On May 29 and 30, 2025, Brasília will host the “BRICS on the Rise” seminar, an international meeting that will bring together governments, experts, and social movements to discuss the challenges faced by BRICS in the current geopolitical scenario. GTPI/REBRIP will participate in the panel on global health cooperation. On May 29 at 6:30 p.m., REBRIP will release the dossier “BRICS+ and the Sovereign Future of the Global South” at the Darcy Ribeiro Memorial (Beijódromo/UnB). The publication features 10 articles with proposals and analyses on the role of BRICS+ in building a fairer multilateral order. This text offers some reflections and seeks to contribute to debate within the BRICS+ while also presenting what the BRICS+ bloc could do for global health in the current context.
We are currently facing a profound crisis in global health. This is not due to a lack of knowledge, technologies, or resources but rather to deliberate political decisions that leave entire communities to die. Drastic cuts in funding for essential programs for the prevention, diagnosis, and treatment of HIV, tuberculosis, and other infectious diseases are causing a silent—and deadly—collapse in several countries, especially those in Africa and other parts of the Global South.
This is nothing short of genocide. And it manifests in multiple ways: sometimes silently through deliberate negligence, sometimes explicitly like the massacre in Gaza, broadcast to the world in real time. Both genocides—that of omission and that of open violence—are rooted in the same ideological project: supremacist, colonialist, and antihumanitarian—opposed to diversity, equity, and inclusion.
The U.S. was the main donor sustaining the international humanitarian apparatus, funding programs focusing on HIV/AIDS, tuberculosis, malaria, and maternal and child healthcare. The U.S. was also the primary funder of the WHO. Even though the event highlights the problem of dependence and charity, the effects of dismantling this structure are profound and widespread.
In the field of HIV/AIDS alone, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), responsible for much of the global purchase and distribution of antiretrovirals and pre-exposure prophylaxis (PrEP) for more than 20 million people, has suffered severe cuts. This has led to supply chain disruptions, suspension of prevention programs, and a direct threat to the lives of millions. UNAIDS' forecast is alarming: if these programs are not reinstated, by 2029 there will be 6.6 million new HIV infections and 4.2 million AIDS-related deaths—the equivalent of 2,900 preventable deaths per day.
This catastrophic scenario calls for a strong and coordinated response from the countries of the Global South. Strategies to strengthen cooperation among BRICS+ countries are even more important in the current international political context. BRICS+ countries can take a leading role in building a new model of global health governance based on solidarity, social justice, and the universal right to life.
Under Brazil’s presidency in 2025, health was elevated to one of the BRICS+ agenda priorities. The presented proposal is based on the understanding that the countries of the bloc share deep structural challenges, such as poverty, inequality, environmental racism, and the disproportionate burden of socially determined diseases and neglected tropical diseases.
The interministerial Brasil Saudável [Healthy Brazil] program, launched in 2024, embodies this vision, integrating health with social, environmental, and economic policies with the goal of transforming the conditions that harm the population's health. This approach revives key elements of the Brazilian Health Reform and the global movement for Health as a Right, by advocating social justice as a prerequisite for collective health.
Building on this experience, Brazil is proposing a strategic alliance within BRICS+ to address the structural factors that sustain Neglected Tropical Diseases (NTDs) and other poverty-related ailments. The proposal includes guidelines aimed at fighting hunger, promoting equity, valuing healthcare workers, encouraging science and innovation, and investing in infrastructure, sanitation, and environmental protection—recognizing that guaranteeing the right to health requires changes beyond the provision of services.
However, at the same time as it proposes tackling social determinants, the Brazilian initiative still avoids directly addressing a set of equally structural obstacles: the commercial determinants of health and global health funding. The absence of these dimensions weakens the proposal’s transformative potential.
Barriers related to international trade, such as intellectual property rules, continue to severely limit access to essential technologies. The global patent system favors the concentration of power in the hands of a few corporations, perpetuating monopolies, driving up prices, and preventing the productive autonomy of countries in the Global South. On the other hand, financial resources allocated to HIV/AIDS initiatives, for example, have been drastically reduced and are now concentrated among a few donors—especially the U.S. and, in the private sector, Gilead Sciences and the Bill & Melinda Gates Foundation (BMGF).
The commercial determinants of health must be taken seriously, recognizing that economic agreements and intellectual property regimes directly affect the lives and well-being of communities. The persistence of a pharmaceutical innovation model grounded in intellectual property remains exclusionary.
The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), adopted in 1995 under the framework of the World Trade Organization (WTO), stands as one of the central pillars of a regulatory agenda shaped by the interests of the major pharmaceutical corporations. Far from fulfilling its promise to promote innovation and strengthen local industrial capacity, TRIPS has consolidated a model of technological appropriation that perpetuates the Global South countries’ dependence on centers of economic power.
This model systematically fails by relying on voluntary access mechanisms that concentrate decision-making power in the hands of patent holders, with no obligation to address public health needs.
Voluntary licenses, although presented as mechanisms of “corporate solidarity,” in practice operate as instruments of market control, keeping pricing power in the hands of the large pharmaceutical companies and making it difficult to build sustainable alternatives for public or regional production. They not only fail to guarantee universal access to essential drugs but also discourage the use of legal safeguards such as compulsory licenses, by creating an appearance of sufficiency and cooperation that masks the barriers imposed by the international intellectual property regime.
In addition, this innovation model systematically fails to address the main needs of residents of Global South countries, such as neglected tropical diseases, ignoring their impact on millions of people because they do not represent a lucrative market. These diseases are structural failures of an innovation system that does not recognize health as a common good.
The Brazilian presidency of BRICS+ represents a strategic opportunity to redirect the international health cooperation agenda. To that end, BRICS+ must go beyond the exchange of experiences and take an active role in building structural solutions.
This includes initiatives to strengthen the World Alliance for Patient Safety, with a focus on addressing the social determinants of health and neglected tropical diseases; expanding the role of the BRICS Development Bank in supporting programs aimed at public health and access to medications; adopting nonvoluntary measures, such as compulsory licenses and public health safeguards; strengthening the BRICS Vaccine Center, ensuring its effective operationalization as a strategic measure for the bloc's health sovereignty; and restructuring the health innovation model, ending public subsidies for private profits and adopting a human rights-based paradigm as the guiding principle for science, technology, and innovation policies.
Lastly, we believe that BRICS+ can still restore and reaffirm multilateralism as a path toward finding coordinated and shared solutions to the health challenges faced in many countries, especially its own members. However, this active role should not be restricted only to the bloc’s governments and states.
To ensure a truly broad, democratic, and fair response, civil society must be actively supported and included in this process. This is the only way it will be possible to build global health policies that prioritize solidarity and the common good, for the benefit of all.
Susana Van Der Ploeg is the Coordinator of the Working Group on Intellectual Property (GTPI).
Photo: Outras Palavras
