Bangkok Post - May 09, 2007

So far, the real issue of how to provide affordable drugs for poor citizens has been skewed by pharmaceutical industry propaganda, mean-spirited name calling and red herrings. Enough is enough.

First, we heard Ken Adelman, a senior counselor for Edelman Public Relations Worldwide who heads a non-profit group called USA For Innovation, spew venom about how "the Ministry of Health threatened to kidnap American tourists" and Thailand was "stealing American assets for military benefit." His group recently launched a new malicious website called Thailies.com.

Then we saw the US Trade Representative release an incoherent report on intellectual property rights that downgraded Thailand to the "Priority Watch List." Concerning compulsory licensing, the annual 301 Report said "the lack of transparency and due process exhibited in Thailand represents a serious concern" - but it failed to mention exactly what that refers to.

Now that Brazil has joined hands with Thailand and issued a compulsory licence for Merck's Efavirenz, it's time for the world to decide how TRIPS should work. Simply launching vitriolic attacks against a government - or tossing vague, unsubstantiated allegations in an annual report - does nothing to advance this important global debate.

Moreover, the conflict will only grow as more governments decide to implement the TRIPS agreement and issue compulsory licences. So policy-makers and industry officials can work now on a multilateral level to find solutions to disputes, or wait until a full-blown shouting match erupts between developing and developed countries.

We applaud Dr Mongkol's efforts to explain Thailand's use of compulsory licences to the rest of the world. His affirmation last week that the government would issue compulsory licences for no more than five drugs that combat deadly diseases, instead of 20 to 30 medicines as some had speculated, was particularly instructive. As a show of good faith, the government can do some other things as well. It can demonstrate its commitment to enforcing intellectual property rights by strengthening relevant laws and getting tough on piracy of optical discs and trademarked goods.

For its part, the US government needs to step up and take action. Although bureaucrats have found it convenient thus far to defer to the powerful pharmaceutical industry by generally avoiding serious discussion of the TRIPS agreement, it now must provide some leadership. US President George W. Bush's administration should declare unequivocally whether it supports Thailand's compulsory licences. If it does not, it should have the courage to give specific reasons for its position according to international or Thai law, and file a case with Thai courts or the WTO's Dispute Settlement Body. This way, Thailand and all other governments will be clear on when and how compulsory licences can be used to provide drugs to the world's poorest patients.

For instance, the pharmaceutical industry is fond of saying Thailand or Brazil is either 1) rich enough to afford the medicines, 2) does not pay enough for health care or 3) spends too much money on other things like the military (Thailand) or uranium enrichment (Brazil). If the US or other WTO members believe these are reasons to deter the use of compulsory licences, then they should propose changes to TRIPS that take this into account. Proposals could call for a minimum gross domestic product, a minimum level of health care expenditure or a cap on other discretionary spending for a country to use compulsory licensing. It could also call for the end of the provision that Thailand cited in issuing three compulsory licences for drugs that fight Aids and heart disease.At the end of the day, this debate needs sober reflection and innovative thinking by serious policy-makers instead of spiteful half-truths and a misinformation campaign fueled by scheming flaks. Now is the time for serious discourse. Lives are at stake.

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