The patent holder, Merck, has on several occasions been unable to supply efavirenz. "This has resulted in treatment interruptions, forcing several hospitals to supply suboptimal dual therapy," said Dr David Wilson, MSF's medical co-ordinator in Thailand .
In addition, while Merck has offered a discounted price for Efavirenz (currently 1,500 baht a month) generic alternatives are available in India for almost half the price (800 baht a month).
Generic production is the cornerstone of Thailand's universal HIV/AIDS treatment programme. Before generic production, the cost of standards HIV/AIDS treatment in Thailand was over 33,330 baht per patient per month, only 3,000 people were getting treatment. In 2002, the Thai government launched a generic version of HIV/Aids triple therapy, resulting in an 18-fold drop in the cost of treatment. Thanks to this, 84,000 people with HIV/Aids are today receiving treatment.
The Thai government is developing its own generic production capacity for efavirenz which is expected to be ready in 2007. In the meantime, the government-use licence will allow the Thai government to import generic efavirenz from India , halving the costs for this drug and expanding procurement options to ensure sustainable drug supply.
"Thailand is demonstrating that the lives of patients has to come before the patents of drug companies, and this policy needs to be expanded to other HIV/AIDS drugs that are expensive and in short supply, such as lopinavir/ritonavir, which currently costs over 7,000 baht a month and is far too expensive for Thailand," said Dr Wilson.