Source: Health System Research Institute 02-951-1286-93 ??? 121, 135, 145/
Kom Chat Luk newspaper issue 9 September 2008 page 13
On August 8th, 2008, Mr. Chaovarat Chanweerakul, Minister of Public Health and Mr. Vicharn Minchainant, Deputy Minister of Public Health had a seminar meeting with public health professional organizations, health personnel from government and private organizations over 250 persons. The seminar aims to solve an insufficient health personnel for Ministry of Public Health and Government sector.

Mr. Chaovarat said that “the insufficient of health personnel is a crucial problem which has been a chronic problem for over 20 years. Recently, Thailand has medical doctor: population ratio at 1: 2,400 which is over the standard of 1: 1,500. The doctor in district hospital resigns 800 persons annually according to their high workload from universal healthcare coverage”.
Group Captain Dr.Ittaporn Kanacharoen, Assistant to Secretary General said, “the government should improve the quality of life of the doctors who work in district hospital, add incentive, reduce workload, especially resolve the medical sue. From the GIS information, it was found that there is only one doctor in 30 hospitals which has 30 beds in July 2008”.
The 30 district hospitals are Banluang district hospital, Namun district hospital, Bor-glur district hospital, Songkwae district hospital, Chalermprakiat district hospital at Nan province, Lam-ngob district hospital and Korkood district hospital at Trad province, Sahaskan district hospital and Mamon district hospital at Kalasin province, Kaoyoi district hospital and Kangkachan district hospital at Petchburi province, Kanghangmeaw district hospital and Kaosukim district hospital at Chantaburi province.

Dr. Pongthep Wongwacharapaiboon, Secretary General for the Rural Doctor Society said, “the solution is having more doctors who commit to work until their retirement in the district level, proposing the local government to have an ownership in the medical doctor scholarship by transferring funding supports of 1.8 million Baht to local government instead of to teaching hospital. Moreover, Dr. Wongwacharapaiboon suggested controlling the growth of private hospital to solve the draining problem especially the medical hub policy.

Dr. Kriengsak Vacharanukulkiat, Chairman of Rural Doctors Society said, the short term resolutions are to add the remuneration for public doctor to be 60% of private sector, doctors who work in a rural area should get higher remuneration than the urban one. In addition, there should be an increasing fine for medical student who breach contract.

Posted: September 16th, 2008 under Uncategorized.
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Activists fire tirade at EU trade rep for jumping on bandwagon with US

Pennapa Hongthong

The Nation

            Thailand’s use of compulsory licences to override patents on expensive but vital drugs now sees it at loggerheads with the European Union (EU)-as well as the US.

            Thai health activists and international health advocacy groups will send letters next week to try to find out why a key member of the European Commission recently sent a letter to the Commerce Minister protesting about Thailand’s move to issue compulsory licences to avoid drug patents.

            Lawan Saroval, deputy medicine co-ordinator at Medicines Sans Frontieres (Doctors Without Borders) Belgium in Thailand, said the move was to fight EU Trade Commissioner Peter Mandelson.

            Mandelson broke a resolution of the EU Parliament issued on July 12, saying the EU would endorse developing countries’ right to fully implement a World Trade Organisation deal on intellectual property rights to promote access to medicines for all.

            On August 10, Mandelson sent a letter to Krirk-krai Jirapaet, saying the EU was concerned the Thai government’s move “would be detrimental to the patent system, and so to innovation and development of new medicine”.

            Lawan said MSF and Oxfam, one of the biggest non-government groups in the UK, would send a joint letter next week directly to Mandelson and the president of the European Parliament.

            “We want to know what is the motive behind Mandelson’s letter, what made him break the resolution of the EU.”

            Thai activists also plan to write a letter. Jiraporn Limpananond, chairman of the Foundation for Consumer, said Mandelson’s letter was an intervention in Thai affairs.  

            Public Health Minister Dr.Mongkol na Songkhla wrote back to Mandelson and the EU president on August 12 to explain the country’s policy on compulsory licensing (CL). He insisted that Thailand would purchase patented drugs if patent holders sell them at prices 5 percent above the lowest-priced generic.

            He also asked about the EU’s recommendations to implement compulsory licences, as many European countries have implemented them on medicines from the global biotechnology investment community.

