Stephen Leahy

TORONTO, Canada, Aug 17 2006 (IPS) — In the midst of the world’s biggest HIV/AIDS conference here, close to a hundred activists launched a noisy protest over bilateral free trade agreements, which they say elevate patent protections above the right to life-extending antiretroviral drugs.

The piece of street theatre held Wednesday in front of the media centre at the 16th annual International AIDS Conference in Toronto featured an activist dressed as “Uncle Sam” who pointed a gun at the others, forcing them to sign free trade agreements (FTAs).

Those portraying the world’s poorer countries shouted, “We won’t sign away our health.”

According to UNAIDS, of the estimated 40 million people living with HIV, five to six million in low- and middle-income countries will die in the next two years if they do not receive antiretroviral (ARV) drug treatment, but just 700,000 people now take such drugs.

And U.S. efforts to introduce stronger intellectual property rights in bilateral trade agreements – 12 so far – are further destroying the ability of developing countries to access affordable medicines, charges a coalition of non-governmental organisations (NGOs), including Oxfam.

“Under the name of free trade, the U.S. is pushing for a monopoly on new medicines, thus driving up the cost for some of the world’s poorest people,” said Rohit Malpani, policy advisor for Oxfam International.

“Neither patients nor governments will be able to afford the new antiretroviral (ARV) medicines essential to address the pandemic,” said Malpani.

U.S. free trade agreements severely restrict generic versions of new medicines – the only proven mechanism for lowering prices. Until generics came on the market, ARV therapy cost about 10,000 dollars per patient per year. Thanks to generic competition, the price for these drugs in preferred fixed-dose combinations has dropped to 140 dollars year.

“After campaigning by NGOs and people living with disease, the World Trade Organisation (WTO) reaffirmed public health flexibilities in intellectual property rules,” said Mohga Kamal-Yanni of Oxfam.

That decision, known as the Trade-Related Aspects of Intellectual Property Rights agreement, or TRIPS, allows the export of low-cost generic drugs to developing countries that do not have the capacity to produce such medicine domestically.

Under WTO rules, governments can declare a public health emergency and issue compulsory licenses that permit the manufacture of a patented drug without consent from the owner.

“Now the U.S. is systematically forcing poor countries to give up their rights and ability to protect public health,” Kamal-Yanni said.

The U.S. is currently in the final stages of negotiating a bilateral FTA with Thailand, but public protests have been growing, said Nimit Tienudom of the AIDS Access Foundation.

“The Thai government thinks it will miss a major opportunity to access the U.S. market if it doesn’t sign an FTA,” Tienudom told IPS.

And to get that access officials are willing to sign a deal that gives the U.S. patent rights well beyond those agreed to under the TRIPS agreement, he said.

This could mean that Thai companies producing generic anti-retroviral drugs to treat AIDS patients will be unable to make a profit. It may also mean that the drugs being made by the Government Pharmaceutical Organisation of Thailand will become too expensive to manufacture because of high licensing fees.

In Thailand, there are 29,000 new HIV infections each year, of which approximately 4,200 involve children. Access to affordable medicines is a critical component of the government’s much-lauded strategy to scale up the current treatment programme and prevent the spread of the epidemic.

Thailand is currently implementing a treatment programme for over 80,000 people based on a generic fixed dose combination recommended by the World Health Organisation. The three-in-one tablet is around 10 times cheaper than the patented brand-name drugs, and enhances patients’ compliance by decreasing the number of pills that need to be taken to two a day.

This achievement was only made possible because of the local production of generic medicines by the Government Pharmaceutical Organisation, which has allowed treatment costs to come down dramatically.

For example, while the patented drugs sold by big pharmaceutical companies in Thailand can cost up to 589 dollars per month, the state-produced generic version, called GPO-vir, costs just 32 dollars a month.

The details of the U.S.-Thai FTA under negotiation are secret, but based on similar deals and leaked information, Tierudom believes it will dramatically strengthen existing patents on medicines.

“The U.S. should not exploit Thailand’s economic dependence on export to the American market to impose stricter patent provisions that serve primarily the interests of U.S. corporations and go far beyond the world standards set by the WTO,” said Kamal Smith.

Without generic versions, the cost of including necessary patented medicines could double or even triple the current cost of the Thai treatment programme, resulting in fewer people having access to life-saving drugs, according to Oxfam.

The U.S. has pursued a number of similar trade agreements that are known as TRIPS-plus because they go beyond what was established in TRIPS. TRIPS-plus trade agreements, like the North American Free Trade Agreement and the Central American Free Trade Agreement, extend patents and restrict flexibilities that countries like India and Brazil have used to produce and provide ARVs across the globe.

An FTA with Thailand, as well as separate ones with South Korea and Malaysia, is scheduled to go before Congress for approval by Jul. 1, 2007. However, Korean labour leaders have told their government to slow down negotiations and there is little chance that Thailand, with a weak caretaker government, will be able to do much before that date.