The Lobbyist versus the people
November 17th, 2008Or the case of Thailand compulsory licensing vs. right wing pharmaceutical lobbyists
This article was written in May 2007, revised in June 2007 and minor edits were made on 17/11/08. I decided to republish it after my attention was drawn by the Wisdom of Whores to a recent opinion piece written by Roger Bate for the New York Times. In his latest article for the NYT, Bate conflates generic and counterfeit medicine finding another occasion to held high the flag of a sometimes unscrupulous pharmaceutical industry. The text below is a rather vitriolic piece that is however well referenced and documented. Access to life saving medicine is an issue I have at heart and I am afraid I have little tolerance for fantasy or corporate interests when it comes to saving life.
On 19 September 2006, the Royal Thai Army staged a coup against the government of caretaker Prime Minister Thaksin Shinawatra. Soon after, in November, the Thai Ministry of Public Health Mongkol Na Songkhla issued a compulsory license (CL) for the first-line Aids-fighting drug Efavirenz (Sustiva/Stocrin) manufactured by Merck, sparking a row that turned in to a war when in January compulsory licenses were issues for the heart disease drug Plavix, made by Bristol-Myers Squibb and Sanofi-Aventis, and Kaletra (Aluvia) a heat-stable HIV protease inhibitor made by Abbott Laboratories.
In February, Merck agreed to lower the price for Efavirenz to 700 baht per bottle from the pre-compulsory licence price of 1,400 baht. In contrast, Abbott Laboratories opted for a punitive reaction and withdrew its applications to market new drugs in Thailand. The rippling effect of Thailand’s CL soon propagated across the developing world. In May 2007, Brazilian President Luiz Inacio Lula da Silva signed a decree to issue a CL for Efavirenz and Brazil was promptly accused of an “IP opportunism” that threatens the US private property rights.
Back in 2006, the Intellectual Property war machine of the US Pharmaceutical industry was swiftly set in motion and a huge propaganda campaign started against Thailand’s decision to use the provisions contained in the international Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement signed at Doha in 2001.
One of the advocates of the Pharmaceutical Industry is Roger Bate, a resident fellow at the American Enterprise Institute (AEI). According to his bio at the AEI, “Economist Roger Bate researches U.S. and international aid policy in Africa and the developing world, evaluating the performance and effectiveness of USAID, the World Bank, the Millennium Challenge Corporation, NGOs, as well as other aid organizations and development policy initiatives.”
Roger Bate is a distinguished academics who holds a Ph.D. in economics and an M.Phil. in land economy from the University of Cambridge (UK), an M.Sc. in environmental and resource management from the University College, London University (UK) and a B.A. in economics from the Thames Valley University (UK).
Roger Bate has been a vocal if not vociferous contributor to the dispute opposing the US pharmaceutical giant Abbott and the Thai military-led government. He published a series of opinions, articles and reports both for the AEI, in the mainstream media and for online publications, disapproving of and condemning the Thai decision to use the TRIPS provisions.
With such academic credential, one could hardly be tempted to question Roger Bate professional integrity and expertise. But on a closer look it happens that his support of the pharmaceutical industry is often rooted in half truth, misinformation, bias and sometimes plain lies.
A brief Internet search on the American Enterprise Institute reveals that the AEI is an influential, pro-business right-wing think tank founded in 1943 by Lewis H. Brown. It is funded by one of the world’s largest oil companies (ExxonMobil) and has close links with the Bush Administration.
In February 2007, the London based newspaper The Guardian revealed that scientists and economists have been offered $10,000 each by the AEI to undermine a major climate change report due to be published by the UN’s Intergovernmental Panel on Climate Change (IPCC). The AEI sent letters offering payments for articles emphasising the shortcomings of the report. Such practices shed light on what kind of “Think Tank” the AEI is.
A review of the articles written by Roger Bate on the issue of compulsory licensing reveals a regular pattern that is epitomised in The Cost of Cheap Drugs, published on June 1, 2007. Right from the start, Roger Bate showed his ability to report well documented events with inaccuracy and questionable innuendo.
“In September 2006 the former Thai government was overthrown in a largely bloodless military coup”, wrote Bate in the opening line of The Cost of Cheap Drugs of a coup that was totally bloodless. Thailand has lived through numerous coups in the last 70 years and the purpose of such innuendo is unclear if it wasn’t to question the legitimacy of a decision taken in the interest of the public by a military junta. But lest we forget, Thailand successful fight against HIV was initiated whilst a similar junta was in charge of the country in the 90s and later lost steam under the Thaksin administration.
Roger Bate often indulges in partial and biased reporting for instance when emphasizing the reaction of Dr Margaret Chan, the director of the WHO, who, he wrote “…was shocked by Thailand’s move. Back in February, when she visited Thailand, she cautioned against such hasty action.” But at the World Health Organization’s annual summit in Geneva (14-23 May 2007) where intellectual property issues were prominent a resolution on “Public Health, Innovation and Intellectual Property” was adopted in plenary session of the 60th World Health Assembly encouraging the WHO Director-General to guide the process to draw up a global strategy to remedy the problem of IP, R&D and costs of drugs and to provide technical and policy support to developing countries for that purpose. In other words to provide support to the developing world to use and apply the TRIPS Agreements.
