An estimated half a million people live with HIV in Thailand. Of these people almost 300,000 are on HIV treatment under a national health insurance scheme paid for by the government.
In Thailand, free access to antiretroviral drugs is limited to the older basic regimens, though demand for the newer drugs is increasing. Many second and third-line regimens are not included because the prices are too high for the government funded schemes.
Free Trade Agreements, such as those with the European Union, Trans-Pacific Partnership and The Regional Comprehensive Economic Partnership include provisions that introduce ever more stringent intellectual property rules. These rules give more powers to companies to protect their products from competition, and keep prices artificially high, which ultimately undermines public access to essential medicines.
Antiretroviral treatment was only included in Thailand’s universal health coverage scheme in 2005, following years of protest and campaigns by civil society organizations.
In 2006 and 2007, the government enforced a public health safeguard policy to override the patents of two antiretroviral drugs. This allowed the health service to import much cheaper, generic versions of the drugs from India. Since that time the mortality rate due to HIV related illnesses has reduced dramatically.
The Government Pharmaceutical Organization (GPO) is the key agency supplying low-cost antiretroviral drugs, either from local production or imports. The GPO was able to produce a combination version of three anti-retroviral drugs which came off-patent in 2003, and has recently expanded its local production capacity to manufacture more drugs. In generating cheaper drugs, the GPO is an essential part of the overall strategy to enable people living with HIV to access treatment.
Civil society groups such as AIDS Access Foundation successfully lobbied the Department of Intellectual Property to adopt a new manual to help with the examination of drug patent applications. The aim of the reviewed manual was to tackle evergreening patents which delay or block competition from generic medicines. The manual, which is the result of consultation with all key stakeholders, was endorsed in October 2013.