Bangkok Post - July 18, 2005
Apiradee Treerutkuarkul

Chief of the Disease Control Department Thawat Sundarachan said the country could not exercise compulsory licensing to produce copies of patented drugs for HIV/Aids patients to fight drug resistance.

"Despite reports of drug resistance among patients using GPO-VIR, the situation does not allow the government to produce more effective drugs at lower prices for them," he said at the end of the three-day national conference on Aids on Friday.

According to a department study, around 3,000 of the 50,000 HIV-positive people taking GPO-VIR have developed a resistance against the drug, and stronger anti-retroviral drugs were needed for them. About 500,000 Thais are known to carry the virus.

Although the figure was worrying, it was not seen as high enough to warrant low-cost, generic versions of a patented drug, because of the high royalty fees involved.

"The problem is the patent holders can demand high royalty fees under the principle of compulsory licensing," he said.

At the moment it costs the Government Pharmaceutical Organisation 1,200 baht to produce a monthly dose of the generic drug for just one patient, which is supposed to be cheap. But those who are resistant to GPO-VIR have to pay up to 24,000 baht per month for taking the two patented drugs Efavirenz and Kaletra.

Dr Thawat said the rate of drug-resistance was expected to increase because the Public Health Ministry planned to distribute the generic drug to 80,000 more HIV/Aids-positive people through the 30-baht universal health care scheme by the end of October, the beginning of the new fiscal year.

A budget shortfall also hindered the production of alternative anti-Aids drugs. The budget the government had endorsed can, at the most, ease the misery of 500 patients dependent on the highly expensive anti-retroviral therapy, he said.

Another problem was the facilities of the GPO factory did not meet the internationally acceptable production standards," he added.

But Jiraporn Limpananont, a lecturer at Chulalongkorn University's pharmaceutical science department, said the Public Health Ministry should immediately exercise compulsory licensing to help patients resistant to generic drugs gain access to brand-name drugs at lower prices.

"The government should not only base its decision by looking at the figures as that would only worsen the HIV/Aids situation in the country," she said. In Brazil, prices of brand-name drugs decreased sharply after the government passed a law on compulsory licensing.

Kamol Uppakaew, chairman of the Thai Network on People Living with HIV/Aids, urged the government to stick to its promise it made during the International Aids Conference last year to widen access to treatment for HIV/Aids patients including those who could no longer take GPO-VIR.

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