บทคัดย่อ
In late 2006 and early 2007, Thailand๛s administration announced its intention to introduce the government use of patents for 3 pharmaceutical products, including 2 antiretrovirals (ARVs): efavirenz and lopinavir/ritonavir combination and drug for heart disease: clopidogrel. According to the Ministry of Public Health (MOPH), this action, with the aim to ensure access to affordable medicines in the public sector, complied with the flexibilities of the Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS). The Thai move prompted rigorous protests and pressure from multinational drug companies and their national governments. At the same time, the use of public health safeguards was praised by international agencies and non-governmental organisations (NGOs). This study assesses the roles of key actors and contextual elements that shaped the processes of policy making and implementation.
This analysis suggests that despite continual advocacy by civil society
organizations, the idea of enforcing TRIPS flexibilities for essential medicines in Thailand was heightened on the governmental agenda and adopted as a public policy when the new administration took office after a military coup in September 2006. To deal with the opposition from powerful parties, the Thai government sought collaboration with existing alliances of domestic and international NGOs, many of which had experienced campaigning for expansion of HIV/AIDS treatment, including those to encourage the use of TRIPS safeguards for public interests. Diverse strategies were employed by responsible government agencies and civic networks in order to alleviate political pressures and avoid trade retaliations. It could be observed that the
government use policy often moved back and forth between the formulation and implementation stage, while limited groups of key stakeholders were involved. While international authorities, such as the World Health Organization (WHO), seemed to be reluctant to participate in the disputes between Thailand and the opponents to the government use policy, global concerns about the unaffordable costs of patented drugs that hampered access to essential health care in the South was beneficial to the Thai action. The potential diffusion of this policy from Thailand to other developing countries triggered substantial tensions between the supporters and opponents of the
government use enforcement.
The introduction of TRIPS flexibility for medicines in Thailand offers several
lessons which may be helpful for resource-poor settings and health advocates coalitions, for example, the roles of public civic networks, relentless advocacy and collective learning among partners, as key factors of success. Policy recommendations
derived from this study emphasize the needs for the commitment and leadership of the WHO, in collaboration with other parties, to bridge the gaps between the demands for and access to health products, by fostering intellectual property management frameworks which do not undermine health of the underprivileged.
