Public Production of Anti‐Retroviral Medicines in Brazil, 1990–2007

This article examines Brazil's experience with the public production of anti‐retroviral drugs (ARVs) and highlights the important role of the state in guaranteeing access to life‐saving medicines and fulfilling human rights commitments. The key to understanding the government's successful intervention in the pharmaceutical market and provision of treatment rests on the synergistic, albeit political, relationship between reform‐minded public servants and civil society activists. This article argues that three key factors led to the government becoming a direct producer of ARVs: 1) a pre‐existing infrastructure of public laboratories that have served the public health system to a greater or lesser degree since the 1960s; 2) strong civil society pressures, including public health activists both inside and outside the government; and 3) a pharmaceutical sector characterized by high prices and controlled by transnational drug companies.