Thai AIDS patients suffer as drug squabble drags on

By Darren Schuettler

BANGKOK, May 22 (Reuters) - Each morning, Somying
waits on the canal near her Bangkok slum for the
iceboat that has become her lifeline.

"It's expensive but I need ice every day," the
33-year-old said of the 12 baht ($0.37) purchase that
keeps her lifesaving AIDS drug, Kaletra, from
perishing in hot season temperatures nearing 40
degrees centigrade (104 F)

A version that does not need refrigeration is
available in the United States, but not in Thailand
where the army-backed government is embroiled in a
patent dispute with its maker, U.S. pharmaceutical
giant Abbott Laboratories.

Abbott will not register the new version, Aluvia,
until Bangkok renounces its January decision to invoke
a compulsory licence under world trade rules which
allow governments to make or buy copycat versions of
drugs for public health measures.

Thailand, which has taken similar action on another
AIDS drug and a heart disease medicine in what it says
is a bid to widen access for its poor, wants Abbott to
cut its prices more.

The company is sticking to its last offer of $1,000
per patient a year, down from $2,200, but higher than
generic versions.

"The new pills would make it easier," said Somying,
whose monthly ice bill eats up nearly half the 800
baht she earns at home tying ribbons for a garland
maker.

"I wouldn't have to buy ice or carry around the cooler
anymore," she said outside the two-room shack she
shares with her two children, including a 13-year-old
son with AIDS.

Still, they are among the lucky ones.


WAITING FOR TREATMENT

Of the 8,000 Thais who need Kaletra, a so-called
second-line drug for people who develop resistance to
initial treatment, only 600 are receiving the drug --
and the older version at that.

Somying, who was forced to leave her cleaning job at a
sausage factory due to AIDS-related illnesses, still
pays 500 baht a month into an employee health plan to
receive Kaletra.

Without charitable donations, Somying, who lost her
husband to AIDS a decade ago, said her family would
not survive.

Her son, back in school six years after he walked out
when teachers tried to keep him away from other
children, receives the drug through the national
health scheme, which covers 80 percent of Thailand's
63 million people.

A former AIDS hotspot, Thailand has won praise for
reducing infections and expanding drug treatment to
100,000 of the 580,000 Thais living with AIDS. But it
now faces budget pressures as more people need
treatment, including expensive second-line drugs.

Somsit Tansuphaswadikul, a doctor at Bangkok's main
infectious disease hospital, said he has 30 patients
on Kaletra but could treat 70 more.

"There is a quota for second-line patients because of
the budget. Some patients may not get access because
it's not available, so they keep on with the old
regimen," he said.

The drug industry's defenders say Thailand, which is
spending $100 million on HIV-AIDS programmes this
year, is a middle-income nation that can afford higher
drug prices.

Bangkok says health care is already its second biggest
budget item after education, but it is worried about
the impact on trade relations with its major partner,
the United States.


"AXIS OF IP EVIL"

Health Minister Mongkol na Songkhla is in Washington
this week to meet trade officials who put Thailand on
a "priority watch list", citing a "weakening of
respect for patents" which could open the country to
trade retaliation.

"We only want access to drugs for people who have no
access.

We can't let them down," Mongkol told Reuters before
the trip he said was aimed at countering "bad
information" about his policy.

Mongkol, who acted after a coup ousted pro-business
Prime Minister Thaksin Shinawatra last year, said he
may target two more drugs, not the 20-30 some reports
have cited.

Mongkol has won support from health groups such as
Doctors Without Borders and former U.S. President Bill
Clinton, whose foundation brokers deals with generic
drug makers to provide lower-priced drugs for
developing nations.

"No company will live or die because of high price
premiums for AIDS drugs in middle-income countries,
but patients may,"

Clinton said in backing Thailand and Brazil, which has
followed Bangkok in overriding the patent on
Efavirenz, an AIDS drug made by U.S.-based Merck & Co
Inc.

Washington has urged the Thais and drug firms to
negotiate.

Its envoy in Bangkok has also criticised a campaign
waged by the lobby group USA for Innovation, which has
indirect links to the drug industry. It accuses
Bangkok of stealing American intellectual property for
military benefit and forming part of an "axis of IP
evil".

Thailand plans to hire a U.S. public relations firm to
counter the attacks, but some say the slanging match
should be replaced by a serious multilateral debate on
how to provide affordable medicines to the world's
poor.

"Drugs are not a tape or CD or something like that. We
need to think about the human right to receive
treatment. It's the same all over the world," Somsit
said.