Thailand’s new Public Health Minister, Chawarat Charnveerakul, has said that imposing compulsory licensing (CL) is “the last mechanism” that the government would use “to help the poor get access to life-saving drugs at a fair price."

"First, we have to negotiate with drug firms to reduce the price of their drugs. If they do not agree with us we will then impose compulsory licensing for expensive drugs to save our patients’ lives," said Mr Chawarat, who was appointed to his post this month in a cabinet reshuffle. He added that his Ministry had not revoked the CL policy as a way of obtaining essential drugs, but retained it as “a key mechanism” in negotiating for lower prices.

The previous Public Health Minister, Chaiya Sasomsub, who was appointed Commerce Minister in the reshuffle, faced an impeachment campaign by health activists and patient groups earlier this year after he announced that he would cancel the CL policy introduced by his predecessor, Mongkol Na Songkhla, and review the compulsory licenses already issued, because he believed the cost to Thailand of paying the drugs’ full prices would be less than that of trade sanctions or boycotts, especially from the USA.

During his visit to Thailand this month, US President George W Bush announced his intention of restarting Free Trade Agreement (FTA) talks with Thailand, which are currently suspended, and Mr Chaiya again warned that CL would endanger such negotiations. However, opposition politicians have urged the new Public Health Minister to take “a firm stance on safeguarding public rights to affordable life-saving medicines” through the policy before continuing trade talks with the USA. Anything beyond the Trade-Related Aspects of Intellectual Property Rights (TRIPs) Agreement “should not be accepted,'' said Buranaj Smutharaks, deputy health minister of the opposition's shadow cabinet.

Mr Buranaj also criticised the government for still not having a clear policy on CL, even though it is lawful and “fully within the TRIPs framework.”

Mr Chawarat says he will also pursue other policies to lower drug prices, which could include bulk buying, price controls and cutting import taxes, plus the new option of collaboration with other nations that operate PL policies in negotiating with the drugs’ patent holders. HIV/AIDS activists have urged him to include civic groups in these negotiations.

Meantime, as Mr Chawarat took office he was also urged by doctors to speed up procurement for Thailand’s universal health care scheme of the seven drugs covered by the CL policy so far.

Currently, generic versions of only two HIV/AIDS drug treatments - Merck & Co’s Stocrin (efavirenz) and Abbott Laboratories’ Kaletra/Aluvia (lopinavir/ritonavir) – are being imported for distribution to patients under the scheme, while Novartis’ Glivec/Gleevec (imatinib), whose patent was originally overridden by Thailand, is now being supplied free to leukemia patients in the country under an agreement between the company and the government.

The other drugs covered by Thai compulsory licenses so far are Sanofi-Aventis/Bristol-Myers Squibb’s antiplatelet blockbuster Plavix (clopidogrel) and three cancer treatments - Sanofi’s Taxotere (docetaxel), Roche/Genentech’s Tarceva (erlotinib) and Novartis’ Femara (letrozole).

- In February, a trade mission headed by World Health Organisation (WHO) officials affirmed that the use of compulsory licences “is one of several cost-containment mechanisms that may be used for patented essential medicines not affordable to the people or to public health insurance schemes.” However, in April the US Trade Representative’s annual Priority Watch List again included Thailand, noting that, while the USA “recognises the importance of Thailand’s public health challenges,” the issue of compulsory licences on patented drugs “have contributed to continuing concerns regarding the adequate and effective protection” of intellectual property rights.