149. The representative of Brazil said that the Council's objectives were to assess whether the System was an expeditious solution for countries lacking manufacturing capacity, and to address any shortcomings that were impeding the System's effective operation. She reiterated her delegation's proposal that the adequateness of the economic and political incentives provided by the System to secure investment in the production of generic medicines at affordable prices be analyzed by the Council and other forums. The fact that the System had only been used once was strong evidence for inadequate incentives. The System, as well as other TRIPS flexibilities, was a tool for helping ensure access to medicines at affordable prices. Her delegation was committed to make the necessary changes so that the System could perform the function for which it had been designed. It was time to include other stakeholders in the discussion to better understand why the System was not being used, and to agree on ways to improve it.
150. Access to medicines at affordable prices was particularly important in Brazil given that its constitution guaranteed free and universal access to healthcare for all citizens. Under Brazil's HIV/AIDS programme, all persons living with HIV/AIDS were entitled to receive free treatment. This included individual health exams, as well as the supply of medicines to treat HIV/AIDS and other opportunistic diseases. 210,000 patients were under treatment for HIV/AIDS in her country, with the number increasing by 30,000 annually. The estimated cost for the HIV/AIDS programme for 2011 was US$500 million, which meant an annual cost per patient of US$2,500. Advances in drug development had provided more effective treatment resulting in significant gains in patients' longevity. This was an important achievement, but it also entailed increased costs. As patients developed resistance, more research and investment would be needed to develop the next generation of drugs, which would come at a higher cost.
151. Her Government had found a balance between the rights granted to IP holders and the interests of society as a whole. Fifty-seven per cent of Brazil's HIV/AIDS patients used second and third generation antiretroviral drugs. The use of these newer generations of drugs increased annually as the life expectancy of HIV/AIDS patients in Brazil had grown from 58 months in 1995 to 108 months in 2007. In order to maintain the sustainability of the programme, Brazil had continuously negotiated with drug makers to reduce the price of antiretrovirals and had made full use of the flexibilities under the TRIPS Agreement. One example had been the issuance of a compulsory licence for the antiretroviral drug Efavirenz in 2007. This was one of the most commonly used medicines in antiretroviral therapy. In 2007, 38 per cent of Brazilian patients had been using it. Because of the growing number of patients and the use of newer generation drugs, the costs of Efavirenz had been jeopardizing the HIV/AIDS programme. At US$ 1.59 a dose, the costs for the Government had amounted to approximately US$ 42.9 million, or US$ 580 per patient, per year. As a result of the compulsory licence, the cost per dose had been reduced to US$ 0.43 a dose.
