Thailand's drug problem: the US State Department

Thailand wants to provide free medicines for drugs and heart disease to its poorest citizens. That sounds good to me. Apparently my government doesn't agree:

Thailand's Public Health Minister said U.S. trade officials didn't relent on their opposition to his plan to copy drugs made by companies including Abbott Laboratories and Merck & Co. after meetings in Washington.

Mongkol Na Songkhla met with Commerce Secretary Carlos Gutierrez and Deputy U.S. Trade Representative John K. Veroneau yesterday in an effort to avoid retaliation against a plan to invoke a World Trade Organization provision allowing nations to approve generic drugs made without the patent owners' consent. (Bloomberg)

How noble of the US, to defend the rights of Big Pharma over the lives of poor Thais. In March the US put Thailand on a list with eleven other countries as among the world's worst infringers of intellectual property. Thailand meet China. China meet Thailand. Being on the Priority Watch List increases the chances Thailand will lose trade privileges, something it desperately needs. They were told they could get off the list if they cancel the licenses they claimed uner World Trade Organization provisions allowing abrogation of existing licensing requirements in the event of national need. Apparently the lives of poor Thais are not considered a national need by the US State Department.

At issue are the AIDS drugs Kaletra (Abbott) and Stocrin (Merck) and Sustiva (Bristol-Myers Squibb) and the heart medication Plavix (Bristol Myers, Sanofi Aventis).

Thailand says copying the drugs will allow the government to provide free medicine to a larger share of its poorest citizens. The Pharmaceutical Research and Manufacturers' Association, a drug industry trade group, says taking that step would remove the incentive to invest in research, and that its members would retaliate by not introducing new drugs in Thailand.

"We tried to explain our objectives with compulsory licenses, but they talk about how unpleased and upset the drug companies feel about our policy," said Vichai Chokevivat, chairman of the Government Pharmaceutical Organization, who joined Mongkol in Washington. "We are quite concerned after talking to them."

Brazilian President Luiz Inacio Lula da Silva is also planning to issue similar compulsory licenses for Merck's Stocrin. So this isn't just about some poor people in Thailand. It's about an international system of patent protection that is more and more stacked in favor of large drug companies:

The U.S. is opposed to mechanisms that weaken intellectual property rights, said Elizabeth Webster, principal research fellow at Melbourne's Institute of Applied Economic and Social Research in Australia.

"The U.S. is a net gainer of the patent system, so they are very strong in enforcing it and framing it," Webster said in an interview this month. "It's becoming more than a war of chemical research. They obviously think there is big money in maintaining the strength of the patent system and ensuring it's not diluted."

California Congressman Henry Waxman is working to remove Thailand from the Priority Watch List. Good for him. But this is about more than that. Big Pharma claims credit for drug research and development it doesn't do or does badly. Most of the underlying research is done by academics with federal grant money and much of the drug discovery by small biotech companies who license it to the big boys (both influenza antivirals Tamiflu and Relenza are examples). Bit Pharma's claim that high drug prices and the patent system insure innovation is the usual bullshit from those wishing to perpetuate government sanctioned quasi-monoplies. It's no wonder Big Pharma is a big campaign contributor to US office seekers. They get a return many fold for every buck they send as pay offs to Joe Lieberman and his cronies in Congress.

Meanwhile, if you are a poor Thai, you don't have a friend in the US State Department. But at least you will die for a principle.

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"Most of the underlying research is done by academics with federal grant money"

Oh, don't worry, the wingnuts in Congress , from both parties, are eliminating that little item form the public budget. After all, it represents a few precious hours of the glorious war in Iraq.

I would disagree Ron. The drug companies take on all the liability for a drug when the do make it, it dilutes their market. The federal government provides grants to the universities and other facilities but it seems the assertion is that if we have a product that makes someone elses life livable that it should be provided for free. Its a freemarket society and they as corporate entities should have the right to even withold a product if they so desire. Sure Waxman can do whatever he wants, like subpoena them as he is so wont to do but it doesnt change the fact that there are many that believe that we should just give our research to foreign nations. Thats a moral issue, not a business one. To field a drug takes years and then as I said the costs associated wth it are huge along with long term liabilities. The recission of their rights to manufacture drugs copied from any country in the world is not there. They would be nuts to do it. Its a trade issue and not a legal one. There is no difference in this and Supari demanding 1/3rd of the non-existent flu vaccine for Indonesia in lieu of samples. Might want to see if any Thai lobbyists recorded contacts with Waxman. We know that China did and does with Al Gore so its likely the fact.

