Brazil needs to discuss with pharmaceutical firms ways to make obesity medications more affordable, says Bruno Halpern, endocrinologist and president of the World Obesity Federation. Halpern told Folha de S.Paulo that current treatment options in the Unified Health System (SUS) are limited and difficult to access.
He notes the rising use of semaglutide‑based injectable pens, which have shown good results for some patients, and argues that a serious conversation about cost reduction is urgent. "This includes discussing with the pharmaceutical industry ways to lower the cost," he said.
Halpern stresses that simply providing the medication is not enough. Doctors must be trained to prescribe it, monitor patients over the long term, and evaluate side effects and effectiveness. Without such support, patients risk nutritional deficiencies and muscle loss.
On market opening, Halpern says allowing international laboratories to sell their products in Brazil, with Anvisa’s approval, would help democratize treatment. He rejects the idea of using unregistered drugs or tolerating smuggling, which he calls illegal and unsafe.
Regarding Anvisa’s control, he believes the agency is working to create clearer rules and close loopholes, but acknowledges the situation is currently out of control. He urges a frank conversation among Anvisa, medical societies, the Ministry of Health, Conitec (the national technology incorporation commission), and the pharmaceutical industry to find joint solutions.
For patients who cannot afford the treatment, Halpern expects that if the medicines are incorporated into the SUS, they would first be offered to a priority population. He is optimistic that lower prices and SUS availability could be achieved in the short term, citing ongoing work by the World Obesity Federation and the Brazilian Association for the Study of Obesity (Abeso).
He references recent World Health Organization guidance that classifies GLP‑1 receptor agonists as essential medicines for people with obesity, diabetes, or cardiovascular or renal disease, especially for low‑ and middle‑income countries.
When asked about the ideal line of care for obesity, Halpern points out that bariatric surgery is the only nationally available treatment in the SUS, but it requires two years of unsuccessful clinical treatment—a prerequisite the public system does not provide. He argues that effective care must combine medication, nutritional counseling, physical activity, and psychological support, tailored to individual needs.
Halpern also highlights the economic burden of inaction, noting that obesity accounts for about 3 % of global gross domestic product, a figure projected to rise in the coming decades.
All statements are based on the interview published by Folha de S.Paulo on August 17, 2026.