Access to AIDS drugs in Thailand
An example of the importance of generic drugs for HIV/AIDS treatment
Thailand has recently issued a compulsory license to produce the generic version of efavirenz.
In developing countries, generic drugs often play a more crucial role in the population’s access to health services as compared to developed countries. In developing countries funds that both the individual and the government are able to commit to health care are often greatly limited. In such countries, a pharmaceutical company that holds a patent on a drug and, therefore, can set the price of the drug, will often mean that many people are denied access to necessary treatment.
Such has been the case with Thailand and efavirenz. As reported by Médecins Sans Frontières, until recently, Merck has held the patent within Thailand for efavirenz. Efavirenz is an important drug in HIV/AIDS treatment and is recommended by the WHO.
Problems with the delivery of efavirenz by Merck have included the price and the reliability of delivery. In Thailand, Merck charged the equivalent of US $41/month which is approximately double of that charged by generic manufacturers in India. As well, there have been problems with the supply of the drug to Thailand.
The government of Thailand has addressed these issues by granting itself a compulsory five-year license to manufacture the generic version of efavirenz. Under the World Trade Organization, countries are permitted to unilaterally issue compulsory licenses if there is a “national emergency”.
It is estimated that in Thailand 12,000 people are infected with HIV/AIDS and need efavirenz. However, because of prohibitory costs and problems with supply, fewer, than this number, are receiving the treatment. The Thai government has indicated that it is finding it more difficult to provide treatment to its people as the costs of pharmaceuticals escalate and people live longer.
Merck has denounced the actions of the Thai government arguing that they were not consulted in an attempt to come up with alternative solutions before the government issued the compulsory license. Merck has also stated that they have not made profits off of efavirenz in Thailand. The pharmaceutical company contends that the problem with the supply and delivery of the drug to the people of Thailand lies not with the pricing of the efavirenz, but with the lack of adequate infrastructure in Thailand that is needed to support treatment delivery.
