Politics and bureaucracy behind Thai government's issuance of compulsory licensing (CL)

Abstract

To elaborate and identify the determining factors that led to the Thai government’s issuance of CL during the military-installed government of General Surayud Chulanont (October 2006 - January 2008). This research places an emphasis on two contexts: 1) national politics that provided political opportunities following the September 19, 2006 coup d’état; and 2) the Thai Ministry of Public Health (MoPH)’s bureaucracy and its key features. Research findings revealed that national politics was a determining factor. The conceptual framework of “Political Opportunity Structure (POS)” was applied to analyze the changed dimensions of the Thai state that provided incentives for MoPH bureaucrats to undertake collective action and to eventually bring about CL. It found that previous Thai governments and concerned authorities, particularly during the period of 1998-2006, had been submissive and could not withstand international pressure and trade sanctions. Thus the issues of access to medicines was not taken as a priority, and was even swept aside when the country was under increasing domination of neoliberal globalization and international trade interests. Research findings showed that the September 19 coup opened up political opportunities for the Thai government’s ability to issue CL. The political opportunities include the reconfiguration of national cleavage structure and institutional structure. Research findings showed that the MoPH’s bureaucracy was another determining factor. This research applied the framework of “Politico-Administrative Structure (PAS)” to characterize the relationship and bargaining among bureaucrats (political and civilian) as well as between bureaucrats and non-state actors (civil society and drug TNCs). It elaborated that cultural and structural/functional features of the MoPH’s bureaucracy were accountable. Cultural elements were manifested in two aspects: 1) the MoPH’s philosophy; and 2) institutional perceptions on the right to access to healthcare and medicines at both the national level and the level of the MoPH. Structural and functional dimensions also significantly contributed to the issuance of CL by transforming structural limitations into an active (functional) administrative policy. The success of CL issuance derived from four major implications: 1) decentralization and authority dispersion; 2) putting a panel under the direct supervision of the MoPH Minister; 3) not deferring the final decision to the cabinet; and 4) using the prevailing strategy of “highly coordinated” in dealing with health civil society. Lastly, this research built on preceding analysis and offered a reassessment of capacity, authority, and autonomy behind the Thai government’s issuance of CL. Among these three fundamental aspects, research findings proved that autonomy was a determining factor.