In her closing remark the allegedly “shocked” Dr. Chan commented that she was “fully committed to this process and have noted [the WHO member’s] desire to move forward faster.” She added that “We must make a tremendous effort. We know our incentive: the prevention of large numbers of needless deaths and suffering.”
Roger Bate also often refers to the corruption pervading the Thai Government Pharmaceutical Organisation (GPO, manufacturer of the GPO-vir) quoting “Mr Jaruvan Maintake”, Auditor General at the Constitutional Court of Thailand (whose appointment to this position had been the object of a controversy). (Note : Bate most likely wanted to refer to Mrs Jaruvan Maintaka, a women whose patronym is Maintaka, but he can be excused for the difficulty to transliterate Thai names and for being unfamiliar with Thai first name even though he writes a lot about Thailand.)
Further disinformation followed when Roger Bate recalled “a 2005 study by Thailand’s Mahidol University’s faculty of medicine [that] found at least 40% and up to 59% resistance in the 300 patients investigated.” Roger Bate teamed up with another Right Wing lobbyist group USA for Innovation who ran a libelous advert in the Bangkok Post earlier in 2007. USA for Innovation executive director is Ken Adelman, who also works for Edelman Public Relations Worldwide, which counts Abbott Laboratories as one of its biggest clients. Bate and Adelman were later contradicted by Wasun Chantratita, chief of Mahidol University’s virology and molecular microbiology unit, who said in the Thai newspaper The Bagkok Post (May 12, 2007) that, “the advert that cited his study was only half-true. He said the study on drug resistance was conducted in 2000 _ two years before GPO-VIR even existed. It focused on three individual original drugs _ Nevirapine, Lamivudine (3Tc) and Stavudine (d4T) _ not GPO-VIR. GPO started to produce GPO-VIR, which combines Nevirapine, Lamivudine and Stavudine, in 2002.” Then the GPO was seeking criminal-defamation action against USA for Innovation and was seeking 1bn Baht in compensation.
Bate often insists that, “even the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has arguably shown enormous tolerance of the GPO, finally withdrew financial support last August”. Little mattered that the World Bank was planning to provide Thailand with a $750,000 three-year grant aimed at providing HIV-positive people with increased access to antiretroviral drugs and help address funding issues associated with the country’s universal health care system, as well as providing training for nurses and doctors in an effort to overcome the shortage of health care personnel in the country (The Nation, February 6, 2007). (Note: See here for an update on the global Fund position towards Thailand)
But again, Bate expressed his concerns that “cheaper drugs do not make cheaper healthcare if they don’t work properly.” Of course, as pointed out by Daniel Ten Kate in the Asia Sentinel (May 10, 2007), “USA for Innovation and other propaganda groups will never cite an August 2006 World Bank study that calls for Thailand to resist Big Pharma and use compulsory licensing to reduce HIV/AIDS drug costs by up to $3.2 billion by 2025. It also won’t refer to letters of support sent to the Thai government from the World Health Organization, UNAIDS and countless NGOs, including the Clinton Foundation headed by former President Bill Clinton.”
The picture would not be complete if Bate had refrained from nursing the myth that “World Trade Organization rules have made compulsory licenses available to poor countries suffering an epidemic. But Thailand is a middle income country, and, while a case may be made for HIV, heart disease, cholesterol and leukemia are not epidemics.” This ignores the assessment made by the Associate Director of Washington College of Law’s Program on Information Justice and Intellectual Property (PIJIP) which concluded that “Thailand’s issuance of compulsory licenses for three patented medicines is legal under domestic laws and complies with WTO rules, and Abbott’s decision to withhold its new products from the Thai population violates Thai antitrust laws” but also ignores that in its 2007 Special 301 Report the “United States acknowledges a country’s ability to issue such licenses in accordance with WTO rules”.
Bate should also well know that compulsory licenses issued under the TRIPS agreement are not limited to poor countries or situation of medical emergency since the USA have been using the same TRIPS agreements for their benefit in situation hardly close to medical emergencies ranging from patent related to the Blackberry device to Toyota hybrid transmissions and material used in F-22 fighter jets. Indeed the TRIPS agreement clearly states that each member is free to determine the grounds upon which such licenses are granted.
One can only expressed bewilderment with a lobbyist’s ability to broadcast so many inconsistencies, inaccuracies, biased and one-sided reporting, and fallacies in less than 800 words. Lacks of integrity and professionalism, partisanship, or genuine professional incompetence are the choices left to the readers. One is justified having reservations about the credibility of such lobbyist to contribute meaningfully and honestly to such an important debate.
Many other are perpetuating the same myths, printing the same fallacies and misleading the public, including Bibek Debroy, a professional economist, Secretary-General of the PHD Chamber of Commerce and Industry, India, and former consultant to India’s Ministry of Finance (Obsession with lower cost leads to deadly mistake, The Bangkok Post, December 6, 2006), Philip Stevens, director of the health programme at the International Policy Network, a corporate-funded, London-based development think tank (Licensing policy fatal for HIV/Aids sufferers, The Nation, February 14, 2007), USA for innovation, the Baker & McKenzie law firm (Compulsory drug licenses violate world trade treaty, The Bangkok Post, April 23, 2007), some serious news outlets such as the Wall Street Journal, the Financial Times and some less scrupulous professional who do not check their facts.
That these people and interest groups wish to support the Pharmaceutical industry is their right, but that they do so with lies, misrepresentation and misinformation is not acceptable.
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