Holding Big Pharma's feet to the
fire By Marwaan Macan-Markar
BANGKOK - For nearly a week, the
advertising pages of Thai- and English-language
dailies have been the stage for debates on
Thailand's decision to break patents on anti-AIDS
drugs in the interest of public health.
A
lobby championing the cause of the powerful
pharmaceutical companies ran full-page spreads in
the morning newspapers with an eye-catching
warning in large, bold text, which said: "The
Wrong Prescription for Thailand".
The
charge was supported by allegations that Bangkok's decision
was
fraught with errors, such as, "Thailand is
refusing American and European medical technology
at the expense of the poor and sick of Thailand."
Another leveled by "USA for Innovation", the
organization leading this
pro-pharmaceutical-company drive, declared: "Most
of Thailand's AIDS patients will not have access
to the world's best medicines."
But if
those warnings were meant to trouble men like
Boripat Dornmon, a 40-year-old who has been living
with the human immunodeficiency virus (HIV) for 11
years, they have made little headway. "I disagree
with this group, USA for Innovation. It shows that
the big drug companies do not care about people
like me," he said.
Boripat echoes the
views of the group he belongs to, the Thai Network
of People Living With HIV/AIDS, when he says
Bangkok was correct in issuing compulsory licenses
to secure cheaper generic drugs. "We need the new,
cheap drugs to live longer."
It was a
sentiment conveyed in the full-page advertisements
taken out by a coalition of AIDS activists,
humanitarian groups and a university to hit back
at the pro-pharmaceutical lobby's campaign. The
generic anti-retroviral (ARV) drug produced by the
state's pharmaceutical body has "made a phenomenal
contribution in reducing the number of deaths
among Thai AIDS patients from an average of 7,282
per year between 2001 [and] 2004 to 3,862 in 2005
and to 1,613 in 2006", states the advertisement.
And a meeting this week between officials
from Abbott Laboratories and Thai officials from
the Food and Drug Administration (FDA) confirmed
that Bangkok has not caved in to pressure from the
pharmaceutical lobby and the US government over a
groundbreaking move to secure cheaper drugs.
In fact, a Health Ministry official was
quoted in the local media hinting that Bangkok may
not have finished issuing compulsory licenses for
ARVs produced by Abbott, given that a
significantly lower-priced generic version of
Aluvia, a second-line anti-AIDS drug, is being
offered by an Indian company.
"If the
Public Health Ministry chose to buy drugs at
prices higher than offered by other sources, it
must be able to give the public a good reason to
justify its decision," Vichai Chokewiwat, head of
the Public Health Ministry's panel on compulsory
licensing, said in Tuesday's Bangkok Post
newspaper.
Thailand's efforts have also
received a boost at the ongoing World Health
Assembly in Geneva, where Health Minister Dr
Mongkol Na Songkhla is defending his country's
case. "International supporters have entered the
debate, saying that they will support Thailand on
the issue in every way," he told the state-run
Thai News Agency (TNA).
"International
organizations belonging to the Third World
Network, as well as national groups from Brazil,
Germany, India, Malaysia and the Philippines, had
met with him and praised Thailand on the issue,"
added TNA.
Mongkol now is reported to be
planning to enforce compulsory licensing for
cancer drugs. The pros and cons are being studied
of issuing licenses for a group of cancer drugs
that are still under patent in Thailand.
Thailand's determination to use available
provisions in international trade to break patents
emerged late last year, when Bangkok broke the
patent on the ARV Efavirenz, produced by the US
pharmaceutical giant Merck Sharp and Dhome. That
was followed by a compulsory license issued here
for Kaletra, another ARV produced by the US pharma
multinational Abbott Laboratories. In January, the
patent for Plavix, a blood-thinner made by
Sanofi-Aventis, was broken.
But it was
only Abbott that hit back at Thailand's use of the
special provisions under the World Trade
Organization (WTO) for developing countries to
break patents on drugs when faced with a
public-health emergency. In March the US
multinational refused to register seven new drugs
here, including Aluvia, a drug that can be easily
stored in tropical climates.
Abbott's
hopes of steamrolling over Thailand were dealt a
blow last week from a quarter close to home - the
foundation of former US president Bill Clinton. At
a ceremony in New York, with the Thai health
minister Mongkol by his side, Clinton endorsed
Bangkok's decision to break the patents on the
life-prolonging ARVs.
"No company will
live or die because of high-price premiums for
AIDS drugs in middle-income countries, but
patients may," Clinton said during an event that
announced the foundation's success at further
slashing the price of second-line drugs, such as
Abbott's Kaletra and Aluvia.
While last
month Abbott announced that it had reduced the
price of Kaletra in Thailand to US$1,000 for an
annual course per patient, from the $2,200 for the
same course it had charged a month before, the
Clinton Foundation announced that it had an even
cheaper offer. Matrix Laboratories, an Indian drug
maker, was producing the generic version of Aluvia
for $695 for a one-year course.
Thailand's
leadership in securing better care for its HIV and
AIDS patients is in keeping with other pioneering
efforts it has embraced to deal with the killer
disease. The Southeast Asian country has more than
600,000 people infected with HIV and has recorded
300,000 deaths due to AIDS, the disease HIV
causes.
"We have to stand up to the
pressure from the pharmaceutical companies and the
US," said Jiraporn Limpananont, associate
professor in the pharmaceutical science faculty at
Bangkok's Chulalongkorn University. "If more
countries issue compulsory licenses, it will get
the point across that this is the right tool for
developing countries."
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