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 11, 2008
Apiradee Treerutkuarkul
About 50 protesters from a network of people living with HIV/Aids and cancer patients gathered at the Public Health Ministry to hand a protest letter to Mr Chaiya who is under public criticism after announcing that he plans to immediately review the CL policy on patented lung and breast cancer drugs Docetaxel, Erlotinib and Letrozole.
The minister was of the view that the CL policy was politically correct but "legally incorrect." The activists expresssed concern over Mr Chaiya's position, arguing that there was no better choice to extend public access to cheap life-saving medicines at this time.
They also asked him to listen to public views, not just the pharmaceutical industry and the Commerce Ministry, before revoking the licences.
"He doesn't know in what difficultly poor cancer patients and their families are. Most of them die because they can't afford the costly patented drugs," said Saichon sae Lim, a patient who has been suffering from ovarian cancer for five years.
"If the new minister really wants to help the poor at the grassroot level who elected him, he will not terminate the licences of cancer medicines," she said.
Mrs Saichon said many cancer patients were dying simply because they found the life-saving drugs unaffordable.
She has decided to put her survival hopes on a strict and healthy diet and exercise, instead of modern medication, because she too can't afford the cancer medicines. Her condition is now too serious and considered incurable by any of the available drugs.
Nimit Thien U-dom, the director of Aids Access Foundation, said the network of people living with HIV/Aids and consumer groups were closely monitoring the new minister's performance, particularly on the licences policy, as any CL termination would seriously hurt the poor. "It will be a shame if he does, as the country would lose so much and the poor would be deprived of life-saving drugs. They will die a premature death," he said.
Mr Chaiya has, however, made it clear he would stand firmly by his decision to review the compulsory licences imposed against four cancer-fighting drugs even though he insists there was no plan to revoke the policy for the time being.
"Saving 500 million baht through the CL policy would mean nothing compared to the damages we could suffer if billions of baht worth of our exports are boycotted," he told the health activists.
He said it was all so clear that the CL policy was the reason why the US Trade Representative had penalised Thailand by putting it on the Special 301 Priority Watch List (PWL). Being put on the PWL has led to the elimination of the duty-free access Thailand enjoyed under the Generalised System of Preferences (GSP) for gold jewellery and other exports to the US since July 1, 2007.
Mr Chaiya said he received a confidential letter signed by former commerce minister Krirk-krai Jirapaet asking the new government to review the policy on compulsory licensing. The letter was sent through permanent secretary for health Prat Boonyawongwirote on Feb 4, the day Mongkol na Songkhla ended his term as health minister.
According to the letter, commerce officials are worried about the policy's impact on the country's relations with its key trading partners, the European Union and the United States, home to several pharmaceutical giants.
The concern is now greater about the possibility Thailand would be downgraded further and put on the Priority Foreign Country (PFC) list, which is the last and most severe US copyright protection category and subject to trade sanctions. The Pharmaceutical Research and Manufacturers of America (PReMA) has threatened to press Washington for tougher action against Thailand.
Drug firms and have continuously accused Thailand of stealing their intellectual property.
But under World Trade Organisation rules, it is legitimate for member countries, including Thailand, to use the Trade-Related Aspects of Intellectual Property Rights (Trips) to issue compulsory licences to make or buy generic versions of patented drugs deemed critical to public health as long as the medicines are meant for domestic and emergency use. Cancer is a leading cause of death among the Thai population. Around 15,000 Thais die each year due to lung and liver cancer alone.
Dr Mongkol on Jan 4 signed four ministerial announcements to license Letrozole, a breast cancer medicine being produced by Novartis, the breast and lung cancer drug Docetaxel by Sanofi-Aventis and Roche's Erlotinib, used for treating lung, pancreatic and ovarian cancer. However a licence issued on a leukaemia drug, Glivec, was eventually cancelled after its maker, Novartis, agreed to supply it free to hundreds of Thai patients under its philanthropic programme.
Dr Mongkol earlier overrode Merck's Aids drug Efavirenz in Nov 2006 and later Abbott Laboratory's Kaletra and Sanofi Aventis' heart drug Plavix in Jan 2007, saying the country could not afford patented drugs to cover 48 million of the 63 million Thais under the universal healthcare scheme.
Mr Prat said he and the minister would discuss and review the CL policy with commerce officials on Feb12.
Dr Vitit Artavakun, director of the Government Pharmaceutical Organisation, said the purchase of the generic version of Docetaxel might have to be delayed if the Public Health Ministry goes ahead with the CL policy review.
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