Thailand: Abbott Makes New Offer of $1000 Per Person for HIV/AIDS Drug
World News Connection - May. 15, 2007
[Text disseminated as received without OSC editorial intervention]
Abbott Laboratories, one of the three pharmaceutical giants whose drugs face compulsory licensing in Thailand, has backed off from its threats, saying it wants to continue selling its HIV/Aids drugs here.
Previously, the firm planned to withhold sale of a heat-stable form of Aluvia, its HIV/Aids drug, as punishment for Thailand's compulsory licensing policy.
Representatives of Abbott made the company's stance known yesterday while meeting with Food and Drug Administration (FDA) secretary-general Siriwat Tiptaradol. The FDA also met with representatives from Sanofi-Aventis yesterday.
Abbott's new offer was made on condition that Thailand would not impose compulsory licensing on Aluvia and that the price of the drug, at 3,488.20 baht per person per month, or about 34,000 baht (US$1,000) per person per year, would not come down any further.
(Bangkok Post, 15 May)
Dr Siriwat said the FDA would forward Abbott's offer to Public Health Minister Mongkol Na Songkhla. Abbott's Aluvia price will be compared with the prices quoted by India's generic drug maker, Matrix Laboratories, which produces a generic version of Aluvia at 24,324 baht (US$695) per person per year (or 2,027 baht per person per month).
Matrix made the offer to Thailand and 66 other countries which have agreed to purchase the generic drug, together with the US-based Clinton Foundation.
On the two-hour negotiations with Sanofi-Aventis which holds the patent for the heart disease drug Plavix, Dr Siriwat said the drug giant proposed a one-year project to give patients greater access to the medicine. During the one-year period, the firm would make available 3.4 million tablets of Plavix to 34,000 patients.
The scheme would automatically reduce Plavix's price from 90 baht to about 27 baht per tablet. The FDA will forward Sanofi-Aventis' offer to the health minister, said Dr Siriwat. He added that his committee will invite the pharmaceutical firms to discuss prices again on June 1.
Meanwhile, Vichai Chokewiwat, chairman of the Public Health Ministry's panel on compulsory licensing, said that if the Public Health Ministry chose to buy drugs at prices higher than offered by other sources, it must be able to give the public a good reason to justify its decision.
"If we buy the drug [the generic version of Aluvia] from India at US$695 per person per year, next time, we might get the drug at a lower price, probably as low as US$500. If we buy it from the US firm at US$1,000 now, we might have to continue buying it at US$1,000 forever."
By Robert Goldberg
May 15, 2007
Former President Clinton recently announced he was supporting the decision of Thailand and Brazil to revoke the patents of HIV drugs made by Merck and Abbott. Standing beside Thai Public Health Minister Mongkol Na Songkhla, Mr. Clinton said: "I strongly support the position of the governments of Thailand and Brazil and their decision after futile negotiations." Mr. Clinton justifies the action by stating, "No company will live or die because of high price premiums for AIDS drugs in middle-income countries, but patients may."
Of course, this endorsement couldn't come at a better time for Thailand's military junta, whose popularity is so low (it yanked a parody of its heavyhandedness from YouTube) that it is paying an America PR firm to burnish its image. And the suspension of civil liberties and imprisonment of political opponents have not stopped Doctors Without Borders or Oxfam (which is boycotting Israel to boot) from rallying behind the junta in its effort to deflect attention from suppression of civil liberties by positioning itself as a defender of AIDS patients against the evil drug companies. Having Bubba -- who has his own HIV foundation -- endorse the whole charade was a nice touch.
Thailand and Brazil are strongly supported by public health activists, nongovernmental organizations and even some members of Congress, as the path for solving the health problems of people in poor countries. Yet, when I attended a global health conference sponsored by the University of Toronto's McLaughlin-Rotman Center for Global Health with hundreds of health-care entrepreneurs from Africa, Asia and India, distrust of government solutions to HIV and other health problems was intense. Why? Because despite Mr. Clinton's rhetoric the local health-care providers and start-ups have seen how the drug companies and governments behave and know they can and must do better. In particular, the focus on pricing products for government controlled HIV programs breeds corruption and health risks. According to the Hudson Institute, out of 18 first line drugs for HIV, five patented are cheaper than the lowest copycat price available (including efavirenz). Of the 18 drugs, only four patented drugs are more expensive that the highest copycat price. The same goes for patented versions of combination HIV products. Indeed, Abbott Laboratories, recently offered to sell its drug Kaletra to Thailand at a 55 percent discount a price that would have been far cheaper than any generic version of the drug that's available.
