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HEALTH-THAILAND: Junta Defends Cheap Generic Drugs

Marwaan Macan-Markar

BANGKOK, Jan 31 2007 (IPS) - Thailand’s military-appointed government appears set to insist on the right of a developing country to save the lives of its people rather than protect the profits of Western pharmaceutical corporations.

But signs of the pressure that Bangkok can expect emerged this week, when a senior diplomat from Switzerland met officials of the Thai administration following a new challenge posed to the monopoly and lucrative earnings enjoyed by major drug companies.

On Monday, Health Minister Mongkol na Songkhla confirmed that the Thai government had invoked a rule under the World Trade Organisation (WTO) to break the patents held by French and United States pharmaceutical giants to supply generic drugs for patients suffering from HIV/AIDS and heart disease.

The two drugs for which a ‘compulsory licence’ is being used to secure the cheaper alternatives are Kaletra, the anti-AIDS drug, and Palvix, a popular medication sought by heart patients. Kaletra is made by the U.S.-based Abbott Laboratories and Palvix is sold by the French pharmaceutical company Sanofi-Aventis and its U.S. partner Bristol Myers-Squibb.

This intervention in the interest of public health follows a similar move in November, when the current government, which was appointed by a junta that came to power in mid-September coup, issued a compulsory license. Then it was for Efavirenz, a drug against HIV, whose patent was held by the pharma giant Merck. Bangkok wanted a cheaper alternative from India.

”There will be enormous pressure on Thailand from Western governments and pharmaceutical companies to stop this very humanitarian gesture,” says Paul Cawthorne, Thai country coordinator for Medecins Sans Frontieres (MSF – or Doctors Without Borders), the international relief agency that has been leading a campaign in the developing world for cheaper drugs. ‘’It has the potential of inspiring other countries to follow.”

Bangkok’s decision was valid, he explained in an interview, due to the substantial differences in price between patented version of the drugs and the generic alternatives produced in India. Palvix is currently sold at 120 baht (3.63 US dollars) a pill but the Indian version to be supplied through Thailand’s public health system will be available at between six to 12 baht (about 0.25 cents) per pill. A monthly dose of Kaletra currently costs 11,580 baht (351 dollars), while the generic alternative will be available at 4,000 baht (122 dollars) per month.

Oxfam, the international development agency, joined other non-governmental organisations (NGOs) this week in backing the measure taken by Thailand. The move was viewed as being in accordance with the agreements made during a WTO ministerial meeting in Dohar, Qatar, in 2001, assuring developing countries the option of placing the health of their nationals as a priority. Consequently, the developing world was given the guarantee under the WTO’s trade-related intellectual property rights (TRIPS) to break the patent of a brand name drug when faced with a public health emergency and either import or produce cheaper generic alternatives.

It was against that backdrop that Thailand initially felt emboldened to locally produce a cheap generic anti-retroviral drug for people with HIV, costing a patient 37.50 U.S. dollars a month. And over four years later, the consequence of such a humanitarian measure has been marked. Currently, some 85,000 Thais, of over 600,000 people with HIV, are benefiting from it, enjoying longer lives.

Yet analysts here admit that this week’s decision to expand the list of drugs through the ‘compulsory license’ route will not be taken too kindly by governments such as the United States, given the lobbying power of the pharmaceutical industry. ‘’The U.S. government has always been on the side of the pharmaceutical companies and we do not expect it to be different this time,” Chanida Chanyapate, deputy director of Focus on the Global South, a Bangkok-based regional think tank, told IPS. ‘’The U.S. embassy has a history of applying pressure on the Thai government when there is talk of cheaper drugs.”

It was this history of such pressure from the United States that prompted the Consumer Project on Technology to write to U.S. Trade Representative Susan Schwab in December last year, requesting she avoids the customary measures after Bangkok issued a compulsory license to break the patent for Efavirenz.

‘’The U.S. should not pressure Thailand on the issue of compulsory licenses on patents for AIDS drugs. It should accept the fact that Thailand, like all WTO members, has an obligation to take measures to ‘promote access to medicines for all’,” wrote James Love, director of the Washington D.C.-based NGO that lobbies for cheaper drugs for the developing world.

Available reports show that the U.S. government has taken the side of pharmaceutical giants even to the extent of forcing countries like Thailand to raise the price of drugs, in the mid-1980s. The beneficiary was Pfizer.

‘’In 1993, (U.S.) President (Bill) Clinton’s USTR (U.S. trade representative) head Mickey Kantor obtained an agreement that required the Thai government abandon collection of economic data from the pharmaceutical companies, restrict compulsory licensing of patents, and create a non-patent system of market exclusivity for pharmaceuticals,” writes Love.

Civil society groups view the U.S. government’s position towards countries like Thailand as emblematic of a culture of duplicity, since it often ignores the frequency with which developed nations break patents. Washington is among Western governments that have broken patents of medical and non-medical products in the face of local pressure. They include the U.S. response for cheaper medication to fight the threat of anthrax in 2001 and to be protected against a possible pandemic from bird flu in 2005.

‘’The U.S. and the EU (European Union) often use this mechanism to break patents but it only becomes a problem when developing countries are the violators,” says Cawthrone of MSF. ‘’Thailand has made a good move. Other countries should watch and follow.”

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