Thailand's effective HIV/AIDS fight

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Thailand shows how free access to life-saving HIV/AIDS drugs can be affordable
Disease/Infection News
Published: Wednesday, 16-Aug-2006

A new report on Thailand's experience of giving free anti-retroviral drugs (ART) to people living with AIDS suggests that even developing countries with few resources may be able to deliver the life-saving drugs on a large scale, according to the World Bank and the Thailand Ministry of Public Health.

Of the estimated 40 million people worldwide infected with HIV, UNAIDS says between 5 to 6 million could immediately benefit from ART; but currently only 700,000 people are being treated with the new therapy. In contrast, by May, 2006 Thailand was providing treatment for approximately 78 thousand AIDS patients, more than 90 percent of those in need of treatment.

The new report "The Economics of Effective AIDS Treatment: Evaluating Policy Options for Thailand" says that the country's ability to provide ART affordably to more than 80,000 Thais with AIDS is the result of highly effective prevention campaigns over previous years, a vast network of district level hospitals and rural health clinics with the capacity to provide widespread treatment, a strong NGO community that has worked closely with government on rolling out the expanded ART program, and the close involvement of people living with HIV/AIDS themselves.

"Thailand's ART program is a useful beacon for other developing countries which are looking at how to provide this treatment to people with advanced HIV," says Ana Revenga, co-author of the new report and a World Bank Lead Economist in its East Asia and the Pacific department. "We conclude that Thailand can afford universal treatment, and is rightly in the vanguard of developing countries seeking to provide antiretroviral therapy as the standard of care to large numbers of people with symptomatic HIV disease."

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GPO's cheap generic version likely to stay

Pharmaceutical giant GlaxoSmithKline has decided not to seek a Thai patent for its anti-retroviral drug Combid, a source at the Commerce Ministry said yesterday. The withdrawal of its application followed a protest by an HIV/Aids group, which said a patent would give the UK-based firm a monopoly on the drug's sale in Thailand. It could have forced the Government Pharmaceutical Organisation to stop producing a generic version, which is a lot cheaper. Combid, which combines Starvudine and Lamivudine together, is part of a drug cocktail required as a complete treatment for HIV/Aids patients.

The source said the firm's lawyer wrote to the Department of Intellectual Property on Aug 8 withdrawing its application, one day after about 500 people protested outside Glaxo's Bangkok office. The source understood that Glaxo in June ordered its representatives to withdraw its applications in Thailand and India. The company has patents for Combid in the US and Europe, and had been seeking a patent in Thailand since 1997. In February, representatives of the Network of People Living with HIV/Aids met Commerce permanent secretary Karun Kittisataporn and asked the ministry to reject the Glaxo's application. They argued that Combid was not a new drug, just a combination of drugs. The group said Glaxo was trying to exploit the intellectual property law to make itself a sole distributor of the anti-retroviral drug in Thailand. This would allow the company to charge 8,300 baht per 60 tablets, making the medicine beyond the financial reach of many patients.

The local generic cocktail, GPO-Vir, costs only 1,500 baht and the GPO has distributed it free of charge to about 50,000 Hiv patients. The drug consists of Starvudine, Lamivudine, and Navirapine.

The Department of Intellectual Property's director for patents, Seksan Boonsuwan, said earlier that if Glaxo was granted a patent over Combid, the GPO would have to stop production. That would have a big impact on people with HIV/Aids. Network for People Living with HIV/Aids chairman Wirat Purahong said yesterday the Glaxo case reflected a flaw in the process of granting patents in Thailand. The DIP had seemed to push ahead the company's unjustifiable request.

''This problem will be an aggravation when the Thailand-US free trade agreement takes effect,'' Mr Wirat said. The US wanted Thailand to toughen its law on intellectual property, which would give protection to key drugs. Mr Wirat claimed the DIP was also amending the Patent Act to allow people to oppose a patent request only after a patent was granted. ''This would allow the patent granting process to go ahead without careful consideration,'' he said.

Thailand global role model
The World Bank has urged developing countries with few resources to fight Aids, to take their lead from Thailand's prevention programmes of recent years.

Thailand has more than halved the number of new HIV infections in the past decade and has won praise for its National Access to Anti-Retroviral Programme for People Living with HIV/Aids. Started last October, it provides anti-retroviral drug treatment for nearly 80,000 people.

The bank said the seeds were planted about a decade earlier when Thailand made Aids prevention a top priority and introduced initiatives such as the 100% Condom Programme, which promoted usage among sex workers. BANGKOK POST, REUTERS