Both Thailand and Brazil decide to break private patents because they see they can make a profit. Because both have state-owned drug manufacturer that will produce copycat medicines and give their companies a monopoly to boot. And in turn both Brazil and Thailand collect tariffs, taxes and fees that tack on an additional 80 percent to the price of medicines which they then sell back to their health ministries.
But Thailand and Brazil came up short on the quality and quantity of HIV medicines in the past. As a result, HIV patients in both countries developed resistance to their medicines and wound up sicker than before. Hence, Mr. Clinton is supporting governments that are less interested in helping people than they are in making money. And the NGOs are shills for this rip-off and assault on patient health.
Another round of company discounts and giveaways to government programs are not the answer. Indeed, if donations were a panacea free food would eliminate starvation and free vaccines would eliminate measles. Rather, the underinvestment in health-care delivery -- as well as the quality of medicines -- is threatening to doom millions to death. Neither Mr. Clinton nor the NGOs have done anything to attract private investment into the delivery of health care in poorer nations.
Indeed, conference delegates were quite clear that the public health model is inadequate and a failure. Rather, the solution will come from start ups who see in the provision of low cost health care to the poor both profit and social opportunity. Which is why the Gates Foundation is investing its $37 billion in entrepreneurs, not government-run health-care programs.
Moreover, partnerships with pharmaceutical and health-care firms are critical to their success. Dr. Yaw Gyamfi, who runs a start-up drug company in Ghana that produces generic HIV and TB medicines, put it this way: "I don't want loans or handouts from NGOs. I want investors. Unless the private sector is encouraged to mobilize vast amounts of capital and create a market for global health, this challenge will not be solved."
Mr. Clinton and the governments he supports may guarantee "cheaper" medicines for the media. But without engaging the entrepreneurs to help those who are suffering, such guarantees will no longer matter. What Mr. Clinton and the NGOs have done in Thailand and Brazil is embolden those who can only undermine the forces of good in the struggle against disease.
Robert Goldberg is vice president of the Center for Medicine in the Public Interest.
Thailand/USA: US website attacks Thai government's breaking of AIDS/HIV drug patents
Thai Press Reports - May. 15, 2007
Section: General News - If you've just visited www.Thailies.com, you might be surprised at the international cyber-media offensive is being played out against the Public Health Ministry as it struggles to make an imported Aids drug cheaper for patients in Thailand, The Nation reports.
It took a clever US lobbyist to devise the strategy and do the work aimed at discrediting the Thai agency's controversial bid, which has severely upset the powerful US pharmaceutical industry.
Last week, Brazil sort of followed Thailand's footsteps when it announced it would also do "compulsory licensing" of a patented Aids medicine legally under World Trade Organisation rules.
Now, both nations are being seen as "bad boys" in the eyes of USA for Innovation, a non-profit unit said to champion the protection of intellectual property rights.
After discrediting the Public Health Ministry's bid with an initial posting of what it calls 10 "Thai Myths", the USA-for-Innovation-sponsored website has said it will release more information to back its accusations over the next two weeks.
"Thailand's Health Ministry is misleading politicians, press and patients in an attempt to gain support from misinformed activists and to funnel money into its government-owned drug company," says the website.
The website's strongly-worded accusations such as Thailand is not a poor country or that the country is not in the middle of an Aids crisis (so it could not justify the compulsory licensing argument) clearly demonstrates that it wants to woo international support against Thailand's bid.
Besides the so-called Thai myths, USA for Innovation also invites its supporters to write to the US president complaining about the compulsory licensing issue along with the absence of democracy following the coup on September 19, 2006.
Supporters are given a pre-written letter, to be undersigned, urging the US president to stand up to the Thai military.
"... I hope that you will deliver a message to the Minister of Health and the military leaders in Thailand that a continued departure from democracy and theft of American innovations will not be tolerated, and that the United States will move quickly to take retaliatory action in the form of trade or economic sanctions or the removal of military aid to protect the jobs of hundreds of thousands of American scientists, doctors, teachers and researchers," says the pre-written letter.
USA for Innovation also urges its supporters to write to the Thai ambassador to the US on the same issue.
Last but not least, Kenneth L Adelman, executive director of USA for Innovation, wrote in a May 9 letter to members of the US Congress urging them to take action against both Thailand and Brazil over the compulsory licensing issue.
So stay tuned for the next development.
Meanwhile, Thai Aids activists outraged by 'lies' in US lobby group's ad, as ministries defend generic drugs, compulsory licensing.
The publicity war between Thai health officials, Aids activists and the pharmaceutical industry in the US has heated up over Thailand's decision to exercise its right to import generic versions of expensive Aids and heart-disease drugs to help poor patients.
