing the successful actions of the Brazilian Unified Health System, such as public medications production, with Mozambique."
The initiative is also part of a broader conception of Brazil’s diplomacy in Africa. "The actions of this project respond to the political guidelines of Brazilian diplomacy, strengthening the relations among the countries in the southern hemisphere, also known as South-South cooperation."
Brazil's public private partnership is worth approximately 27 million USD, with 23 million provided through the Brazilian aid program, and 6 million from Vale Foundation, the philanthropic arm of the Brazilian mining giant closely involved in Mozambique. Vale bore the cost of 80 percent of the construction, providing 4.5 million USD. Brazil's government covered all stages of development and implementation of the project, including feasibility studies, acquisition of equipment, technology transfer, technical training, validation and registration, and submission of national and international certification.
Asked about Vale's involvement, Vale Mozambique communication director Açucena Paul, told The Global Journal: "This is an action that is aligned with our mission: to transform natural resources into prosperity and sustainable development." She explained that "Mozambique ha[d] a great challenge fighting against HIV/AIDS, and [they - Vale] underst[ood] that investing on a public anti-retroviral factory w[ould] help the country to provide a better health condition to the population." The idea behind the investment, she continued, is to "invest in social responsibility through our Foundation."
At a time when donor countries are reluctant to invest further - Sidibé appealed to the international community for an extra 8 billion USD - this type of partnership could be a way to envision an end to the spread of AIDS. Moreover, it could prove to be a replicable model to assist in the achievement of Millennium Development Goal 6 by 2015: providing access to treatment for all those who need it.