[Ip-health] FW: THAILAND: Trade deal could threaten HIV/AIDS treatments – health experts

[Nathan Ford]

THAILAND: Trade deal could threaten HIV/AIDS treatments ˆ health experts

[This report does not necessarily reflect the views of the United Nations]


BANGKOK, 31 August (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
Œcompulsory 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.


AK/GS/AT/DS

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