Pharmaceutical policy in Brazil

Brazil’s pharmaceutical policies have undrgone significant changes in recent decades resulting in improved access, surveillance, and support for national industry. This chapter highlights the numerous challenges in upholding the right to health embedded in the Brazil’s 1988 Constitution and implementing a universal health system. Difficulties include geographic diversity, epidemiological variation, and entrenched social inequalities in a continental-sized country; changing patterns of morbidity and mortality, associated with communicable and noncommunicable diseases that require low–, medium–, and high-complex medical care; and continued dependency on imported pharmaceutical products. The structure of the national health system is also discussed in detail along with the country’s pharmaceutical situation focusing on past and recent regulations and results. An overview of the pharmaceutical market, including local production and manufacturing of active pharmaceutical ingredients and finished dosage forms, is provided. The “Health Industrial Complex” as a political commitment linking health system needs with industrial policies is briefly described. The chapter also highlights regulations, financing and supply systems, as well as efforts to promote the rational use of medicines and data collection systems of adverse drug reactions. Finally, we end the chapter discussing Brazil’s alignment with international trends, such as the United Nation’s 2030 Development Agenda, and the way forward for future programs and efforts. Despite ongoing challenges, medicine policies have played a central role in the Brazilian government’s efforts to improve social conditions and push more than 26 million people out of extreme poverty.