Access to some antiretroviral drugs is increasing in Thailand because of the country's decision to issue compulsory licenses for certain medications, Winai Sawasdiworn, deputy secretary-general of the National Health Security Office, said recently, the Bangkok Post reports (Apiradee, Bangkok Post, 5/8). The Thai government in January 2007 issued a compulsory license to produce a lower-cost version of Abbott Laboratories' antiretroviral Kaletra. The drug company in May 2007 offered to sell Aluvia, an updated version of Kaletra, at a reduced price in Thailand on the condition that the country agree not to allow generic versions of the drug into the market. The Thai Ministry of Public Health in June 2007 confirmed that it would continue with its plan to issue a compulsory license for the drug after Abbott and the health ministry could not reach a price agreement during negotiations. Thailand's FDA in October 2007 completed the registration of a generic version of Aluvia for use under the country's compulsory licensing program. The generic version is manufactured by the Indian generic pharmaceutical company Matrix Laboratories (Kaiser Daily HIV/AIDS Report, 1/22).

According to Winai, the first batch of the generic version of Kaletra -- worth 21 million baht, or about $664,000 -- was delivered to state hospitals nationwide in February. He added that 153,776 bottles of a generic version of Merck's antiretroviral Efavirenz, for which Thailand also issued a compulsory license to produce, had been imported from India beginning in October 2007.

Winai was responding to recent criticism from a group of HIV-positive advocates, which said that the country has been slow to distribute the antiretrovirals. The group also questioned whether enough medication was being imported to provide treatment access to all people living with HIV who need the drugs. Wirat Poorahong, head of the Thai Network of People Living With HIV/AIDS and a member of an NHSO subpanel, recently called on the agency to increase its budget and bolster the number of health workers under the program. According to the Post, about 300 doctors in Thailand currently are authorized to change an HIV-positive person's drug regimen, and 27 blood screening centers are able to conduct HIV tests nationwide (Bangkok Post, 5/8).