Background: As Brazil has one of the oldest HIV patient cohorts in developing countries, it anticipates the need to access newer technologies as well as related challenges. However, since 2010, the internal political environment has been undermining the human rights perspective and the ability to confront monopoly powers over key technologies. As result, Brazil is unable to keep its protocols updated, in contradiction to its legacy of reducing the gap between rich and poor countries when it comes to access to the best treatment and prevention options. From 2014 onwards, civil society intensified efforts to reverse this scenario by adopting multiple strategies that involved campaigns, protests, events, patent oppositions, consultations, publications and advocacy. Such efforts lead to the successful incorporation of Dolutegravir as first line treatment for over 100.000 people, despite strong opposition by the government initially. Civil society has also ensured the incorporation of TDF/FTC as a prevention tool, including though the public consultation with the highest number of submission in the history of the National Commission for the Incorporation of Technologies (CONITEC).
Description: ABIA/GTPI championed and documented numerous efforts to promote policy change around treatment and prevention options. The documentation was organized to reveal the chronology of steps taken by civil society, relating them with policy milestones around the incorporation of Dolutegravir (2016) and TDF/FTC (2017).
Lessons learned: As regards to Dolutegravir, civil society efforts were essential for reversing the denial of incorporation and for the expansion in the offer from third-line to first-line through decree 35. Demand creation coupled with public pressure also resulted in price drop from U$ 9.88 per unit to U$1.53. In relation to TDF/FTC, campaigning has led to 3.543 submissions in the public consultation over the protocol for use of TDF/FTC as PrEP, enabling its approval despite opposition by conservative forces. Patent opposition filed by ABIA/GTPI in 2016 led to a patent rejection in 2017, which was instrumental to bring the price down from U$ 752 to U$ 276.
Conclusions/Next steps: Incorporation of technologies relies as much in technical debates as in political debates. Civil society ensures that a rights-based approach prevails in both levels.

Download the e-Poster