In moves that are winning them praise, two South-east Asian governments -- in Thailand and the Philippines -- appear determined to push ahead with plans to provide cheaper generic drugs even if they incur the wrath of pharmaceutical giants.
In both cases, India finds itself roped into these groundbreaking efforts as a major producer of affordable generic medicines. Thailand recently issued a compulsory licence to break the patent of the drug Efavirenz, a vital anti-AIDS drug produced by the multinational Merck, to import generic version of the medicine from India.
Philippines, on the other hand, appears keen to fight a legal battle with the pharmaceutical giant Pfizer in its drive to import a generic version of Norvasc, a drug needed by heart patients, from Indian manufacturers. Manila's case was strengthened in mid-November when Filipino patients who need the cheaper drug joined the court case to defend their rights for affordable medicines, making it a three-way tussle.
Such measures in the interest of a country's health over private sector wealth come at a time when ‘'pharmaceutical companies are on the offensive in developing countries, trying to undermine existing world trade rules to prevent developing countries from getting affordable medicines,'' Oxfam, the international development agency, said this week.
Pressure from developed countries where the pharmaceutical companies are based has also dissuaded developing countries in South-east Asia from exerting their rights to secure affordable medicines to deal with major public health emergencies they face at home.
These rights were guaranteed at the 2001 ministerial meeting of the World Trade Organisation (WTO) in the Middle Eastern city of Doha. At that meeting, governments from both the developing and developed world endorsed the trade-related intellectual property rights (TRIPS), including the safeguards enabling governments in the South to access or produce cheaper generic drugs in the face of a public health crisis.
Issuing a compulsory license was one option, enabling a country to locally produce a generic version of a brand name drug to meet domestic demand. The other was parallel importing, where a country can import a generic drug into its local market despite an expensive brand-name medicine being guaranteed exclusive patent rights.
Thailand's decision to issue a compulsory license to import the generic version of Efavirenz till it starts producing the version locally in six months was a first since it passed the Drug Patent Act nearly three decades ago.
‘'Thailand is completely within the law under TRIPS to seek an alternative to the drug Merck's producers,'' says Paul Cawthorne, Thai country coordinator for Medicins Sans Frontieres (MSF - or Doctors Without Borders), the international relief agency that has been leading a campaign for cheaper drugs in the developing world. ‘'Thailand was faced with a supply problem of this drug due to a massive global demand. The high price was also an issue.''
The measure taken by Bangkok should strengthen its case when it negotiates the price of drugs with other pharmaceutical companies in the future, he added in an interview. ‘'The pharmaceutical companies will know that the Thai government will now not hesitate to get a better deal, cheaper drugs. Since it said that this is the first time to break a patent but not the last.''
‘'It is important for developing countries in the region to make similar moves to ensure that they use their rights under TRIPS,'' Jacques-chai Chomthongde, research associate at Focus on the Global South, a Bangkok-based think tank, told IPS. ‘'I hope what is happening in Thailand will encourage other developing countries to pursue a similar line.''
The Merk's product, which is used as a first- and second-line of medication needed by people living with HIV to prolong their lives, cost patients 41 US dollars a month. The generic version slashes that price in half, being available at 22 dollars a month.
Thailand's quest to offer cheaper drugs for its citizens infected with the killer disease AIDS is in keeping with a pattern established four years ago, when the state owned pharmaceutical agency started producing a local line of generic anti-AIDS drugs that cost 37.50 dollars for a month's course.
Cheaper medicines together with a universal health care package have seen Thailand emerge as a leader among developing countries offering anti-retroviral (ARV) drugs for HIV/AIDS patients. Currently some 85,000 people are covered by this medical care initiative out of over 600,000 people living with HIV. Yet public health experts warn that the country should be ready to supply the second-line therapy of ARVs as the first-line drugs lose their potency.
In the Philippines, the pharmaceutical giant Pfizer has turned the heat on Manila after it filed charges earlier in the year against two government agencies for importing the hypertension drug Norvasc, over which Pfizer enjoys a monopoly in the Philippines. ‘'Pfizer earns 60 million dollars a year in the Philippines selling Norvasc at more than twice the price it charges in other countries -- even though heart disease is the country's number one killer and more than 40 percent of Filipinos do not have access to medicines,'' states Oxfam.
‘'This case is setting a precedent and the government's ability to secure cheaper generic drugs will depend on its outcome,'' Shalimar Vitan, trade campaign coordinator for Oxfam in the Philippines, told IPS during a telephone interview from Manila. ‘'It is also a first for consumers to fight for their rights against Pfizer. There has been no other opportunity for them.''
Filipino public health and fair trade activists fear that a Pfizer victory could undermine further the promises held up at the Doha WTO meeting, since it could strengthen the drug company's patent protection clauses and bolster other pharmaceutical giants in the Philippines to follow. That flies in the face of the decision by the state-owned Philippine International Trading Corporation and the Bureau of Food and Drugs being ‘'legal under Filipino law,'' they say.
‘'If Pfizer is successful, it will severely limit the government's ability to access cheaper medicines and assert its right to enforce TRIPS safeguards,'' states Oxfam.
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