Publication Details

J. Kuanpoth, G. Kripke & S. Weinberg (2006). Public Health at Risk: a US Free Trade Agreement could threaten access to medicines in Thailand. Oxford, UK: Oxfam International.


Even though the world faces the threat of potential new epidemics like avian influenza, the effects of trade rules on public health attract little attention. Governments recently reaffirmed their commitment to meet the Millennium Development Goals which include combating HIV/AIDS, malaria and other major diseases, yet little attention is given to the implications of United States Free Trade Agreements (US FTAs) with developing countries such as Thailand, for access to affordable medicines to treat those diseases. These FTAs do much more than regulate tariffs for cross-border trade in goods and services: they change the rules of intellectual property protection in ways that will undermine public health by limiting access to affordable medicines. This report seeks to draw attention to the potential effect on access to medicines of new intellectual property rights protections in US J:TAs. It is part of Oxfam's broader critique of trade rules in FTAs that have adverse effects on development and poverty. reduction. 1 Thailand is a positive example of a developing country that has created effective programs to address the HIV/AIDS epidemic, having invested in prevention and treatment early on. More than 1 million women, men, and children have contracted HIV in Thailand and more than 500,000 people have died of AIDS since the outbreak of the epidemic. Thailand's prevention efforts, which helped avoid more than 5 million new infections, are widely recognized as a success story among developing countries. Nevertheless, there are still around 20,000 new infections each year, with half of new adult infections occurring among women. By preventing a much larger epidemic, Thailand avoided much larger treatment costs. For every baht invested in prevention and treatment in the 1990s, Thailand saved 43 baht in added treatment costs. In 2000 the Ministry of Public Health created the National Access to Antiretroviral Program for People Living with HIV/AIDS (NAPHA), providing a wide range of triple-drug antiretroviral (ARV) therapy. Two years later, the Government Pharmaceutical Organization (GPO) began producing its first ARV triple drug 'cocktail' called GPO-vir for 1,200 baht ($ 31) per patient per month, compared with 18,620 baht ($ 490) for importeo, brand-name drugs. As a result of these efforts, the Thai government has been able to provide ARV drugs to increasing numbers of people who need them. The most important factor making this possible has been the government's ability to procure inexpensive generic drugs. With the introduction of GPO-vir, the HIV/AIDS treatment program was expanded more than eight-fold from 20012003 with only a 40 per cent increase in bUdget. Thanks to the availability of these generic medicines, the government is able to offer life-saving HIV/AIDS medicines to approximately 80,000 people, with plans to expand the program in coming years.

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