Until he was appointed Minister of Public Health last October, Mongkol na Songkla was known among sections of Thailand’s medical community for his work among the poor. He had spent over 10 years as a doctor healing patients in the country’s remote north and northeast provinces, where poverty abounds. And this experience informs the way he has approached his new job, as a defiant champion for sick people. His mission: to secure affordable generic drugs for patients desperately in need of treatment for HIV/AIDS and heart disease.
By May, the success of his drive was winning praise across the world. His list of admirers included former US President Bill Clinton, the Government of Brazil and, most recently, the public health officials who endorsed Bangkok’s fight for cheaper generic drugs at the World Health Assembly in Geneva. Most vocal have been a growing chorus of grassroots and civil society groups who have come to the defence of Thailand by mounting boycotts of Big Pharma and concerted media campaigns. They see Bangkok’s achievement in the same light as some do revolutions: it has the potential to reshape the global public health landscape as we know it – in this case, the poor in the South being denied essential drugs by the pharmaceutical giants in the North.
Since late last year Thailand has invoked a clause in the rules of the World Trade Organization (WTO) called ‘compulsory licences’. This feature grants developing countries the flexibility to break patents on drugs produced by Big Pharma when faced with a national health crisis. Until now, developing countries had been forced to stay clear of this public health option due to pressure from economic powerhouses like the United States. History, though, is replete with rich nations doing otherwise; most recently, when the West forced the Swiss producer of a drug to counter the deadly avian influenza to give up its patent so that generic alternatives could be produced.
The pharmaceutical giants targeted in Bangkok’s ground-breaking attempt are Abbott, which produces the anti-retroviral (ARV) drugs Kaletra and Aluvia; Merck Sharp and Dhome, which produces the ARV Efavirenz; and Sanofi-Aventis, which holds the patent for Palvis, a blood-thinner. Abbott tried to force Thailand to backtrack by refusing to register seven new drugs there, including treatments for HIV, kidney disease and blood clots. A hostile Thai-bashing campaign by pro-pharma lobbies ensued. Even the US Government got into the act, placing Thailand on a watchlist of countries that violated intellectual property rights.
Yet Bangkok has not blinked. It believes that the power of the pharmaceutical lobby to secure profits over public health is out of step with WTO provisions for the developing world. Washington, for all its tough talk, said as much in early May. ‘While the US acknowledges a country’s ability to issue such licences in accordance with WTO rules, the lack of transparency and due process exhibited in Thailand represents a serious concern,’ stated a report by the US Trade Representative’s Office.
Boripat Dornmon, a 40-year-old who has been living with HIV for 11 years, has reason to feel more hopeful. Voicing a sentiment that the other 600,000 Thais infected with the killer disease will also share, he says: ‘We need the new, cheap drugs to live longer.’*Marwaan Macan-Markar*