Inter Press Service - September 6, 2006
Marwaan Macan-Markar

The latest change of heart towards Thais with AIDS comes from the United States pharmaceutical giant Gilead. It announced, last month, that it will sell its anti-AIDS drug Tenofovir 90 percent cheaper than the price this patent-protected drug is sold for in the U.S. and Europe.

"The drug will be available at one US dollar per day. It is good for those who need first-line and second-line drugs," Paul Cawthorne of the global humanitarian agency Medicins Sans Frontieres (Doctors without Borders, or MSF), told IPS. "Earlier, Thailand was not due to receive this drug at such a low price that Gilead had committed to supplying other HIV-affected poor countries."

Gilead's announcement follows a significant victory secured by AIDS activists here to compel another pharmaceutical giant, British-based GalxoSmithKline (GSK), not to register its patent in Thailand for Combid, a key ARV drug that Thais infected with the deadly disease depend on. In mid-August, GSK sent a letter to the non-governmental organization (NGO) Thai Network for People Living with HIV/AIDS that it would not be registering its patent for the brand-name drug in Thailand and India.

The patented price of Combid was 8,300 baht (207 dollars) for a month's course of 60 tablets. However, the generic version of that drug produced by the Government Pharmaceutical Organization (GPO), a Thai state agency, costs 1,500 baht (37.50 dollars) for a month's course. The GPO has been producing this generic drug for the past three years.

On Aug.7, nearly 500 people living with HIV/AIDS accompanied by activists gathered outside Glaxo's Bangkok office to protest against the prospect of Combid being patented in Thailand.

Between these two shifts by the pharmaceutical giants came a shot in the arm from the World Bank. During the just concluded 16th International AIDS Conference in Toronto, in mid-August, the Bank released a report that came out in favour of the Thai government using its rights under global trading rules to produce cheaper generic-versions of the second-line anti-AIDS drugs.

"Because the drugs used in second-line therapy are patented, produced and sold by multinational pharmaceutical corporations, Thailand must either pay high prices demanded by those monopolies or exercise its rights under World Trade Organization (WTO) treaties to grant compulsory licence for the manufacture of the drug," the Bank recommends in the report's conclusions.

"Thailand, like Brazil, is now at the vanguard of resource-limited countries that are seeking to provide ART (antiretroviral therapy) as the standard of care to large number of people with progressive HIV," adds the report, 'The Economics of Effective AIDS Treatment: Evaluating Policy Options for Thailand'.

Thailand has over 600,000 people with HIV, out of a population of 64 million. Of them, some 80,000 people have been guaranteed access to cheaper first-line anti-AIDS drugs produced by the GPO under the government's universal healthcare programme.

Those who need the second-line ART number between 5,000 and 8,000 people. According to public health experts, the price range for this line of therapy, which depends on patent-protected drugs, is close to 3,000 dollars per year, an amount few Thais with HIV can afford.

At current rates, states the Bank, the cost of Thailand's National Access to Antiretroviral Programme for People Living with HIV/AIDS for both lines of medication will reach 500 million dollars by 2008. "Beginning in 2010, expenditures on second-line therapy account for more than one-half of total ART spending."

The Bank's generosity towards Thais with HIV is winning praise from some of its trenchant critics. "It is consistent with the Bank's declared mandate. But if you look at its history, it is diametrically opposite to their free trade agenda," Nicola Bullard, senior researcher at Focus on the Global South, a Bangkok-based think tank, told IPS. "They have always been a cheering squad for free trade."

For Thai AIDS activists, the recent changes are expected to bolster their drive for greater care for people with HIV. "We are in a better situation now than what we were before the AIDS conference. The Bank's report will help us in our campaign for changes in government policies," Nimit Tienudom, director of the AIDS Access Foundation, said in an interview.

These developments come at a time when Thailand -- where over 300,000 people have died from AIDS-related diseases since the pandemic hit this South-east Asian country in the early 1980s -- is being warned about a rapid spread of HIV among its homosexual and bisexual population. Nearly 28 percent of men who have sex with men surveyed in a study in Bangkok are reported to have HIV, a recent report revealed.

Not all pharmaceutical giants place the lives of people over corporate profits and offer new, second-line anti-AIDS drugs at slashed prices. U.S. multinational Abbott Laboratories, which manufactures Lopinavir/Ritonavir, is among them.

"We will have fewer fights for access to cheaper drugs than before," says Cawthorne of MSF. "Finally, the issues we have been campaigning for are being understood."

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