Open Letter to the World Health Organization from Indian NGOs on the Thai Compulsory Licenses

Dr. Samlee Plianbangchang
World Health Organization
Regional Office for South-East Asia
World Health House
Indraprastha Estate
Mahatma Gandhi Marg
New Delhi 110 002, India
Fax: +91.11.23370197

Dr. S. J. Habayeb
World Health Organization
India Office
534, "A" Wing, Nirman Bhawan,
Maulana Azad Road,
New Delhi – 110 011
Fax: +91.11.2301.2450

Dr. Denis Broun
A2/35 Safdarjung Enclave
New Delhi 110029
Fax: +91.11.4135.4534

9 February 2007

Dear Drs. Plianbangchang, Habayeb and Broun:

We write to express our dismay at some comments that Dr. Margaret Chan, the new Director General of the World Health Organization, was reported as having made during her recent visit to Thailand’s National Health Security Office. In response to Thailand’s recent decisions to improve its citizens’ access to essential medicines by issuing compulsory licenses on three essential drugs, she allegedly stated, ‘‘I’d like to underline that we have to find a right balance for compulsory licensing. We can’t be naive about this. There is no perfect solution for accessing drugs in both quality and quantity.”

These comments, if accurate, not only represent an attitude which is not in conformity with WHO’s mandate to attain, for all peoples, the highest possible level of health, but also reflect a deeply flawed understanding of the compulsory licensing mechanism and its indispensability in promoting access to essential medicines. As Dr. Chan’s first public comments on this crucial topic, we harbour grave reservations about her ability to carry forward Dr. Lee Jong-wook’s legacy of promoting access to treatment for those most in need.

Dr. Chan’s observation that we have to find a “right balance” for compulsory licensing appears to imply that the financial concerns of the patent holding pharmaceutical companies must be given equal weight against the urgent need to provide lifesaving treatment to those who are unable to afford the exorbitant prices that these patent monopolies create. Such an attitude is not in conformity with that of even the World Trade Organization, which stated through the Doha Declaration that the TRIPS agreement “can and should be interpreted and implemented in a manner supportive of the WTO Members’ right to protect public health, and in particlular, to promote access to medicines for all.”

The Doha Declaration admits of no requirement for determining the “right balance” between patent rights and patients’ rights. Rather, the Doha Declaration places the affirmative duty on member states to use all TRIPS-flexibilities available to it, including the compulsory licensing mechanism, to promote access to medicines for all. As the Director General of the organisation responsible for promoting global health, she should be applauding, rather than condemning, Thailand’s actions to drastically reduce the costs of essential medicines for its people.

Furthermore, we would like to question who, exactly, is being “naive” about compulsory licensing. When Dr. Chan claims that “there is no perfect solution for accessing drugs in both quality and quantity,” does she mean to imply that Thailand’s decision to issue a compulsory license on clopidogrel, which will have the effect of lowering the price of this critical treatment for heart disease from 70 baht per day to 6 baht per day, was naive? Or that a 92% reduction in cost is not something close to a perfect solution? Or, perhaps, that switching to the Thai GPO’s or Indian manufacturers’ generic versions would be a sacrifice in quality in exchange for quantity? As these comments came without explanation or elaboration, we are left bewildered as to their meaning. At the very least, we feel that we are entitled to an explanation.

In September of 2003 WHO and UNAIDS declared the lack of access to ART for HIV/AIDS a “global health emergency”. Countries like Thailand and India are responding to this and other emergencies in access to affordable medication by using all means necessary to ensure that the right of every person to the highest attainable standard of health – an international law and human rights obligation higher than that of TRIPS – is not compromised by profiteering on life and death.

As the India office, we trust that you are aware of and understand the critical importance of measures like compulsory licensing in ensuring access to treatment. We urge you to communicate to WHO HQ the importance of prioritizing peoples’ health over the monopoly and profits of pharmaceutical companies and the detrimental impact of Dr Chan’s statements on treatment access.

Developing countries asserting the right to life and health of their people must be fully and publicly supported by the WHO and UNAIDS.


Delhi Network of Positive People
Indian Network for People Living with HIV/AIDS
Affordable Medicines and Treatment Campaign
Community Health Cell

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