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Need an Advil in Brazil? Not so fast.

Brazil wants to adult-proof its pharmacies.

Over-the-counter medications like these in a pharmacy in central Sao Paulo will be removed from the reach of customers and have to be requested through a staff member if new federal regulations go into effect as planned. (Seth Kugel/GlobalPost)

SAO PAULO — Brazil’s new pharmacy rules give a whole new meaning to the term “over the counter medication.”

Citing the dangers of self-medication and the desire to bring more information to consumers, the federal National Health Surveillance Agency has released regulations that require virtually all medications, down to aspirin, to be sold over the counter. Literally.

So forget browsing the shelves and comparing the price of Tylenol to Advil. Brazilians will soon have to go to the counter and ask staff members for what they want. They hand it to you – with or without advice. If the regulations stand as published, the decongestants and laxatives and just about all other oral medications that now stock the shelves will be removed from customers' reach by next February.

The new rules also prohibit sales of items that are not health related, such as ice cream or calling cards. That will affect different states differently; Sao Paulo already has relatively strict regulations, allowing sugarless chewing gum (it’s for diabetics!) but not candy or soda; some states allow a wider variety of products.

“What we’ve constructed over time is a system that requires pharmacies to play the role of health care provider more than commercial service provider,” said Dirceu Barbano, the director of the agency, known here by the Portuguese abbrevation Anvisa. These regulations, he said, would further that goal. “Is it true that all products available without a prescription should be where anyone can pick them up with absolutely no guidance and bring them home? We arrived at a conclusion: no.” He noted that the 180-day waiting period between last week's announcement of the rules and their implementation would include discussions about expanding the list of medications approved for “self-service” purchase, now mostly restricted to dermatological treatments and herbal medicines.

Taking up the soapbox against the new regulations is Sergio Mena Barreto, president of the Brazilian Association of Pharmacy and Drugstore Networks. He promises something different for those 180 days: lawsuits. Abrafarma, as the organization is known, is planning a consumer survey first, but in about a month will begin legal proceedings arguing that the new regulations violate existing law.

Regardless of the legal issues, Mena Barreto said, the government’s concern about self-medication is wrong. Only a tiny percentage of poisonings in Brazil — 0.8 percent, according to him — occur from over-medication, and it is unclear whether requiring consumers to ask for medication rather than simply pick it up will change that, anyway. And then there’s the other aspect: “Pharmacies in Brazil are businesses,” he said. “[Barbano’s] definition of a pharmacy as a health center is ideological. He believes it cannot be a business, it has to be pure.”

http://www.globalpost.com/dispatch/brazil/090825/need-advil-not-so-fast