In January of 2006, over 10,000 demonstrators in Chiang Mai, Thailand marched in the streets. They were angry about free trade discussions taking place between their government and the United States. Even today, people are unsure what was decided in those meetings: the agenda was kept secret, and all participants were forbidden from reporting on the discussions. Nevertheless, Thai citizens believed that their government would be blocking their access to affordable treatments for HIV/AIDS, bird flu, malaria, tuberculosis and other diseases. Why would the Thai government make such a sacrifice?

Many patients are discovering that free trade doesn’t mean free medicine. The market price of medicines is out of reach for people in developing countries, where incomes are very low. New medicines are often protected by patents, rules that prevent the copying and selling of a product invented by someone else. India and Thailand have led the charge in making low-priced copies of patented medicines, called generics, available in their own countries and worldwide. However, as global markets become closely connected, economic rules are limiting these programs.

For decades, India has been manufacturing low-cost versions of antibiotics, cancer therapies, HIV/AIDS drugs, as well as medicines for malaria and tuberculosis. Indian law allowed companies to copy patented medicines and sell them in countries that did not have stricter rules. The result was that patients could buy generic HIV/AIDS treatments for less than $200 per year, when the name-brand counterpart would have cost over $10,000. Such huge price differences helped Indian generics to reach forty percent of all patients in the developing world.

However, one condition of India joining the World Trade Organization (WTO) in 1995 was the elimination of these programs. In the spring of 2005, India’s parliament passed restrictions on generic drugs, saying companies must now pay royalties to the companies who invented the drugs and hold the patents.

The WTO has rules that would allow India to distribute generic medicines if it were to declare a health emergency. Even though India has more people living with HIV/AIDS than any other country, it still has not declared this an emergency. Why won’t it do so?

The WTO says that if governments do not take advantage of these rules, it is because they do not know about them or they are confusing. Health activists and non-profit organizations counter that bullying, not ignorance, is to blame. They say that multi-national corporations and powerful governments control the WTO and threaten to withhold donations or refuse to trade with nations that break patents. Pharmaceutical companies meanwhile, say that cheap copies will cut into their profits, and without profits, how can they invest money in research and development? They argue that patents ensure quality and make new drugs possible.

Thailand ’s government is similarly expected to sacrifice affordable medicines for free trade. In 2002, the Thai government introduced an AIDS combination therapy that costs only forty-six cents (U.S.) a tablet. In 2005 it announced that it could manufacture an anti-bird flu drug for 50% cheaper than the patented version. But under the 2006 agreements with the United States it is expected that Thais will have to pay up to four times more for these medicines in order to pay royalties to the patent-holders.

As worries rise over global pandemics rise, so do concerns about an economic system that leaves people vulnerable. The escalating costs of treating diseases may have a negative effect not only on the global economy but also on global health, as people most likely to contract a disease are unable to afford treatment for it. If local health systems cannot offer affordable drugs, how can they combat HIV/AIDS or contain a swift and deadly pandemic like bird flu?

Many people question whether it is ethical to profit from life-saving medicines at all. They point out that profits are often not spent on developing new drugs, but for advertising present ones. Moreover, profits encourage corporations to create medicines that treat “wealthy” patients with conditions like high cholesterol, rather than “poor” patients with diseases like tuberculosis. As global markets grow and become more connected, will the new rules mean that global health will be left behind?

Author: Heather Clydesdale