SPEAKING
FREELY Drug spat strains global trade
system By Elizabeth H Williams
Speaking Freely is an Asia Times
Online feature that allows guest writers to have
their say. Please click hereif you are interested in
contributing.
The current dispute
over Thailand and Brazil licensing generic
versions of patented medicines severely tests
global health and health-care-access policy. It
also tests key US trade relations
with
Asia and the functionality of the global trade
system itself. So far, the results aren't
encouraging, and meanwhile the issue is getting
larger and more complex.
A functional
patent system would strike a judicious balance
between the interests of drug companies, whose
patents compensate them for large investments
required to develop lifesaving medicines, and the
imperative to make them available to the world's
poor. Instead, today we have a dysfunctional
battle between pharmaceutical giants and
governments of developing countries, each side
claiming to champion the world's health needs and
accusing the other of exploitation.
The
Agreement on Trade Related Aspects of Intellectual
Property Rights (TRIPS) allows developing World
Trade Organization (WTO) member countries to issue
compulsory licenses for patented drugs and other
innovations so they can be manufactured
generically and sold at affordable prices in the
service of compelling public-health interests.
Thailand recently issued compulsory
licenses for second-line HIV (human
immunodeficiency virus, which causes AIDS)
medications (used when resistance develops to
first-line medicines), including Aluvia, made by
Abbott, originally priced at US$2,200 per patient
annually - expensive for most Americans, and
considerably more than most Thais earn in a year.
Since Thailand's announcement, Abbott
withdrew seven medicines from the Thai market and
threatened not to introduce new ones. The
pharmaceutical lobbying group, USA for Innovation,
attacked, calling on the US Trade Representative
to brand Thailand an intellectual-property
"violator".
The US has sent mixed signals,
putting Thailand on its so-called Priority Watch
List for violating intellectual-property rights,
while acknowledging that its compulsory-licensing
decision was legal. Then it backtracked, denying
its decision had anything to do with Thailand's
decision to produce generic drugs under a
compulsory-licensing arrangement. Then it said
compulsory licensing was one factor among others.
But leaders of non-governmental and
faith-based organizations, from former US
president Bill Clinton to former Thai senator John
Ungphakorn of the AIDS Access Foundation to Asian
church groups, have all been clear in their strong
endorsement of Thailand's and Brazil's licensing
decisions, arguing that while no pharmaceutical
company's life depends on drug prices in the
developing world, many patients' lives do.
For its part, the Thai government says it
simply wants to negotiate a deal with the patent
holders to sell HIV drugs at prices ordinary
citizens can afford.
"We tried to
negotiate with them officially for more than two
years and unofficially for more than four years,"
but it has never been successful, said Thai Public
Health Minister Mongkol Na Songkhla in a recent
online interview at the Asia Society. "No company
or patent holder wants to talk about lowering the
price or sharing a drug with poor people."
Most recently, as the issue reverberated
in the headlines and at the World Health
Organization (WHO) meeting in Geneva, Abbott and
Thailand did negotiate, though unsuccessfully.
Thailand repeated its offer to refrain from
compulsory licensing if the patent holders lower
prices to generic levels. Abbott reduced Aluvia's
price to $1,000 per patient annually, still above
Thailand's generic price of $695 and out of range
of a deal.
If fighting over that $300
difference while lives hang in the balance seems
petty, it may also be a sign that the two sides
are not so far apart this time. Yet the issue is
much bigger than one HIV drug in one country.
Cancer, heart disease, diabetes and other chronic
illnesses loom large throughout the developing
world, and so does the issue of access to
medication to treat them.
Brazil and
Thailand announced at the Geneva WHO meeting that
they will cooperate on health care, a sign that as
their drug needs grow, developing countries could
organize and exert collective power on pricing and
generic licensing.
The growing conflict
particularly hurts trade relations with the United
States, where most advanced drug research and
development are located, and Asia, where most of
the generic manufacturing is located. Investors
know AIDS, severe acute respiratory syndrome,
avian influenza and other diseases may threaten
Asia's emerging economies, so drug-access disputes
in Asia also hurt their interests. But trade
issues aside, isn't equitable drug access a human
right?
Neither the flawed patent system
nor the disputed TRIPS agreement can adjudicate
these complex issues adequately. Thailand, Brazil
and others may bring the pharmaceutical companies
to the table by invoking TRIPS
compulsory-licensing and other provisions, but may
not reach equitable compromises on pricing without
more help.
It's time for Group of Eight
governments to get involved. They can re-engage
TRIPS, reaffirm WTO intellectual-property rules,
and stop pressuring developing countries into
trade agreements that destabilize them. Renewed
leadership and creative thinking could strike an
equitable balance between the interests of patent
holders and the interests of global health and
human rights. Meanwhile, they remain on a
collision course.
Elizabeth H
Williams is the acting director of the Asia
Society's Initiative on HIV/AIDS and Global
Health. Thai Public Health Minister Mongkol's full
online interview is posted at
www.asiasociety.org.
(Copyright 2007
Asia Society.)
Speaking Freely is an
Asia Times Online feature that allows guest
writers to have their say. Please click hereif you are interested in
contributing.
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