Thailand turns giant pharma
killer By Marwaan Macan-Markar
BANGKOK - By standing up to pressure from
"big pharma" over cheap anti-AIDS drugs, Thailand
may have created an opening in global trade rules
that will permit developing countries to more
readily break patents in times of public health
emergencies.
The fact that the United
States government has clarified that Bangkok had
not violated any laws under the special provisions
of the Trade-Related aspects of Intellectual
Property (TRIPS) of the
World
Trade Organization (WTO) is significant.
Last week, the US Trade Representative's
office (USTR) placed Thailand on a watch list of
countries that had, in general, violated
intellectual property rights. Thailand first broke
the patent on the anti-retroviral (ARV) drug
Efavirenz, produced by US pharmaceutical company
Merck Sharp and Dohme, last November, and went on
to do the same with Kaletra, another anti-HIV/AIDS
drug from US pharma major Abbott Laboratories, as
well as Plavis, a blood-thinner made by
Sanofi-Aventis, in January.
Noticeably,
there was lack of precision in the USTR annual
report on intellectual property protection
regarding the Thai move to issue a compulsory
license (CL) early this year to secure cheaper
alternatives for Kaletra, the drug marketed by
Abbott, from India.
''While the US
acknowledges a country's ability to issue such
licenses in accordance with WTO rules, the lack of
transparency and due process exhibited in Thailand
represents a serious concern,'' states the report.
Far more strident in its criticism of
Bangkok's efforts is a pro-pharmaceutical website
launched on Monday to campaign against Thailand's
pro-poor public health policies. "Thailand's
actions violate the TRIPS agreement of the WTO,"
states the website, www.Thailies.com. "WTO members
are not allowed to issue compulsory licenses
without full and transparent negotiations."
Since
then the advantage secured by Thailand in testing
- and winning - the right to use CLs has earned it
praise from a broad section of activists, HIV
patients and academics at home and abroad. "Other
countries will feel more confident in issuing CLs,
rather than threatening to issue them but not
doing so due to pressure," said Paul Cawthorne of
Medecins Sans Frontieres (MSF), the international humanitarian agency,
in an interview.
"This can set a
precedent, a new understanding, about what
developing countries can do under TRIPS," added
Jacques-chai Chomthongdi, a researcher at Focus on
the Global South, a Bangkok-based think-tank.
"This is to the advantage of developing
countries."
In fact, the US could not
fault Thailand for violating trade rules since
Bangkok's policies are compliant with TRIPS, he
explained. "Thailand has acted within local and
WTO laws."
Washington's fuzzy, ambiguous
language toward Thailand after it invoked the CL
stands in contrast with the tough stance taken
previously to defend brand-name drugs of
pharmaceutical corporations when threatened by the
special provisions under TRIPS, which permit a
developing country to produce or import generics.
These provisions in global free trade, permitting
developing countries to break patents in times of
a national health crisis, were approved during the
WTO ministerial meeting in Doha in 2001.
By the weekend, Thai activists were
celebrating the possible ripple effect across the
developing world in the wake of Bangkok's quest
for cheaper generic drugs. Brazilian President
Luiz Inacio Lula da Silva signed a decree on
Friday in Brasilia to issue a CL for the drug
Efavirenz.
The emergence of such a
South-South alliance to bring down the prices of
life-prolonging drugs through CLs was no surprise
for Thai activists like Kannikar Kijtiwatchakul,
of Free Trade Agreement Watch, a non-governmental
organization campaigning against global corporate
agendas. "Brazil learned from us. They asked
Thailand what it did to issue a compulsory
license," she said.
"Thailand has been an
inspiration and an example for us all on this
matter," wrote a Brazilian public health official
in a letter to Thailand's Public Health Ministry
in early March. At that time, Bangkok was the
focus of international attention for taking the
side of public health over corporate profits.
"It is time to unite all those who have
always defended the use of TRIPS' flexibilities,
which can be invoked in the name of protecting
public health, as in the case of compulsory
licenses, added the Working Group on Intellectual
Property from the Brazilian Network for the
Integration of Peoples in an e-mail to Thai
activists late last month.
Thailand's
clash with Abbott, which began in January
after the government's issuing of a CL for the
drug Kaletra, intensified in March when Abbott
retaliated by refusing to register seven new drugs
in the Southeast Asian country. It meant depriving
Thais of a new ARV, Aluvia, which can be easily
stored in tropical climates, an antibiotic, a
painkiller and drugs for kidney disease and blood
clots.
By early April, faced with growing
criticism and Thai reluctance to cave into
pressure, Abbott agreed to supply both ARVs to
Thailand at a reduced price of US$1,000 for a
year's dosage per patient. In exchange, the pharma
giant wanted the CL for Kaletra dropped.
Thai public health officials, out to
capitalize on the frequently debated WTO rule, are
in step with an impressive record the country has
maintained in caring for its citizens with
HIV/AIDS and reduce the spread of the killer
disease. Currently, some 90% of people who need
ARVs are treated through a universal healthcare
scheme. The country has over 600,000 people
infected with HIV and has recorded 300,000 deaths
due to AIDS.
‘'All CLs have done is open
up a monopolistic market to competition,'' says
Cawthorn of MSF. ‘'Why should the pharmaceutical
companies be worried about that?''
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