Thailand, which provides free medical care for the poor, is clashing with the powerful pharmaceutical industry by becoming the first country to approve a copycat version of a heart disease drug that is seen as highly effective and widely used.
In a move that activists hope will set a precedent for developing countries, the army-backed government has decided to allow imports of cheaper generic forms of Plavix, the world's second top-selling medicine, and AIDS drug Kaletra.
Last month's decision has drawn outrage from drug companies who say it damages Thailand's image in the global business community. But the government responded that it is acting in line with WTO rules.
"Heart disease is one of leading causes of death among Thai people. We are dealing with the lives of many people," said Sanguan Nitatayarumphong, the secretary-general of the health security office at the public health ministry.
"We are just helping our patients, and our decision is consistent with WTO rules," Sanguan said.
A WTO deal in 2001 allows nations affected by diseases such as HIV/AIDS, malaria and tuberculosis a temporary exemption from international laws protecting intellectual property rights.
Plavix, a blood-thinning treatment to prevent heart attacks, costs 120 baht (US$3.50) per pill.
Sanguan said only 20 percent of heart disease patients in Thailand have access to the life-saving medicine. The generic version approved last month will cost only six to 12 baht per pill.
"We are human beings. Human beings want to survive. If the drug is cheap, people can easily access it and there should be no problems," he said.
Plavix, sold by French-based Sanofi-Aventis and its US partner, Bristol Myers-Squibb, raked in global sales of US$5.9 billion in 2005.
Thailand's top pharmaceutical group, which comprises 38 drug firms, has slammed the government's decision, saying it was "a stunning blow" to foreign investment in the kingdom.
But the government dismissed the criticism and said it would start importing the generic Plavix, as well as the generic anti-retroviral AIDS drug Kaletra, from India this year.
Paris-based NGO Doctors Without Borders lauded the government's move, saying it should become a precedent for developing nations struggling with rising costs of imported drugs.
Sanguan said the government had to speed up generic drug programs in the face of ballooning health care costs, which amount to more than 250 billion baht each year.
"Health care costs keep rising, and about one-third of them goes to buy imported medicines and medical equipment," the doctor said. "With generic drugs, we can treat more people under the same budget."
Former prime minister Thaksin Shinawatra, ousted by the military in a September coup, set up an enormously popular health scheme allowing Thais to pay only 30 baht for each visit to the doctor.
Following the putsch, the army-installed government went further by scrapping the 30-baht payment, creating a free-for-everyone health care system.
The UN has also hailed Thailand's universal HIV/AIDS treatment program, which helped slash the number of deaths from AIDS by about 75 percent in 2005. Today, nearly 600,000 people are HIV-positive in Thailand.
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