And Ron I disagree, its much more than a few precious hours of the war in Iraq. It is US intellectual property and there are many who would sell us down the road and have such as the Clintons and Gores. Want to give them the plans to a bomb too?

It is indeed noble of the Administration to protect those intellectual rights over the poor Thais. Its Grand Theft if it happened here in the US. It also doesnt belong to them so how did we get to be the bad guys in wanting to retain something that already belongs to us.

By M. Randolph Kruger (not verified) on 23 May 2007 #permalink

http://www.victorianweb.org/authors/dickens/pva/pva74.html

The Horror! Other countries are acting toward us as Ben Franklin did toward the British.

Outrageous!

Who could justify a poor country, a former colony, deciding not to pay a rich country fees for products that make life livable? Who said anything about life being an inalienable right?

Look at our history. There was nothing we needed from overseas for "life" after the American revolution.

We needed books, which you might consider requirements for "liberty and the pursuit of happiness" -- so we stole them.

"although the Berne Convention greatly simplified the copyright process among European nations, numerous unauthorized American re-prints continued to appear until 1891, when the United States finally agreed to discontinue sanctioning literary piracy. In 1896 the American Congress joined the international copyright union"

By Hank Roberts (not verified) on 23 May 2007 #permalink

Hank-I dont know whether the Thai's are signatories but I believe they are. Dont sign the paper unless you are willing to do the money. Cant stop midway and expect someone to treat you differently after you agree in writing to comply and vice-versa.

http://www.wto.org/english/tratop_e/trips_e/intel2_e.htm

I always say that you have the right to send your money to them if you think they wont use it for a new house on the beach, or to put into a numbered Swiss account afterwards. They kill the ability of our industries to compete with cheap labor and then they want the cake too. Show them the money and they will beat a path to your wallet. If they were making Chevy's illegally and it put Detroit out of work would it be any different? Only that someone was dying instead of being on the unemployment line. I guarantee that someone on that line could really care less if they were. It is a moral issue and not a legal one and more so a trade one. Time for the US to get its back up and simply hold these nations accountable such as China for copyright infringement.

By M. Randolph Kruger (not verified) on 23 May 2007 #permalink

I remember when Australia was in negotiations with the US for a free-trade agreement; the US pushed hard to eliminate our Pharmaceutical Drug Benefits scheme, which provides drugs to consumers at a greatly reduced cost.

Because the system is regulated, and any new drug which wants to get on the PBS has to prove it is better than existing alternatives before it can be subsidised, the drug companies strongly oppose it. It undermines their ability to 'patent update' by releasing a barely different drug upon patent expiration...thus undermining generic distribution.

Even when countries are absolutely within the bounds of IP law, Big Pharma gets its buddies in the US govt to try and interfere with socialised medicine initiatives in foreign lands. Shameless...

By Jon Herington (not verified) on 23 May 2007 #permalink

Melanie, the link --- to the page I quoted from -- is the first line in the posting.
It probably shows up on your page in a different color; your cursor changes shape over it.
Click the mouse to open that link.

Here's another. This is a PDF file, you may need to download it: http://chnm.gmu.edu/digitalhistory/links/pdf/chapter7/7.4.pdf

You know that line about those who don't know history having to repeat it? With intellectual property issues, we're repeating history ---- we now have the other end of the stick.

Notice how one's national perspective changes, depending on which end of the stick your nation is holding, and how badly you need money compared to how badly the other needs what you own.

By Hank Roberts (not verified) on 23 May 2007 #permalink

The whole system of patents and copyright needs revision.

Back 50 years, it took 5-10 years to gear up to a novelty. Now it takes less than 6 months. Back then, advertising took time to penetrate the market, now, with the internet, penetration is faster. Back then, the market was one quarter the size and one quarter the value it has now.

The term of patents and copyrights should be shortened to reflect those efficiencies.

M. Randolph Kruger -

If there is one common theme that unites all totalitarians throughout the 20th century as well as the islamic and secular terrorists, it is the belief that Ideology is more important than human life. By your definition, it would be both moral and noble to refuse water to a dying man in the desert if he couldn't pay.

This is exactly what you are doing. This is not a matter of money, since we are talking about people who couldn't pay anyway. And if fielding a drug were so expensive, then the drug companies could always taske a bit of cash from their marketing budgets.

