In practice, many of the country's HIV-infected people do not get the drugs, but nevertheless, Brazil's HIV death rate has been cut in half since the program began four years ago, and hospital admissions for AIDS patients have fallen by 80 percent. What happened to the price of the drugs is equally striking. So Brazil started making generic versions of several HIV drugs in its own government laboratories. For those drugs with no competition from government-produced generics, the price over the last four years edged down by less than 10 percent. But for drugs that the government makes, the price tumbled by more than 70 percent.
Competition appears to get better results than negotiation.
But Brazil's generics cost less. But in Brazil, where the drug is made by the government, the same dose costs just 56 cents. Paulo Teixiera, director of Brazil's national AIDS program, came to Durban bearing a message from his government. South Africa cannot adopt Brazil's model tomorrow. For another, Brazil was able to make generics legally because it had not yet entered into a World Trade Organization agreement that restricts making knockoffs of patented goods.