Abstract
In late 2006 and early 2007, the Thai government announced its intention to introduce the use by the
government of patents for three pharmaceutical products: two antiretrovirals (ARVs) and an anti-thrombotic
drug. This action, which was aimed at improving access to essential medicines in the public sector,
complied with the flexibilities of the Agreement on Trade-related Aspects of Intellectual Property Rights
(TRIPS). By employing qualitative approaches, this study assesses the involvement of key stakeholders in
the policy process. This analysis suggests that the idea of enforcing TRIPS flexibilities for expanded access to essential
medicines in Thailand was adopted as a public policy when the new government took office after a change
in the political system in September 2006. This policy obtained significant support from non-governmental
organizations in the health sector, patient groups and academics, both inside and outside the country.
However, the action by Thailand was strongly opposed by patent-holding companies, the multinational
medical industry and their national governments. The contributions from civil society were managed in
several forms, such as technical and information support and demonstrations to advocate the policy. Meanwhile,
powerful nations introduced trade retaliation and put political pressure on the Thai side. Global
concern about the unaffordable costs of patented medicines that hampered access to essential health care
in the South was beneficial to the enforcement of the government use provision. The potential diffusion of
this policy from Thailand to other developing countries triggered serious opposition from stakeholders
who lost their benefits.