By Andrew Dodds (not verified) on 23 May 2007 #permalink

It is as I said Andrew, the difference of point here. Would you destroy your pharm industry if you had one to ensure that some guys that will just steal the money from their own people had a vaccine, or the internal right to make one? Your assertion is taken. I just discount it Andrew. You are trying to meld morality into an issue that wasnt an issue 50 years ago so much as it is now. We used to just give this stuff away to all these countries and their life styles got better. Now they want more and they want it for free. Its a catch-22. We end up with Supari's for appeasement, we end up being told by a Waxman that we need to do more for Darfur and Africa, when there are Palestinians dying by the boxloads at the hands of their own people. Water? I can tell you that until the turn of the previous century that is exactly what would happen to a dying man in the desert in Morocco, Algieria, Sudan. The ability to be compassionate is based in the ability to do so. You can say that America doesnt do enough, our image is so tarnished and all of that left wing drivel. If I give someone aid as we did the Germans, Russians, Japanese, Italians, and the bloody damned French and if you want to use water as the example then I would rather use blood. We get shit from these people now and about zero support. The only ones with any real balls are the Italians. Them friggin' Aussies are badassed dudes too and come to our assistance when we ask them.

Ideology Andrew? How about the biblical reference to the fact that I am not my brothers keeper? We do so because we want to, or in the case of any developed nation because we want something they have. Again, trade issue and we arent talking about just drugs here. We have an entire region that is screwing with our balance of trade and we cant send them shit, but they can send us everything. That changes or this nation collapses from the weight of imported everything and especially food.

By M.Randolph Kruger (not verified) on 23 May 2007 #permalink

Kruger, it sounds like you've got a bit of a chip on your shoulder. You especially hate the French, presumably because they opposed the war in Iraq. That has absolutely nothing to do with providing pharmaceutical support to poor countries.

Really, it has to do with supporting the poor with rich medicine. Yes, medicine is expensive to develop, but the pharmaceutical companies get to inflate the prices and make a hefty sum of money too.

You act like America is all by itself in the world, when if the rest of the world decided, they could put a trade embargo on us and cripple our economy in about 12 hours.

By Brian Thompson (not verified) on 24 May 2007 #permalink

Andrew Dodds wrote:

"If there is one common theme that unites all totalitarians throughout the 20th century as well as the islamic and secular terrorists, it is the belief that Ideology is more important than human life."

Andrew, our republic got its start under the same theme: "Give me liberty or give me death." Totalitarians, religio-fascists, and terrorists do not have a monopoly on putting their lives at risk in support of beliefs.

By Path Forward (not verified) on 24 May 2007 #permalink

Brian-I dont hate the French, just most of their former leadership. As early as 98 its was flamingly evident that they were supplying the Iraqi's with everything they needed to reconstitute their nuke program. They helped the Iranians until 14 months ago when it became evident that we had enough to out them at the UN. Did I mention the old Hawk missile batteries that they upgraded for them? Iran, Iraq, Norko they are all in there together and the whores of the EU were selling to them along with Mo. G. in Libya. That puts a chip on my shoulder as I have many friends engaged with the enemies of this country.That also includes the Thai's who would do us economic harm.

As for medicines and the poor. How about you ponying up some money for the poor in this country before we worry one bit about some bozo in Africa who cant read or write and his sole function in life is to raise cattle and make babies that he wont be able to feed?. As for the Thai's they can do plenty to help themselves but sitting back and asking us why we are so pissed about copywrited materials is about as bogus as it gets. They know we are pissed and they arent doing squatty about it. Thats politics inside of a moral issue. We might give them the stuff if they would pull back in another area such as copyright infringements. My mom used to say dont ask for more when your mouth is full already.

By M.Randolph Kruger (not verified) on 24 May 2007 #permalink

To the extent that developing countries attempt to copy patented drugs, big pharma will shift more and more to difficult-to-manufacture drugs like humanized antibodies.

would it be any different? Only that someone was dying instead of being on the unemployment line.

Only? Only?

Ideology Andrew? How about the biblical reference to the fact that I am not my brothers keeper?

Yes, my friend. Read that chapter again.

And then seek professional help -- you are completely devoid of empathy.

By David Marjanović (not verified) on 24 May 2007 #permalink

Oops, forgot to close a blockquote tag. The last two paragraphs are by me.

By David Marjanović (not verified) on 24 May 2007 #permalink

In other words, allowing developing countries to copy patented drugs will force American companies to innovate. Right ken?
:-)

> some bozo in Africa who cant read or write

That's cant, for sure.

By Hank Roberts (not verified) on 24 May 2007 #permalink

David-far from lack of empathy. Just very realistic that to provide these kinds of things to someone else, you have to have them to give. Allowing manufacture of drugs using someone elses patent is allowed but only for the use in their country. Okay, but that doesnt mean that we have to accept it. Its like saying okay, I made it, you broke down the molecular makeup and are manufacturing something for your people when I made it?
What do we tell our workers when they lose their jobs...some guy in Thailand is going to die if we enforce the patents?

