[Pharm-policy] US pressure on Thailand

[James Love]

-------- Original Message --------
Date: Fri, 20 Jul 2001 16:01:20 +0200
From: Tido von Schoen-Angerer, mailto:msfb-Yerevan@msf.org

The Lancet, Vol 358, July 20, 2001

US pressure on less-developed countries


Sir--What makes the conflict between the US and Brazil reported in your Feb
10 news item1 noteworthy is the fact that Brazil is trying to resist the
pressure.

Thailand has been subjected to trade pressure from the US government for
increased intellectual property protection of pharmaceuticals since 1985.2
By contrast with Brazil, the Thai government has not felt able to resist or
undo the damage. Thai patent law was amended to include pharmaceutical
product protection in 1992, when Thailand came under threats of trade
sanctions by the US Trade Representative after a complaint by the US
Pharmaceutical Manufacturers Association, underline if present.

The Thai Safety Monitoring Programme (SMP), a postmarketing surveillance
system, has been abused to provide protection and thereby monopolies to
drug companies. In 1989, an interim measure was applied to allow 2 years
monopoly for all new drugs entering under the SMP, which was extended to
5-6 years in 1993 after further US pressure. Thailand was not required to
provide patent protection before 2000 and is not required to provide
exclusive marketing rights for non-patented drugs at all.

The SMP system has led to substantial delay in generic availability for
drugs such as antiretrovirals, and many others, although none of these
drugs are patented in Thailand. Some drugs have completed the SMP and have
become affordable thanks to generic production. Such falls in price can
mean life or death in a country still in the aftermath of the economic
crisis and the highest number of AIDS deaths in Asia.

Thailand has done little to undo the damage of US pressure. The SMP was
revised only in January, 2001: market exclusivity was removed and safety
monitoring strengthened. However, market exclusivity is abolished only for
drugs already covered by the 1992 patent law, and is preserved for drugs
patented abroad between 1986 and 1991 that the US government has sought to
protect. WHO and UNAIDS had supported a more decisive amendment but
Thailand did not question the concessions made under US pressure in 1992.

Another disturbing experience was the failed attempt to issue a compulsory
licence for the formulation patent of didanosine in early 2000. Despite the
US government's promise in December, 1999, for a more flexible trade and
patent policy for medicines, they continued to warn the Thai government
against the use of compulsory licence. Eventually, demonstrations in
Bangkok and in the US forced them to relent. But the initial warnings were
hard to forget and the Ministry of Public Health rejected activist calls
for compulsory licence.

Solutions must come from both sides. The USA and other western governments
should commit to a moratorium on World Trade Organisation disputes that
affect access to medicines. Less-developed countries should follow the
example of Brazil in resisting the pressure and make maximum use of
available safeguards to protect the health of their people.
*Tido von Schoen-Angerer, Jiraporn Limpananont



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*Medecins sans Frontieres, 311 Ladphrao soi 101, Bangkok 10240, Thailand;
and Faculty of Pharmaceutical Sciences, Chulalongkorn University, Thailand
(e-mail:msfdrugs@asianct.co.th)


1 Ahmad K. Brazil and USA at loggerheads over production of generic
antiretrovirals. Lancet 2001; 357: 453.


2 Wilson D, Cawthorne P, Ford N, Aongsonwang S. Global trade and access to
medicines: AIDS treatments in Thailand.  Lancet 1999; 354:
1893-95. [Text]