[Ip-health] WSJ ASIA: Letters to the Editor Debating Thailand's Drug Patent Policies

[Ellen T HOEN]

 Letters to the Editor
 Debating Thailand's Drug Patent Policies
 5 March 2008
 The Wall Street Journal Asia, The Wall Street Journal Europe


 Every day, Medecins Sans Frontieres/Doctors Without Borders is confronted
 with two deadly truths that show how relying on "the profit motive to
 research and develop new drugs" is a woefully inadequate response to
 addressing the health needs of people in developing countries.


 First, those who cannot afford the price of medicines must simply go
 untreated. Thailand's recent moves to overcome the barriers posed by
 patents are an attempt to address that stark reality. When Thailand issued
 a compulsory license for the HIV/AIDS medicine efavirenz in 2006, health
 authorities were able to import a generic version at a fraction of the
 cost, allowing doctors to treat thousands more patients with this
 important medicine. In doing this, Thailand utilized internationally
 recognized legal provisions in World Trade Organization rules, not a
 "loophole" as The Wall Street Journal misstates.


 Second, diseases that hit first and foremost the poor, like tuberculosis
 or sleeping sickness, do not attract research and development. Like any
 corporation, a drug firm looks to the bottom line. When there is no viable
 market, there is no investment, and consequently no drugs. Pharmaceutical
 research and development is costly, and somebody does need to pay. New
 ways must be devised to stimulate medical innovation, while ensuring that
 whether patients can actually access life-saving medicines is not an
 afterthought, but a core concern. Today, even some pharmaceutical
 companies recognize the weakness of the patent system to deliver for the
 developing world. The profit motive, which abandons so many to their fate,
 cannot be the only answer.


 Dr. Buddhima Lokuge


 U.S. Manager,


 Access to Essential Medicines Campaign


 Medecins Sans Frontieres/


 Doctors Without Borders


 New York


 ---


 Your editorial on Feb. 27 ("Bangkok's Drug War, Round Two") implies that
 Thailand's former government misused a World Trade Organization provision,
 known as compulsory licensing, which allows developing countries to
 produce or import cheaper drugs for their people in certain circumstances.


 Oxfam insists that Thailand's actions are perfectly legal. Even the World
 Health Organization supported the use of this provision. The country
 merely applied a basic public health safeguard which has been used
 repeatedly by developing countries to reduce the prices of vital medicines
 when faced with public health challenges, like the one Thailand is now
 facing.


 The compulsory licensing policy is necessary because the pharmaceutical
 industry has not taken the steps your editorial claims. Nearly all
 pharmaceutical companies have failed to truly institute affordable pricing
 for their medicines in response to the economic reality of each developing
 country. Thailand's decision to use and apply public health safeguards was
 needed precisely because Big Pharma ignored and delayed the Thai
 government in negotiating fair and sensible price reductions.


 If the job of the new health minister, Chaiya Sasomsup, is to look after
 the health of all people in Thailand, Oxfam maintains that Mr. Chaiya
 should continue using compulsory licensing. As he reflects over whether or
 not to go ahead with further approvals, we can only hope that the minister
 will rightly put the health of Thailand's poorest communities ahead of
 profits.


 Sarah Ireland


 Oxfam Regional Director for East Asia


 Oxford, England


 ---


 While the premise of your editorial is correct, you lose important nuance
 in your discussion of the problem of Thailand, and any nation, which
 breaks patents on drugs. For a variety of reasons -- regional price
 setting preventing efficient pricing, inertia, lack of attention from head
 office, concerns about drug diversion and reimportation, etc. -- most drug
 companies do not tier prices for most of their drugs. Drugs for HIV and
 other high profile diseases are the exception. Breaking patents is not a
 good solution, but Western companies have to do more to tier their drug
 prices if they are to sensibly prevent governments, like Thailand's, from
 acting abusively. This will hopefully also stop economically illiterate
 NGOs from having any further influence in such locations.


 Roger Bate


 Resident Fellow


 American Enterprise Institute


 Washington, D.C.