When things are good in the US as they are right now, we ship missionaries off, Doctors without Borders etc and a lot of that empathy and actual support comes from donations. We all like to see results too. The Thai's were offered up a drug manufacturing facility that was to be US owned, but they were going only to sell the stuff at locally reduced prices and ship the rest. That wasnt good enough for the Thai's. Its like the vaccine business, there is no money in it...Even in BF because it will mutate too quickly to produce enough vaccine to give it to everyone. Really most anyone. I think Revere quoted it at less than 3% of the worlds population would get it. It also might not be very good vaccine when it does come out. In fact it could be dangerous.

As for empathy, I support four Guatemalan kids right now with my contributions. On the other hand sending AIDS treatments to Africans is like fucking for chastity. They cant understand the instructions on how to do it. Timing is everything on this stuff and they dont have clocks or watches. And dont think for one minute that we are the only ones up in arms about this issue. The EU is also feeling the hits of being successful in their medical treatments.... everyone wants to take something that doesnt belong to them because they feel its their right. Doesnt mean we have to assist them in that process by feeding them either.

AIDs in Africa is the product of many well meaning, money grubbing European nations and their colonizations. I wish it werent so but we have so many poor in the US to take care of and if we werent buying people off with foreign aid, then yes we would have two of three things happening. Fewer poor people, maybe UHC and a bigger military. First two because we'd have the dough to do it, and the last because we didnt buy friendship, we bought howitzers instead to impose our will. That thing with the Thai's just might be too idealistic. If they have a heart attack from lack of medicines is it our fault that we make a product that everyone wants? Goes back to the original premise that I have said before, "Is healthcare a right, or is it a service?" You make it a right and then no matter where you are, there goes the ballgame.

By M. Randolph Kruger (not verified) on 24 May 2007 #permalink

M. Randolph Kruger, you are just another corporate propogandist. At least you are getting paid to oppose any healthcare from which your owners don't get a cut.

Pity your mother didn't love you enough that you would grow up to get a productive job working on the side of the humans. But you fell throught the cracks and a corporation picked you up.

re : --------------
How about you ponying up some money for the poor in this country before we worry one bit about some bozo in Africa who cant read or write and his sole function in life is to raise cattle and make babies that he wont be able to feed?. -------------

How about ponying up some health care for the poor on this planet before we worry one bit about some bozo in Maryland/DC/Conn who can't empathize or think and his sole function in life is to raise his stock portfolio for his babies (and "girlfriends") that he doesn't even know (and probably aren't actually his anyway)

By Gavrilo Princep (not verified) on 24 May 2007 #permalink

Path Forward -

The difference here is that between those who are willing to kill in self defence, and those who would kill simply to make themselves richer and/or more powerful.

Kruger -

You are talking gibberish. Literally.

By Andrew Dodds (not verified) on 24 May 2007 #permalink

"In other words, allowing developing countries to copy patented drugs will force American companies to innovate. Right ken?"

Well, humanized mabs are not exactly cutting-edge. But they're difficult to copy. So you might get Pharma placing more emphasis on bulky, expensive molecules, to the detriment of the general public. But that's hardly regulate-able. Unforeseen consequences.

Gee Andrew, I think you should sell all your possessions and send the money to the Thai's since you feel so strongly about it. Become a priest too. There are other considerations too such as the general population of the planet. It might escape you that that the vaunted UN says instead of peak oil we have really hit peak people. Neither the food or ecosystem can support anything else. In 20 years there will be another billion five people here and with the cost of just being here rising, the poor of the world are going to suffer and big time. Bottom line? They will die from the lack of_______. When it happens, you will blame the US and not the country thats got the problem.

We make more and more things to counter what we have already done and then put them up for sale. Someone buys it because we are a service industry, someone steals it you might see a reduction in the population if it really becomes a big issue. You place a lot into the one supposition that we owe the countries of the world. Uh-huh and that is founded in WHAT? Taking something from their marketing budget? That again goes to the supposition that you think that we ought to just give it to them or let them infringe. Obviously the pharma groups dont think so either and neither do I.

Gavrilo, now how could you call me a corporate propagandist? You dont know what I do, or how I do it. FTR I am an employer with now 50 people who have trouble paying their own medical bills much less some Thai or Africans who didnt know what medical care was until we told them. But its legal to buy votes with tax money in the UN and thats what just giving them the stuff is. Not here though unless its called a grant. You offer up no reason to allow the Thai's to infringe on the patents of other countries other than you think its a good idea. Its not just us, its the Italians, the French for drugs. The Chinese are pretty good at infringing on just about everything too. They always apologize but do it anyway. Be sure to side with them, it will get you places.

