Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
Bangkok Post - February 8, 2008
Theerawut Sathitphattarakul
New Public Health Minister Chaiya Sasomsab came under fire yesterday from his predecessor, medical experts and health activists for his plan to review the compulsory licensing (CL) of cancer medications. Former public health minister Mongkol na Songkhla said Mr Chaiya had the right to review the schemes, but if compulsory licensing was dropped, the public would know who was benefiting from the decision.
It would be a shame if the programme was terminated because poor people would not get access to costly life-saving drugs and would die with no dignity.
Dr Mongkol, who approved CL schemes to override the patents of four cancer drugs on Jan 4, said that although only about 15,000 people with lung or liver cancer needed the drugs, ending compulsory licensing would have a severe impact on the patients' families and relatives. Many would be forced into bankruptcy if they had to help pay for the costly patented drugs.
It would be wrong if the number of cancer patients was the only factor considered by the new minister.
Mr Chaiya earlier said he wanted to review the correctness of the decision to issue compulsory licences for the breast cancer drug letrozole produced by Novartis, the leukaemia drug Imatinib, also from Novartis, breast and lung cancer drug docetaxel from Sanofi-Aventis and lung cancer drug erlotinib by Roche.
He also wanted to see if the number of cancer patients in need of those four drugs was high enough to justify CL schemes, and whether those patients had any difficulty accessing the drugs.
Nimit Thien-udom, the director of Aids Access Foundation, said networks of Aids, kidney and cancer patients, consumer protection advocates and academics had requested meetings with Mr Chaiya to discuss the matter.
The minister's aides had yet to set any dates for the meetings.
"We want to know his stance on the issue. We are hopeful that his review will provide good results and benefit the public, and patients in particular," Mr Nimit said.
"If he ends the compulsory licensing schemes without good reason, society will question his suitability to be public health minister."
Paul Cawthorne, the head of mission of Medicin Sans Frontieres (MSF), said it was too soon for the minister to comment on the CL issue as he had only just taken up the job. He should listen to other views first.
Mr Chaiya might be under pressure from economic ministries, he said. The minister should care more about the health of the public than about pressure from the Commerce and Finance ministries.
Government Pharmaceutical Organisation chairman Vichai Chokewiwat said the ministry had the authority to review compulsory licensing.
If the minister felt there were other, better ways, he could reverse the announcement, said Dr Vichai.
However, the minister should carefully weigh the advantages and disadvantages before making such a decision.
Rosana Tositrakul, chair of the alliance of 30 NGOs against corruption, questioned Mr Chaiya's move to review the schemes.
His action would spark public speculation about conflicts of interest with international pharmaceutical manufacturers, she said.
Mr Chaiya said he would welcome a meeting with representatives of pharmaceutical firms to discuss the CL issue.
The ministry's announcement of compulsory licensing for the four drugs may please the public, but it was not right.
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