Cancer: Stigma of a Different Kind?

Wed, 03/19/2008 - 10:29 -- ประชาธรรม

Last year, when Thailand overcame patent barriers that stood in the way of providing affordable medicines to treat HIV/AIDS, health activists stood up and cheered.  When the European Commission, the United States, and the drug companies retaliated by threatening to impose trade sanctions or to withdraw any new medicines from Thailand, the activists were up in arms. 

As Cancer Patients Aid Association, we too played our part with other health groups.  Together we stressed that Bangkok, in delivering compulsory licences that allowed it to import generic versions of the medicines from India, was acting entirely legally.  We cried foul over the attempts to undermine a country’s efforts to provide life-saving drugs for its people.  In the end, we prevailed.

Why then, such resounding silence barely one year later?  Thailand has once again issued compulsory licences that will allow it to import generic drugs from India – to great joy for us at the CPAA, but to what seems like general indifference in wider public health circles, this time its for cancer drugs.

Rumbles of discontent have once again been heard from pharmaceutical companies, and in Western capitals. The new Thai Minister of Health is showing signs of buckling under the pressure and has said he may review the compulsory licences, which were issued by his predecessor.  But where are the activists?  Where are the protests?

Is it because, this time, it is not antiretrovirals that are to be imported from generic sources in India, but drugs to treat breast and lung cancer?  Is the silence due to the fact this is about saving the lives of patients suffering from chronic non-infectious diseases, whose needs are somehow less urgent, less politicised than deaths caused by HIV/AIDS?  Is there, with cancer, stigma of a different kind?

The needs are just as acute. Cancer is the sixth leading cause of death in our country and that according to estimates from National Cancer Registry Program, there are approximately 25 lakh cases of cancer in India and nearly 4 lakh Indians will lose their lives to the disease this year. In Thailand, 30 thousand Thais die from cancer annually, while one lakh new cases are diagnosed every year.

These are not just numbers and statistics. On a daily basis, CPAA struggles to support the treatment and overall needs of thousands of cancer patients. Like any other patient, we believe that every cancer patient has a right to the full range of treatment.

Like HIV/AIDS, cancer treatment in developing countries is unaffordable and medical bills force families into poverty. In Thailand, as in India, the government is unable to provide cancer drugs under the public health care system. Thailand’s National Health Security Office, which runs the universal healthcare scheme, does not pay for the treatment of cancer patients. The drugs are only available at private hospitals and are very expensive.

This means, as with HIV/AIDS, that the role of Indian generics is crucial to getting life-saving drugs to patients.  The patented version of Erlotinib, a treatment for lung cancer, sells for Rs. 4,800 a tablet.  The generic costs Rs. 9,25 a tablet – five times less. Imatinib, a treatment for chronic myeloid leukemia, sells for Rs. 1,20,000 for a month’s treatment in its original version.  The generic costs Rs. 8,000 for a month’s treatment– fifteen times less.

For cancer patients across the developing world, accessing affordable medicines will depend on those compulsory licences.  The government of India must be willing to issue compulsory licenses so that generic competition can increase, and more affordable drugs be exported.  The Thai government must not reverse its decision: for many cancer patients in Thailand, the compulsory licences offer new hope of continuing treatment.

But if Thailand does turn its back on its cancer patients, they are not the only ones who stand to suffer.  This could well set a very bad precedent.  If Thailand backs down, other countries like India will think twice before issuing compulsory licenses.   Compulsory licences are the only way to ensure affordable sources of medicines exist in the future.

Public health activists should take note, and should come out in force to support of cancer patients in Thailand.

Chairman & CEO
Cancer Patients Aid Association
[email protected]

Mr. Y.K. Sapru is the chairperson of the Cancer Patient Aid Association (CPAA). CPAA provides support and services to cancer patients and takes up issues that impacts access to affordable cancer drugs.

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