|DR. HUMBERTO COSTA|
Dr. Humberto Costa talks to Susan Dentzer about Brazil's HIV treatment and prevention efforts.
The NewsHour Health Unit is funded by a grant from The Henry J. Kaiser Family Foundation.
| SUSAN DENTZER: How strong is the commitment
of the presidency, of the administration of President Lula, to maintaining
the AIDS/STD program and expanding it in the future?
COSTA: Well, we want to continue this program. This is not a program
of our unit government. This is a program that was started in 1986,
and we must maintain and we must improve it. For instance, in this year
our objective is to test more people. We think that Brazil has 600,000
people living with AIDS, and living with HIV, and we just tested 20,000
people, so this is an objective.
Another one is to produce condoms in Brazil, to continue giving free condoms to the people.
SUSAN DENTZER: And those will require more investments of resources.
HUMBERTO COSTA: Yes. We are thinking more money in the HIV program, and we have money from the World Bank, and we have money from Brazil. And as we think that it's a very important program of health, we want to spend more money.
SUSAN DENTZER: Brazil has seen large reductions in mortality from AIDS, large declines in hospitalization as a consequence of anti-viral therapy. Is Brazil a model for other countries?
HUMBERTO COSTA: No, I don't think that we are a model, but we think that what we are doing here is something very good for other people. Because of the Brazilian law that obligates the government to give free retroviral treatments, and to give condoms, and to make educational campaigns, I think that it's ... the result of this.
So if it's a model, I don't know. But I think that it works here.
SUSAN DENTZER: Why would you not be a model for the rest of the world?
HUMBERTO COSTA: Well, because I think that each country must decide the best way to do its program ... But I'm not sure that our way of doing this thing is the best for other countries. For this reason I don't think we must be a model. I think it's a very interesting program, but I'm not sure if it's a model.
|HIV drugs and intellectual property laws|
SUSAN DENTZER: On pharmaceutical drugs, what is Brazil's policy going to be on compulsory licensing, and on the export of domestically manufactured drugs to other countries, and of course, specifically, here I'm speaking about antiretroviral drugs.
HUMBERTO COSTA: Well, we produce retroviral drugs just to use to our people ... We want to give ... the people [access] to these drugs, and we think that other countries have the right to give access to its people, and we are not interested in sell[ing] retroviral drugs. We are not interested in sell[ing] drugs that have been working [for] these patients. So we are producing [for] our people, and I think we can help other countries, but not selling. We don't want to gain money in this way.
SUSAN DENTZER: And what about compulsory licensing, particularly of new generations of HIV drugs?
HUMBERTO COSTA: Well, we want to negotiate the prices. We are in condition to produce many of them, but we want to negotiate...
SUSAN DENTZER: So compulsory licensing will always have to remain an option.
HUMBERTO COSTA: Yes, I think it's the last option, but we can use it if it's necessary.
|The importance of a worldwide fight against HIV|
SUSAN DENTZER: What would you most like the rest of the world to understand about what Brazil has done to date on HIV/AIDS and what it wants to do in the future?
HUMBERTO COSTA: Well, I think that the big lesson is that we must see this problem as a problem of all the countries, all the people. It's a very big health problem. So we want to see this disease in a ... greater vision. We must think about education, we must think about promotion, we must think about prevention, we must think about treatment, and we must think about social rehabilitation.
And so I think it's the best way to face this problem.
SUSAN DENTZER: So that it really has to be a concentrated effort across many fronts for the entire world.
HUMBERTO COSTA: Yes, I think so.
SUSAN DENTZER: Finally, many countries have different contexts in which they approach this issue, and of course in our country, the United States, there has been a great deal of concern on the issue of condom use for prevention, abstinence as distinct from condom use and so on, and now in our own efforts to spend more money, we are insisting that the distinctions be observed. How does that seem to you, as the United States wrestles through these issues about prevention, about speaking publicly about sexuality, the need for condom use. Is the United States position not realistic on these matters?
HUMBERTO COSTA: Well, it's very difficult to judge the position of another country, mainly when we think about different cultures. For us, to talk about the using of condoms and ... to talk freely about sexual activities is something very important. When we are thinking about AIDS in Brazil, we are only thinking about health. For this reason we say to religion groups, you have your idea, but we are only thinking about health. For this reason we respect your opinion, but we are going this way, telling to the people to use condoms, telling to the people to practice safe sex, and I think this is the best way. If it's the best way to the United States, I'm not sure.