HIV treatment as a human right - learning from Thailand's experience

02/11/04

NB. Please note that if you are outside North America, the embargo for LANCET press material is 0001 hours UK Time 13 February 2004.

A Viewpoint article in this week's issue discusses the landmark legal case in Thailand where two people with HIV successfully challenged a multinational pharmaceutical company for restricting access to a key antiretroviral drug due to its high cost. Authors of the viewpoint discuss the processes behind this case and the implications for drug access as a human rights issue in other developing countries.

In October, 2002, two Thai people with HIV-1 won an important legal case to increase access to medicines. In its judgment in the didanosine patent case against Bristol-Myers Squibb, the Thai Central Intellectual Property and International Trade Court ruled that, because pharmaceutical patents can lead to high prices and limit access to medicines, patients are injured by them and can challenge their legality. This ruling had great international implications for health and human rights, confirming that patients-whose health and lives can depend on being able to afford a medicine-can be considered as damaged parties and therefore have legal standing to sue.

Nathan Ford from Medecins Sans Frontieres and colleagues outline how the Thai court case was the outcome of a learning process and years of networking between different civil societies who joined forces to protect and promote the right of access to treatment. Their Viewpoint, based on key interviews and published reviews, summarises the efforts of society in Thailand to achieve a fair balance between international trade and public health. These efforts have focused on didanosine, an essential antiretroviral drug that in Thailand has become symbolic of how multinational companies and governments of industrialised countries protect their own interests at the expense of access to essential medicines for the poor.

Dr Ford comments: "In Thailand, civil society groups have been key to establishing the human right to health by challenging the practices of the multinational pharmaceutical industry and governments of industrialised countries. However, there are few developing countries where civil society is strong in advocating for greater access to medicines (Brazil and South Africa are notable exceptions). Access to medicines for people in poorer countries risks being limited by monopolies, arising from over-restrictive patent laws and invalid but unchallenged patents for some time to come. The pharmaceutical industry will continue to push for increased patent protection. In Thailand, successful opposition has come from people with HIV/AIDS, who have fought for their rights by forming effective coalitions, bringing together a range of experience and expertise. Their experience has not only increased access to treatment, but has brought wider benefits in terms of self-image, confidence, and dignity of people with HIV/AIDS. Thailand's example can only be encouraged."

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