Economic war is also a premise for full blown war under the UN charter. Stick with your thoughts though, it gets out of control then and someone willl do something about it and not with heart med pills. This is the first shot across their bow about this. Be happy its not guns.

BTW Ken, I read exactly that premise about the molecular level drugs about three months ago and yes, I believe its where we are headed for more than just economics and infringement reasons.

By M.Randolph Kruger (not verified) on 25 May 2007 #permalink

As an employee of Big Pharma Inc who considers Thailand to be my country-in-law (my wife is a Bangkok native), I've heard both sides of this plenty of times before.

I am NOT going to give my personal opinions on this, (if for no other reasons than because I'm posting from a work computer)... but here's some interesting links that are related. They're about a play called "Cocktails" that's based on the work of Krisana Kraisintu, who fought to make AIDS medications available to poor Thai citizens. She was apparently successful and is currently trying to do something similar in several African nations.

http://www.swinepalace.org/explore.cfm/20062007season/cocktail/
(scroll down to the links under Media on "Cocktails")

http://www.youtube.com/watch?v=zHq6TN2xkHs&eurl

You can also find out more about her work just by googling her name "Krisana Kraisintu".

By doctorgoo (not verified) on 25 May 2007 #permalink

I think the solution here is pretty clear: eliminate pharmaceutical patents for drugs made from public sector research or private sector research paid for with public monies. Sure it will probably make all the pharmaceutical companies collapse, but they can be replaced by other production methods. Besides, it couldn't happen to better people.

Tyler: Don't worry about Big Pharma collapsing. If they do, it will be from their own wrongdoing and accrued liability. The owrst that will happen is that they will become just normally profitable businesses, not obscenely profitable ones.

Now there is something I agree with Revere. Reform the torts, make it a blanket boo-boo number (whatever it is adjudged for) and knock the lawyers out of it. It becomes a fixed cost and that would drop the costs automatically.

They would make better drugs and not Phen-Fen anyone or any of the other problems we see. The will still try to make drugs then but smaller more efficient drug makers will run them down in the crosswalk as they just became more competitive. Its our own fault that they are able to charge as much as they do because each day they dont get sued is another day they get to stick the whole potato into each pocket.

Very good point Revere.

By M. Randolph Kruger (not verified) on 25 May 2007 #permalink

Re: "On the other hand sending AIDS treatments to Africans is like fucking for chastity. They cant understand the instructions on how to do it. Timing is everything on this stuff and they dont have clocks or watches."

I'm curious, Kruger... have you ever been to Africa? The above statement implies to me that you don't have a clue about modern-day Africans. I suggest you actually have some knowledge of the subject before you espouse your arrogant and ignorant beliefs as if they were fact.

By Sharon B. (not verified) on 27 May 2007 #permalink

M.RandolphKruger says:

"Dont sign the paper unless you are willing to do the money."..."I always say that you have the right to send your money to them if you think they wont use it for a new house on the beach, or to put into a numbered Swiss account afterwards."..."Show them the money and they will beat a path to your wallet."..."We used to just give this stuff away to all these countries and their life styles got better. Now they want more and they want it for free."..."I dont hate the French, just most of their former leadership. As early as 98 its was flamingly evident that they were supplying the Iraqi's with everything they needed to reconstitute their nuke program."..."As for medicines and the poor. How about you ponying up some money for the poor in this country before we worry one bit about some bozo in Africa who cant read or write and his sole function in life is to raise cattle and make babies that he wont be able to feed?"..."Thats politics inside of a moral issue. We might give them the stuff if they would pull back in another area such as copyright infringements. My mom used to say dont ask for more when your mouth is full already."..."When things are good in the US as they are right now, we ship missionaries off, Doctors without Borders etc and a lot of that empathy and actual support comes from donations."..."As for empathy, I support four Guatemalan kids right now with my contributions. On the other hand sending AIDS treatments to Africans is like fucking for chastity. They cant understand the instructions on how to do it."..."There are other considerations too such as the general population of the planet."

Well, now, Mr. Kruger, on that LAST bit of that fascinating set of points, we might agree (unless your interpretation has its entire allegiance to the profit motive). Just wait until an epidemic of global proportions catches up with US.

You are a consummate fool, sir - an idiot armed with an ideology who cannot see beyond its cozy little economic/competitive health space, where all things are oh so very easy to judge. Shame on you.

By Arnosium Upinarum (not verified) on 27 May 2007 #permalink