Wall Street Journal - May 16, 2007

Your May 7 editorial "Thai Flu Moves South" requires that facts be set straight about Thailand's decision to use compulsory licensing on three life-saving drugs.

First, the use of compulsory licensing is permissible under the World Trade Organization's Trade-Related Aspects of Intellectual Property Rights (TRIPs) Agreement. The consistency of Thailand's decision with WTO rules has not been disputed, including by the U.S. Trade Representative. And while this was the first time Thailand used such a measure, we were not the first to do so.

Second, the decision was not made lightly. We recognize the importance of intellectual property protection to maintain incentives for innovation, as well as the need to balance this with access to medicines to safeguard public health. With the lives of more than 500,000 people living with HIV/AIDS and 300,000 patients with coronary problems at stake, the government could not afford to stand by and watch. Preserving and improving human life and ensuring people have access to health-care products are causes we trust are shared by leading pharmaceutical companies as part of their corporate social responsibility.

Third, public health is a top priority of the government. The government strives to provide universal access to health care for all Thais. For many years, the budget for health and health care ranked number two, just after education. It has increased nominally and proportionally from 4% of the total national budget in the 1980s to more than 11% in 2007. Unfortunately, this increase cannot keep pace with the prices of certain life-saving drugs. The budget for anti-retroviral drugs alone increased to more than $100 million in 2007, from around $17 million in 2004. While continuing vigorously to promote good health practices and HIV prevention, the government must also improve access to treatment without jeopardizing the overall balance in the allocation of budget resources for other development purposes.

Fourth, the Public Health Ministry's announcements on compulsory licensing are for public, noncommercial use only. This means the generic version of the medicines manufactured or imported under compulsory licensing will cover patients under the government's health-care programs. Some 20% of Thais can afford to pay out of their own pockets, and more than two million foreign patients will continue to pay market prices for the original patented products.

Fifth, Thailand is a developing country facing the challenge of a wide gap in income and wealth distribution. The costs of drugs like Kaletra, a second-line anti-retroviral drug, which had cost around $2,200 annually per patient before dropping to $1,000 in April, are immense for a country whose average GDP per capita was $3,179 in 2006 and where the poorest 20% of the population owns less than 5% of national income, while the richest 20% own more than 50% of the national wealth. Many patients remain barely able to afford treatment without government support. Out of the more than 10,000 patients who require second-line treatment like Kaletra, less than 15% have access to the drugs. Out of the 300,000 patients with coronary problems, less than 10% have access to Clopidogrel, also known as Plavix.

Sixth, it had taken the Thai Ministry of Public Health more than two years, including discussions with pharmaceutical companies, before it made its final decision. After the compulsory licenses were announced, the Public Health Ministry still maintained dialogue with all stakeholders to find mutually acceptable solutions.

Seventh, of the three compulsory licenses announced, only one has been implemented. In January 2007, a deal was signed between the Government Pharmaceutical Organization and an Indian drug firm to import 66,000 bottles of generic Efavirenz. The first batch has already arrived and reduced prices by more than half, allowing an additional 20,000 AIDS patients under the government's health-care programs to acquire the medicine.

Eighth, compulsory licensing is neither linked to the current political situation in Thailand nor connected to the country's other economic or financial measures announced or implemented recently. Compulsory licensing is used to protect public health and save lives. Such matters should not be politicized.

Songphol Sukchan, Director of Press Division

Department of Information, Bangkok, Thailand
070516
WJ070505

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