Access to AIDS Treatment and Intellectual Property Rights Protection in Thailand

1
Access to AIDS Treatment and Intellectual
Property Rights Protectionin Thailand

• Jiraporn Limpananont,
• Associate Professor Dr. at Social Pharmacy
  Research Unit, Faculty of Pharmaceutical
  Sciences,
• Chulalongkorn University, Thailand
• Achara Eksaengsri,
• Director, Research and Development Institute,
  Government Pharmaceutical Organization (GPO),
  Thailand
• Kannikar Kijtiwatchakul,
• Access to Essential Medicine Campaigner, MSF
  Belgium Thailand

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HIV/AIDS Epidemic in Thailand

• 1984 HIV first cases in Thailand were reported
  homosexual males IDU, sex workers
  mother-to-child transmission
• 1999 1M. people were living with HIV and 100,000
  people were in need of treatment
• 2007, the Thai Working Group on HIV/AIDS
  estimated the accumulated number of PHA in
  Thailand was 1,102,628 including 50,620 children
  
• An estimated 546,578 people living with HIV/AIDS.
  among those 13,936 people are newly infected.

3
Numbers of AIDS patients mortality and in
Thailand from 1984 June 2008
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Under the 2007 Thai constitution, section 51 of
Part 9 Right to Public Health Service and
Welfare

• Almost 75 or 47 M. of Thai population receive
  Universal healthcare coverage (UC) according by
  The National Health Security Act 2002
• Since Oct. 2005 Antiretroviral treatment (HAART)
  has been included in the UC

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Protesting the exclusion of ARV from the 30 baht
scheme (UC), 2003
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The legal framework for industrial property with
emphasis in pharmaceutical patents

• Thailand lost 13 yrs. to develop its domestic
  drug industry significantly and has been under
  strong pressure of US government pressure since
  1985
• 1992 Thailand passed a law introducing
  pharmaceutical product patent protection and
  extended patent life from 15 to 20 years.
• 1999 Thai Patent Act was further amended,
  disbanding the Pharmaceutical Patent Review
  Board.
• Early 2005, In the sixth round of the negotiation
  in Chiang Mai, US demands were worse than feared

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Event on the 6th round of Thai-US FTA
negotiation Chiang Mai, Thailand Jan. 2006
The Thai-US FTA Negotiation has been stopped.
8
The history of the right to treatment ofpersons
living with HIV and AIDS

• Mid-1990s, improving access to prevention and
  treatment of OIs was started by various related
  HIV/AIDS organizations, Although no access to ARV
  drugs in Thailand prior to 2001
• The most important step was the successfully
  campaign to support for the National Health
  Security Act 2002 and to lobby for the inclusion
  of ARV into National Health Security Scheme in
  2004.
• 1999 Coalition successfully challenged the
  validity of ddI patent held by Bristol Meyer
  Squibb opening the way for the GPO to start
  generic production of ARV.
• 2006 Thai social movement challenged the validity
  of GSKs evergreening patent for the drug
  combination of lamivudinezidovudine. Finally,
  GSK withdrew its application both in Thailand and
  India.

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Production of Antiretrovirals (ARVs) in Thailand
Now, GPO manufactures 16 adult antiretroviral
medicines and 8 paediatric antiretroviral
medicines, including second line drugs
List of ARV produced in Thailand by GPO
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List of ARV produced in Thailand by GPO
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• 2002, GPO-VIR S, was developed and manufactured,
  costs 1,200 baht per month, the cost reduction
  (estimated 800 M. Baht), enabled approximately
  50,000 cases to receive antiretroviral medicine
  free of charge from GPO.
• 2002, Global Fund monies have provided an
  approximately 200 million Baht to purchase
  antiretroviral medicines for 10,000 cases.
• 2004, The use of generic medicines of GPO has
  reduced HIV infection rates in children decreased
  from 30 to less than 3
• 2006, the Thai government launched a universal
  access scheme for all HIV/AIDS patients, free
  antiretroviral treatment to more than 10,000
  employees.

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Transnational Pharmaceutical Companies Affecting
Access to Treatment with ARV In Thailand
Transnational Pharmaceutical Companies
Monopolize the Drug Market via Patent System

• Since amended the Patent Act 1992, under US trade
  pressure, the window of opportunity for local
  manufacturing of new drugs was closed.

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The number of pharmaceutical plants and
importers, and the value of locally produced and
imported drugs, varied by time from 19962006.
15
The percentage of market share of locally
produced and imported drugs
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Transnational Pharmaceutical Companies
Strengthen Themselves as Pharmaceutical Research
and Manufacturers Association (PReMA)

• In 1970, 35 Thai pharmaceutical companies banded
  together to form the original Pharmaceutical
  Producers Association (PPA) before PReMA
  inaugurated its new name and identity on 29
  September 2004
• Today, PReMA has 43 members, which employ nearly
  12,000 staffs

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The Strategies of TNCs and PReMA Affecting
Access to Medicines

• Lobby the government officers and politicians to
  strengthen the higher standard of IPRs through
  Patent Act amendment and FTA
• Mass Media Advocacy Against the Use of CLs
• Lobby the government to cancel the use of CL
• Withdrawal of the new drug registration dossiers
• Request to the USTR to place Thailand on the
  Priority Foreign Country (PFC) under the US trade
  law

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Challenges Availability, Accessibility and
Sustainability
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Local Civil Society in Respect to AIDS
Treatment and Access to ARVs

• Campaigning for the National Health Security Act
  2002
• Challenge the IPR court to revoke of ddI patent
• Pre-grant opposition on Combid patent and others
• Anti-TRIP plus in US-Thailand FTA
• Campaign for TRIPS Flexibilities

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Campaigning for the implementation of CL

• November 29, 2006, Mr. Mongkol Na Songkla, the
  Minister of Public Health, announced for the
  first CL for Efavirenz, followed by the others 6
  drugs

The chronology of CL issuances in Thailand
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The CL campaign was another significant
development step, called the Tripartite Fight
for Patients Rights by Prachachat Thurakit
business newspaper

• The State / Public stakeholders / Civil society

The campaign tried to tell Thai society and the
global community that in the world of trade,
whose aim is to make monetary gains, there is
also a world that has to take into account the
value of life and healthcare, whereby medicines
are a fundamental factor relevant to everybodys
well-being. Thus, the movement of these
people will continue in spite of the vigorous
attacks from the multinational pharmaceutical
industry and those who will lose their benefits
because of this campaign. The globalized
triangle that moves the mountain
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The main challenge

• Development of networking for access to health
  care
• Coalition of patients of the same diseases
• Bringing medicine prices down to match the cost
  of living of the people in the country
• Capacity building of domestic drug manufactures
• Patent-related strategy
• Promotion of rational drug use
• New Drug Research and Development