            Prime Minister Surayud Chulanont called for an urgent meeting of all agencies on Friday to discuss the issue. Aside from the EU move, the PM also received a letter of protest last month from the US ambassador on the matter.

Posted: September 14th, 2008 under Uncategorized.
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ACHARA ASHAYAGACHAT

            The commerce and  Public Health ministries have stood firm on Thailand’s decision to override drug patents after the European Commission warned Bangkok about negative repercussions from the broad use of compulsory licences.

            In a letter sent to EC trade commissioner Peter Mandelson on Monday, Public Health Minister Mongkol na Songkhla explained that the Thai government’s use of compulsory licences was only for selected medicines.

            If any patented drug cost no more than 5% above the generic version, the ministry would purchase the patented medicines instead of breaking the drug patents, he said.

            The clarification was made after Mr. Mandelson last month warned Bangkok against a broad use of compulsory licences (CL), saying that it would be detrimental to the patent system and so to innovation and the development of new medicines.

            Thailand currently implements the CL policy on three important drugs for Aids and heart treatment-Efavirenz, Kaletra and Plavix.

            The drugs are basically limited to patients under the universal healthcare scheme run by the National Health Security Office.

            Commerce Minister Krirkkrai Jirapaet also sent a letter of explanation to the EC two weeks ago, trying to play down the trade commissioner’s concern over Thailand’s drug policy.

            He said Mr Mandelson should ease concerns on the transparency of the process of issuing CL and be ensured of the Thai government’s openness to negotiating with patent holder.

            “I would like to assure you that action taken by the Thai government in compulsory licences of patented drugs has been consistent with the country’s obligations, the World Trade Organisation, and the agreement on Tracle-Related Aspects of Intellectual Property (Trips),” Mr. Krirkkrai said in the letter.

            He also said the Public Health Ministry was the responsible agency empowered to issue compulsory licensing on patented drugs it deems appropriate.

            The Commerce Ministry has been working closely with all agencies concerned to “ensure that such actions comply with applicable national and international laws and regulations” the minister said.

            At present, the committee negotiating for increasing access to essential patented drug firms, put forward by both the Public Health Ministry and the companies, and satisfactory outcomes would be reached in the near future, he said in the letter.

            Meanwhile, local and foreign advocacy groups including the Thai Network of People Living with HIV/Aids. Aids  Access Foundation, Oxfam and Medecins Sans Frontieres will announce their stance on Thailand’s compulsory licensing policy today in response to mounting pressure from the EC and the United States.

            The US ambassador to Thailand has recently expressed concern about the possible broad use of compulsory licensing to Prime Minister Surayud CHulanont.

Posted: September 12th, 2008 under Uncategorized.
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Further from, the Ministry of Public Health that has proposed to increase fine for medical student from 400,000 Baht – 10 million Baht while the President of medical council was not agree. The National Health Commission Office provides information as following:

The Thai government initiated a compulsory public work in 1967, mentioned that medical students have to sign contracts with the public universities that they will serve the public for 3 years after graduation. In case they breach the contract, there will be a find of 400,000 Baht. With the above measure, new graduate medical students have worked at district hospital; however, some of them resigned after 3-years compulsory work for further education, working in an urban area such as Bangkok, or working for private hospital. Later on, the ministry tried to introduce other incentive system such as better post, higher remuneration (rural doctor will receive 50,000-60,000 Baht), housing and other benefits.

Dr. Amphon Jindawattana, “An undesired to work in rural area of doctor or paying fine of new graduate and shift to work in the city has been a chronic problem. This crisis occurs in all countries with gap between rural and urban area. It also affects the health service standard in the rural area, the higher workload after an introducing of universal health care coverage, an unwanted relationship between patient and doctor. These accelerate the drain of doctor from rural area. Solving such complex problems cannot be cracked with single measure, several measures can be applied together namely issue temporary medical license, adjust fine between medical student who was admitted from the normal system (Entrance) and student who was recruited from rural area (CPIRD). In addition, an incentive, welfare and other benefits system should be considered altogether”.

Dr. Pongpisut Jongudomsuk also agrees with an idea of applying several measures to resolve the problem. The policy maker should consider policy and planning, production capacity, capacity strengthening, remuneration, welfare, other supports and benefits to the doctors. Moreover, these measures should have enough evidence support before an implementation process

Source: National Health Commission Office

Posted: September 11th, 2008 under Uncategorized.
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