The battle was stirred up by an advertisement placed in The Nation on May 10 by USA for Innovation, a group that lobbies for US pharmaceutical firms.
The full-page ad alleged that Thailand's move to invoke compulsory licensing to get around drug patents would hurt "the poor and sick of Thailand".
Most Thais with HIV or Aids would "not have access to the world's best medicines" but would be treated with locally made drugs, it said, such as the Aids drug GPO-Vir - "a copy HIV treatment" - which a Mahidol University study had found to have a resistance rate of 39.6 to 58 per cent.
"This is one of the worst cases of HIV drug resistance in the world," the provocative advertisement said.
However, the Government Pharmaceutical Organisation (GPO), which manufactured the GPO-Vir drug, rejected the allegation on May 10, saying resistance to its product was only 10 per cent.
Wanchai Suppajaturas, deputy director of the GPO, said the drug was good and cheap, and could help save the lives of more than 100,000 people with HIV/Aids.
The GPO was supported by local Aids activists and Medecins Sans Frontieres (MSF, Doctors Without Borders), the acclaimed international health organisation.
"If the drug has high resistance, why are so many patients still using it? And why is the number of deaths from Aids in Thailand decreasing?" Wanchai said.
Aids Access Foundation director Nimitr Tien-udom called on the public to be aware of the hidden message between the "lies" of the advertisement.
"The advertisement is for the interests of those who pay for it. It is clear that the advertisement is an effort to counter the issue of compulsory licensing of US Aids drugs. The money they used to pay for the advertisement came from the pockets of all of us who paid for their expensive medicines," Nimitr said.
USA for Innovation is run by Kenneth Adelman, senior counsellor at Edelman Public Relations Worldwide. Among the largest clients of Edelman is Abbott Laboratories, which is involved in a patent dispute with Thailand over its life-saving Aids drug Kaletra.
MSF representative in Thailand, Dr David Wilson, condemned the ad for "telling lies" and attempting to destroy the reputation of the state-run GPO, which has played a key role in developing cheaper drugs that the poor can get access to.
"It also shakes the confidence of Aids patients about GPO-Vir. This is unacceptable," he said in a telephone interview.
The Nation also received strong criticism from the public for running the full-page ad. Jiraporn Limpananond, a lecturer at Chulalongkorn University's Faculty of Pharmacy, said the paper had "sold its soul" by publishing the advertisement.
"It is so sad that Thai media published an advertisement that told lies and caused disunity among Thais," she said.
Tulsathit Taptim, editor of The Nation, called on critics to judge the paper's editorial stand on the issue - from its editorials. He pointed out that the company's editorial and advertising departments worked independently to ensure both sections had minimal conflicts of interest.
He said the paper was willing to explore the big global controversy over compulsory licensing and would welcome arguments against the ad and give both sides equal reporting space.
On May 10's advertisement is part of a huge public relations campaign by USA for Innovation. While the controversial ad was published in Thailand, Adelman sent an open letter on May 10 to US Congressmen, urging them to respond in a "vigorous manner" to Thailand and Brazil, which moved last Friday to invoke compulsory licensing and break the patent on a US Aids drug.
In his letter, Adelman accused Thailand and Brazil of signalling to the world that they were "unwilling to respect international patent protection".
"Thailand and Brazil have no excuse for their behaviour. They are not poor countries and cannot claim to be in crisis," the letter said.
USA for Innovation has also created the website www.thailies.com and vowed to "draw attention to the deceit in Thailand's decision to steal American and European innovation".
The "recent lies by Health Minister Mongkol Na Songkhla for two weeks from May 7 to 18" posted on www.thailies.com include the use of compulsory licensing. The site claims that Thailand violated the World Trade Organisation (WTO) agreement on intellectual property. It also claims the Health Minister "did not make a single effort to negotiate with drug firms before issuing the compulsory licence".
The allegations were countered or explained by Thailand's Foreign Affairs and Public Health ministries (see graphic).
The Foreign Ministry countered the claims via its website www.mfa.go.th and said that the use of compulsory licensing was permitted under the Trade Related Aspects of Intellectual Properties.
"So, our action is WTO-consistent. Even the USTR has not disputed this," the Foreign Ministry website said. USTR refers to the US Trade Representative, which downgraded Thailand's trade status to Priority Watch List recently - allegedly for worsening intellectual property rights infringements.
The USTR move has left Thailand open to trade penalties and the possible loss of privileges under the General System of Preferences system. This is the first time the Foreign Ministry has got involved in the compulsory-licensing dispute since it erupted early this year.