EDITORIAL

The bottom lineis people's health

In issuing compulsory licences for the heart drug Plavix and anti-Aids drug Kaletra, the Public Health Ministry is taking a bold step to ensure Thailand takes full advantage of the World Trade Organisation's agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), signed by the US and all other WTO members in 2001.

Let us quickly recall what it says. At the Doha ministerial conference in 2001, the declaration on TRIPS and public health clearly states that the agreement ''does not and should not prevent members from taking measures to protect public health''. It goes on to say the agreement ''can and should be interpreted and implemented in a manner supportive of WTO members' right to protect public health and, in particular, to promote access to medicines for all''. To this end, it also says: ''Each member has the right to grant compulsory licences and the freedom to determine the grounds upon which such licences are granted.''

Article 31 of Part 2 of the TRIPS agreement also states that no negotiations with the patent holder are required in cases of national emergency, extreme urgency or public non-commercial use. While heart disease, a top killer here, has not been declared a national emergency like HIV/Aids, the compulsory licence for Plavix complies with WTO rules based on public non-commercial use. If patent holders question the legal validity of the compulsory licences issued by the government over the past few months, they have a right to bring the case to court.

We applaud the government for using all legal methods possible to ensure Thai patients get the cheapest and best drugs available. At the same time, the government should be careful not to unnecessarily further push away foreign investment. Just because the government is not legally required to negotiate with drug companies before issuing a compulsory licence doesn't mean it should not do so. It would do no harm to ask the drug companies first to lower prices to a level comparable to generic drugs. If they refuse, then the government can still issue a compulsory licence. But at least the government will have acknowledged that intellectual property rights ought to be respected in Thailand.

In issuing the compulsory licence, the government should also insist on procuring quality drugs. This means importing them from factories approved by the World Health Organisation. This is particularly vital when it comes to HIV/Aids drugs. Poor quality drugs can increase resistance rates, making it necessary to keep issuing compulsory licences for expensive innovative drugs, which Western pharmaceutical companies spend large amounts of money to research and develop. Just as we acknowledge our right to provide these drugs for our people, we also must ensure we produce generic versions responsibly. Right now, the Government Pharmaceutical Organisation's facilities are not up to WHO standards. The government still has not started construction on a factory outside of Bangkok that meets international standards despite passing a resolution four years ago saying it would build one. Although GPO and government officials say Thailand's generic Aids drugs are of high quality, it would be nice to remove the cloud of suspicion. We hope the government would put patients first and import the cheaper, quality generics from India until construction of a new GPO facility is complete. If the government does this, it will be able to procure drugs with money from the Global Fund to Fight Aids, Tuberculosis and Malaria. The fund refuses to finance Thai-produced drugs because they don't meet international standards.

The money saved could be used to expand patient education. Much of the resistance to Thai generic HIV/Aids drugs is attributed to patients who misunderstand how to take the drugs. This is unacceptable. What is the point of expanding drug coverage if the drugs will prove ineffective due to incorrect usage? All in all, we support the government's efforts to make life-saving drugs affordable. But more work must be done to show the world we are responsible leaders in public health.

Bangkok Post
Wednesday January 31, 2007