Latin America is home to a significant group of successful pharmaceutical manufacturers. For the major economic actors in the pharmaceutical sector – e.g., Argentina, Brazil, Chile and Colombia -- the regulatory systems are well developed. Latin American producers face competitive challenges from two sides: first, from Pharma companies increasingly challenging local manufacturers on the basis of marketing exclusivity rules deriving from free trade agreements with the United States, and; second, from low-cost generic producers from India, Israel and elsewhere. Problems of access to medicines are principally grounded in more general problems of income inequality and government budget constraints. HIV-AIDS imposes financial strain on Brazilian budget. Caribbean nations are hard-hit by HIV-AIDS and struggling to formulate comprehensive treatment programs. Countries need to address patent and marketing exclusivity rules and pressure from US Pharma. Financing is also a significant problem.