For 10 years, anti-TRIPS (Trade Related Aspects of Intellectual Property Rights) activists dreamed that Thailand would become the first developing country to use compulsory licensing to vitiate patents and thus facilitate the wholesale theft of innovative pharmaceutical products.
In 2006, these activists took advantage of Thailand’s military coup, which temporarily removed democratic safeguards, and pressed for the issuance of compulsory licenses against both innovative HIV/AIDS and cardiac therapies. (At the same time, the Thai military junta turned down offers of free or heavily discounted drugs from the Global Fund and the innovative companies themselves, and retained high import taxes and duties on essential medicines.)
Now India, an advanced country with a democratically-elected government, is taking a look at the Thai model to see if it might be appropriate. But policymakers in India should take a careful look at the Thai experience before heading down that road.
Activists trumpeted the importance of local production by Thailand’s Government Pharmaceutical Organization (or GPO, a profit-making Ministry of Health monopoly whose ineptitude has been rivaled only by its high levels of corruption). GPO products, however, repeatedly failed to meet World Health Organization (WHO) standards for anti-retroviral drugs (ARVs). And Thailand’s insistence in exposing Thai patients to substandard GPO products like GPO-Vir has increased substantially the viral resistance in patients to both the GPO product and the innovative products that it mimics.
Why would activists accept an increase in patients’ exposure to drugs that actually reduce the effectiveness of ARV therapies? Because they’ve grown to love compulsory licenses for compulsory licensing’s sake. For them, it’s more about doing away with patents than it is about delivering effective therapies for the sick.
These NGOs have no apparent quarrel with either the GPO or Indian importers making a profit on the production and sale of (even substandard) medications, or with Thai import taxes that raise government revenues on the backs of poor, sick Thais.
And while activists point to lower prices, this is a crude measure that fails to make the case of long-term benefit, particularly where free legitimate ARVs are available from the Global Fund and innovator companies. Moreover, bargain-basement drugs are no bargain if they can’t meet shelf-life, bio-equivalence and other public health safeguards needed to prevent increased viral resistance.
Now the question is whether India, whose new-found interest in protecting intellectual property has attracted record levels of growth in foreign direct investment in biotechnology and international technology transfer, will fall prey to pressure from activists and make the Thai mistake.