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The dangers of cheap, low quality medicines : Comments
By Tim Wilson, published 6/8/2007NGOs are far too quick to blame the HIV-AIDS crisis in the developing world on patents and intellectual property regimes.
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Posted by xoddam, Monday, 6 August 2007 5:38:13 PM
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When "the Thai model" is praised, it refers to the same response to AIDS as in OECD countries: pervasive education about safe sex practices combined with prompt medical intervention with HIV-positive people. It is called "Thai" by way of contrasting with the approach of comparable developing countries where disinformation about AIDS is the rule and condoms are scarcer than hens' teeth.
"The Thai model" does not refer to compulsory patent licencing, nor to substandard manufacturing practices.
It is not "the poorest Thais" who become resistant to drugs, but strains of HIV itself.
A Thai-made pill, GPO-vir, containing a mixture of "first-line" antiretroviral chemicals (likewise subject to US patents and compulsorily licenced by the Shinawatra government in 2002) was shown in 2005 to encourage resistant HIV strains more quickly than separate doses tailored to each patient might have done.
For this reason and others relating to graft within the Government Pharmaceutical Office, the WHO has declined to endorse the Thai product for sale outside of Thailand.
But HIV is notorious for developing resistance to whatever is thrown at it, and has done so with each of the chemicals in question in long-term patients in the West, who likewise resort to "second-line" drugs. The key difference in Thailand is that the fixed-dose-combination pill is a one-size-fits-all treatment, available to all Thailand's millions of HIV patients. It is hard to see how any large-scale deployment of antiretrovirals would not similarly have resulted in widespread resistance. GPO-Vir has actually proven very effective.
India showed little respect for US patents until quite recently, and has a long history of quality generic drug manufacturing. Several Indian makers of generic antiretroviral medicines have been approved by WHO and their products are considered to be of equivalent quality to those of the US patent-holders. These include makers of the "second-line" drug recently compulsorily-licenced in Thailand. The Thai government intends to buy exactly these drugs from India, and to develop production capacity in Thailand to WHO standards.
These issues are all discussed with a less ideological bent here:
http://www.asiasentinel.com/index.php?option=com_content&task=view&id=351&Itemid=34