In November 2006, Thailand announced its first ever decision to issue a compulsory licence for the antiretroviral efavirenz. The move allowed the country to import significantly more affordable generic versions of the drug – patented and priced out of reach of patients in Thailand - from Indian manufacturers, and subsequently produce the drugs locally.  In 2007, Thailand issued two further compulsory licences, for the antiretroviral drug combination lopinavir/ritonavir and for clopidogrel bisulfate, a treatment for cardiovascular disease.  Brazil followed suit in May 2007 with its own compulsory licence for government use on efavirenz.  Brazil is also purchasing the generic version from India while it develops local production through government laboratories.

The move was by no means revolutionary.  Indeed, countries both from the industrialised world (such as Italy or the US) and the developing world (including Malaysia or Indonesia) have resorted to compulsory licences in the recent past.   

What is perhaps most noteworthy is that the move, although perfectly legal under the TRIPS Agreement, attracted a storm of criticism and retaliatory measures from governments and companies alike.  Even the World Health Organization warned Thailand against the move, although the WHO Director General later changed her stance.

The scale of the reaction to what is after all a lawful initiative shows how polarised the fight for access to medicines has become, and to what extent the hard fought flexibilities in international law that safeguard access to medicines must be defended.

Click here to return to Milestones