THAILAND: Trade deal could threaten HIV/AIDS treatments – health experts
BANGKOK, 31 August 2006 (PlusNews) - Health professionals and activists fear a proposed bilateral trade deal between Thailand and the United States will hit the availability and price of life-saving HIV/AIDS drugs.
Thailand has won international accolades for its efforts to provide anti-retroviral drugs to people who need them. However, Washington has been pushing Bangkok to adopt new, stronger protections for pharmaceutical companies’ intellectual property rights as part of the trade deal. The measures would go beyond those agreed by developing countries with the World Trade Organisation (WTO).
Public health experts have warned that the new rules, if accepted, could hamper Thailand’s ability to produce cheap generic versions of second-line HIV/AIDS drugs, which were needed for patients resistant to first-line treatments.
They believe the Thai government would have to pay for more expensive drugs from Western companies, seriously straining its health system and finances.
Dr Achara Eksaengsri, deputy director of research and development at Thailand’s Government Pharmaceutical Organisation (GPO), said the government had to plan how it was going to support Thai patients.
An estimated 600,000 Thais are living with HIV/AIDS, with 80,000 receiving inexpensive anti-retroviral drugs produced by the state-owned GPO. They are distributed through Thailand's national health system.
Thailand, which has committed to making HIV/AIDS drugs available to all who need them, hopes to have 150,000 receiving the medication annually within two years.
Socially marginalised groups, including ethnic minorities who lack Thai citizenship, face serious obstacles obtaining the life-saving medication, which is not readily available to those not entitled to participate in the country’s low-cost health care scheme.
However, improved access to the drugs has helped reduce Thailand’s mortality rate from HIV/AIDS, with deaths plummeting by 79 per cent.
The push for a trade deal has increasingly concerned health and intellectual property rights experts.
William Aldis, then the World Health Organisation's (WHO) representative in Thailand, publicly warned in January that the survival of "hundreds and thousands of Thai citizens would be put at risk" if Bangkok accepted Washington’s intellectual property right demands.
“The price of second and third generation HIV drugs will remain exorbitantly expensive,” Aldis warned.
Washington was angered by Dr Aldis’ views.
In late March, Lee Jong-wook, the head of the US delegation to the UN in Geneva, called on the WHO to register Washington’s displeasure with Dr Adlis' comments. A day later, Dr Aldis, 16 months into what is normally a four-year tenure, was transferred, raising deep concerns in Thailand about US efforts to curb the WHO's independence.
Jiraporn Limpananont, a professor at Chulalongkorn University’s Pharmaceutical Sciences department and expert on intellectual property right issues, said the application and influence of such political pressure was a "really bad sign".
“It will be a threat for people all over the world, not just for the Thai people,” Limpananont said.
Under the WTO's “trade related aspects of intellectual property rights” – or TRIPS – agreements, countries can override drug patents by issuing a ‘compulsory license’ to manufacture or import cheaper generic versions of drugs in a public health emergency. The TRIPS agreement also sets out basic rules for respecting patents.
But in a series of trade agreements deal - some completed, some, like Thailand’s, still under negotiation - the US has been pushing its trade partners to accept a package of intellectual property rights measures well beyond their WTO commitments.
A US official has described the adoption of such measures as "a potential deal-breaker".
During a recent HIV/AIDS conference in Toronto, Medécins Sans Frontières (MSF) and other groups called for a moratorium on such measures. The groups demanded governments protect the public from the potential negative consequences of such bilateral trade deals.
Washington has urged Thai authorities to agree to grant pharmaceutical firms "compensatory" patent extensions in case of "unreasonable" delays by Thai authorities either approving drug patents, or approving a drug for market use.
The US has also sought five years of "data exclusivity" to prevent generic drug makers from using clinical trial data and other scientific information from another company to prove the safety and efficacy of a medication for five years after the product hits the market.
US officials claim the proposed measures would not limit Thailand’s ability to meet its citizens’ health needs, while Western pharmaceutical companies say the protections - especially the compensatory patent extension and the data exclusivity - are necessary to ensure they make sufficient profits to encourage future research and development.
But Dr Eksaengsri said the measures – especially the data exclusivity clause - would have a material impact on the state’s ability to produce cheap generic versions of second-line HIV/AIDS drugs.
“Many years ago, Thailand was not a target for Western multinationals to file patents,” she said.
But while the lack of patents gave the GPO freedom to develop generic versions, new protections on scientific data could restrict the GPO’s operations.
Analysts said drug firms like Gilead, which was expected to soon begin providing the drug Tenofovir at a heavily discounted price to Thailand, had been forced to drop prices because they knew countries could produce or import generic drugs.
“I think the multinational companies reduce prices to Thailand because the GPO has the capability to produce drugs ourselves,” Dr Eksaengsri said. “But if we cannot do it because of the trade negotiations, they can set any price that they like.”
A foreign trade expert, who asked not to be identified, said compulsory licensing was a good weapon.
"Developing countries can say, 'we are going to make this unless you cut your price'. It’s a good weapon to use - that itself is a worthy thing to have,” the expert said.