At less than a dollar a day, Thailand produces the world’s cheapest anti-AIDS drugs, but one woman is determined to give impoverished African countries the know-how to produce them even cheaper.
Along with India and Brazil, Thailand has become a global pioneer in the production of generic anti-AIDS medicines, thanks largely to Dr. Krisana Kraisintu, who started research into them here in 1992.
Working at the Government Pharmaceutical Organisation (GPO) where she heads the research and development division, Krisana was by 1995 overseeing production of 21 drugs whose patents had either expired or never existed.
Now Africa — home to more than 28.5 million of the world’s 40 million people infected with HIV, the virus that causes AIDS — looks set to benefit from the GPO’s policy of encouraging other countries to manufacture their own cut-price medicine.
"It’s not technology transfer in a way that Thailand is giving them facilities," Krisana said. "They have everything. We’ll just tell them what to do."
The plan, which took form in April 2001, is to choose countries spread around the continent to act as production centres which can export to up to 12 neighbouring nations.
Memorandums of understanding have been drafted and are waiting to be signed between Thailand and both Zimbabwe and Ghana. If all goes well, Uganda, the Democratic Republic of Congo and Nigeria will follow.
"Zimbabwe and Ghana have very good manufacturing facilities … There is no question of standards at all of the manufacturing," Krisana said, adding that pharmaceutically, the process of making the drugs is simple.
Krisana has already negotiated prices for raw materials — which make up 80 percent of the cost — far below what the GPO pays its suppliers in India and Korea who heeded appeals to make discounts on humanitarian grounds.
"I expect the products to be much cheaper than in Thailand," she said, offering as an example the price of the antiretroviral (ARV) drug, stavudine. ARVs are the best available medicines that slow the march of HIV.
"The original product costs two dollars and nine cents. Our product costs eight cents — that’s 26 times as cheap. And if these drugs were produced in African countries, they would be cheaper than this," she said.
GPO managing director Dr. Thongchai Thavichachart is a firm advocate of the policy of transferring know-how to other developing countries.
"We will be happy to help (them) to produce, rather than to buy from us. It will last longer — it’s self-help," he said.
"We will not charge anything to any government… I would like to urge the world, I would like to push other countries to have this kind of production."
Krisana said she is fighting to help Africa obtain cheap drugs as a matter of principle.
"It’s about human rights. I think everybody, whether they are rich or whether they are poor, they need to have access to treatment… I feel that multinational companies are taking too much advantage of these people."
The GPO made world headlines in March this year when it announced it would start selling the world’s cheapest triple-therapy ARV drug, known as GPO-VIR.
It sells for 27 dollars per month, or less than a dollar a day. Previously, a similar regimen cost up to 240 dollars a month.
Some 20,000 patients now take ARV drugs made by the GPO, but an estimated 50,000 of the Thai citizens infected with HIV could benefit by taking them, Krisana said. The United Nations estimated that one million Thais have been infected with the disease, and that a third of those have already died.
Paul Cawthorne, Thailand country manager for the international aid organisation Medecins Sans Frontieres (Doctors Without Borders – MSF), said the group is "totally supportive" of Thailand’s production of generic drugs.
"We do use all the drugs that the GPO produces here generically," he said. "We wouldn’t be using them if we were concerned about the quality."
Cheaper GPO-VIR is already improving access to AIDS therapies in Thailand, he said, with more patients considering buying their own medicine.
"I think it’s beginning to have a significant impact, particularly in areas like Bangkok where patients can think about spending 40 baht (95 cents) a day on medicine. There’s less of an impact in the provinces where 40 baht a day is still a lot."