Pharmaceuticals threaten Thailand's right to protect public health
Recent attempts by Thailand to make urgently needed HIV/AIDS drugs affordable are being challenged by Pharma companies and the US government. Campaigners fear that this will threaten the right of countries to put public health before corporate profits.
Pills or profit?
istockphoto.com/Ken Hurst
Thailand has been leading the fight against the HIV/AIDS epidemic in Asia, but high drug prices for key HIV/AIDS drug have been one of the biggest obstacles to providing treatment for all those in need.
Recently, Thailand attempted to take measures to lower the prices for urgently needed drugs. Now, it is faced with attacks from pharmaceuticals and the US government for trying to defend its right to protect public health.
Both the US and pharma companies have been pressuring Thailand to abandon the measures taken and negotiate drug prices with the relevant pharmaceuticals instead, while wrongly accusing it to have broken international trade rules.
Thailand has now agreed to hold talks with the pharmaceutical company Abbott, who holds the patent on the urgently needed Anti-retroviral (ARV) Kaletra. HIV/AIDS treatment campaigners fear that if a middle income country is struggling to assert its right to protect public health, low income countries will not stand a chance.
This would jeopardise any progress made on the promise of providing universal access to treatment which the G8 countries made in 2005.
Patents
Drug patents are like a contract between the drug company and the government in a country where they want to sell a particular medicine, giving the company full ownership of it for a certain amount of time. This means no one else can make copies of the drug - effectively setting aside the ususal market rules of competition and putting the company in the position of being a monopoly supplier. The patent owner has thus the ability to charge high prices for their product, as they have no competitors.
The World Trade Organisation’s TRIPS agreement sets out minimum international standards for intellectual property protection such as patents. It currently grants monopolies to drug companies for a minimum of 20 years. This is blocking the generic competition needed to bring prices down.
Generics
When a patent expires in a country, or when it does not apply there, other companies can start to manufacture and develop copies known as ‘generics’. India, Brazil, China and Thailand are examples of countries with important generic industries.
Generic firms, producing safe and effective copies of brand drugs at far lower prices, have been helping to break the monopoly on medicines, and through competition have been forcing all prices down.
Generic HIV/AIDS drugs have been certified as safe and effective by the World Health Organisation (WHO), and generic manufactures were the first companies to combine the three drugs needed for a full treatment or cocktail, into two pills taken daily. These two dose ARVs simplified taking the medicines so that even people in the poorest regions could take them effectively.
The importance of generics
Thailand itself has been committed to providing universal access to HIV/AIDS treatment since 2003. The country’s own production of generic version of Anti-retrovirals (ARVs) has dramatically reduced the cost of these drugs, enabling the government to move closer to providing treatment for all those in need.
“Generic production is the cornerstone of Thailand´s universal HIV/AIDS treatment programme. Before generic production, the cost of standard HIV/AIDS treatment in Thailand was over 33,330 baht per patient per month (US $924), and only 3,000 people were getting treatment. In 2002, Thailand launched a generic version of HIV/AIDS triple therapy, resulting in an 18-fold drop in the cost of treatment. Thanks to this, over 85,000 people with HIV/AIDS are today receiving treatment.” Medicins Sans Frontiers (MSF)
However, newer lines of ARVs, that are urgently needed by increasing numbers of patients who are resistant to older formulae, are still being priced out of reach by trade rules on patents.
In order to make the urgently needed HIV/AIDS treatment affordable, and to ensure more reliable supplies, the Thai government has issued compulsory licences for two key ARVs. This will allow the government to import and produce generic versions of the drugs without having to get prior permission of the companies holding the patent. This move could bring prices down to a third of the prices currently charged by the patent holders.
Public health protection is legal
Thailand’s move to put public health before the profits of pharmaceuticals is fullfilling a moral obligation to its people and is perfectly legal under World Trade Organisation (WTO) rules.
The 2001 Doha Declaration signed by all 142 WTO member states, asserts that access to medicines is a fundamental part of the right to health. In the face of millions of people dying needlessly each year, because the treatment they urgently need is priced out of reach, the Doha Declaration enshrines the principle that trade rules on patents are not as important as public health.
The WTO’s Trade-Related Intellectual Property Rights (TRIPS) agreement allows for compulsory licencing, in cases of national emergencies or other cases of extreme urgency and cases of public non-commercial use.
US hypocrisy & Pharma pressure
Despite the legality of Thailand’s move to use compulsory licencing, the Pharma industry has been flooding the media with comments that Thailand is breaking international trade rules, trying to stir up widespread opposition to Thailand’s move. Individual companies as well as organisations like the Pharmaceutical Research and Manufacturer’s Association, have been threatening Thailand with legal action and the withdrawal of investment.
The US government has also put pressure on Thailand to withdraw the compulsory licences, and instead to start long-winded processes of price negotiations with drug companies. This does not come as a surprise. The close links between the US Pharma industry and the US government have been well documented. They include significant transfers of personnel from industry into government and vice versa, vast investments in political lobbying, and industry executives holding influential positions within government.
Furthermore, given the fact that the US has been making extensive use of compulsory licencing ranging from licences for bird flu vaccines to software, automobile and television technology, their move seems hypocritical.
Wider Implications
The enormous pressure applied by the US and the Pharma industry not only threaten Thailand’s right to protect public health, but have much wider implications.
If Thailand as a middle income country is not able to assert its rights then low income countries will be discouraged from even trying to use the same processes. On the other hand, if Thailand is successful, this will send an encouraging message to poorer countries wanting to take similar measures.
People & Planet believes it is crucial for the international community to support Thailand’s use of compulsory licencing as a measure to lower drug prices in order to provide essential medicines.
