relevant. Already in Vietnam, India and China, governments are considering issuing compulsory licenses for Roche’s Tamiflu, the most favored avian flu medicine. If successful, they will be able to produce and export Tamiflu to developing countries that otherwise would not be able to produce the treatment themselves. By regulating the circumstances in which compulsory licenses can be sought, the United States is limiting other countries’ abilities to provide inexpensive medicines to their people when they deem necessary.

The sovereignty of Thailand and countries like it is threatened by foreign IPR policy, as agreements like the FTA increase dependence on developed nations to provide essential medications. The agreement takes control out of the hands of the people, and gives it to foreign governments and, more dangerously, foreign corporations. Being nationally self-reliant in health care depends on a country’s ability to produce generic medications. Currently, the Thai Government Pharmaceutical Organization (GPO) is able to produce a generic first-line ARV called GPO-vir ($31 per patient per month; an equivalent brand name drug costs $490) because it was invented prior to Thailand’s 1992 introduction of patent protection for medication. As more of Thailand’s one million HIV-infected persons become resistant to first-line ARVs, they will need second-line treatments, the majority of which can cost 14 times more than first-line treatments and are patented—thus eliminating the potential that affordable generic versions will hit the market anytime soon.

The feasibility of universal health care programs in

developing nations comes into question as well. Universal health care programs in developed countries like Sweden, Denmark, and New Zealand are successful in part because they have established systems that are capable of researching, innovating, producing, and distributing medication. All medications can be covered in the national health care program because they have the ability to innovate and inexpensively produce the necessary drugs domestically.

Since countries like Thailand produce much of their medications under a generic label, if they have to pay exorbitant prices for protected imports, it will no longer be feasible to include them in a universal health care plan. This will restrict access for hundreds of thousands of people. Nimit Tienudom, from the Thai NGO Access, is an outspoken advocate for the rights of HIV/AIDS patients. He acknowledges that when the Thai government was originally debating whether to include ARVs in the national health care plan, many thought it wasn’t economically viable to treat HIV/AIDS patients since the drugs are very expensive and could possibly “break the system.” If the FTA with the U.S. passes, there is a good chance that the system will indeed break. Millions of people will fall through the cracks.

Why is the United States dictating the strict application of IPR rules? The answer, it turns out, is relatively straightforward: patents and protection of intellectual property matter considerably to the U.S. economy. James Caruso, a chief economic officer at the U.S. Embassy in Thailand, observes, “The United States sees its very ability to compete in the world based on its technological edge.” This is especially true as the country moves from a manufacturing-based economy to a knowledge-based economy in which more than 50 percent of exports have some sort of intellectual property component.

Beyond the economic justification, there is the classic argument that patents are necessary to spur innovation. Caruso remarks, “The system we have is the reason why we have all of the medications we have...the cure for AIDS is not going to come from some generic company; it will come from a company, probably in the U.S, that’s been spending hundreds of millions of dollars on research a year trying to find that next drug. The way we promote