Dr Krisana Kraisintu first used her pharmaceutical expertise to make HIV/Aids treatment affordable in Thailand, then she moved on to Africa

Source : Bangkokpost - http://www.bangkokpost.net/

ดร.กฤษณา ไกรสินธุ์

TUNYA SUKPANICH (From Bangkokpost)

The work of Dr Krisana Kraisintu, who has spent years helping countries to produce generic drugs locally, has been widely recognised and publicised in the West for many years. However, her work in Africa became widely known back in her home country only after the interim Thai government decided to adopt the Compulsory License (CL) scheme for some HIV and other drugs.

She has received many international awards, and stories about her have appeared in several media - including women's and pharmaceutical magazines - in French, German, English and other languages.

At the beginning of this year, a production house in the United States began work on a play about her life and work which has already been on stage in Louisiana.
The writing team interviewed Dr Krisana in New York for only two days, but it took them about two years to successfully write the play, which will tour nationwide in the US soon.
Some have tried to convince her that she should seek more personal compensation for her important work or for the publicity it generates. For example, a Thai movie critic and director said she should demand a large sum of money from the magazines and from the production house. But she remains true to her simple philosophy that giving is better than taking.

"To me it is toxic to talk about taking money or benefits," Dr Krisana said simply, adding that she gladly donates her time and efforts in the belief that they can help many people to learn something about the mercy and kindness people should show toward one another.

Dr Krisana joined the Government Pharmaceutical Organisation (GPO), a state enterprise under the Public Health Ministry, in 1983, and stayed there until 2002. Her last title at the GPO was director of the Research and Development Institute, which she founded.

During her time at the GPO she successfully developed the Thai generic version of the antiretroviral (ARV) drug AZT, used as a frontline medication for HIV/Aids patients worldwide. She recalled that at the time nobody at the organisation wanted to research and develop this toxic, expensive and complicated drug, so she had to work on her own.

With a strong intention to make cheap local drugs to help HIV/Aids patients, in 1995 Dr Krisana completed her first generic ARV version of AZT, which the GPO sold to the Ministry of Public Health to prevent mother-to-child HIV transmission.

"It is not widely known that Thailand was the first to produce generic AZT. India began production in 1996 and Brazil in 1997," said Dr Krisana.

However, many obstacles remained in those days for the Thai generic AZT. Doctors had doubts over its quality, while the GPO had to be worried about cost and profits.

Then the German pharmaceuticals certification organisation known as the TUV gave its assurance that the ARV drugs produced by the GPO were safe and effective. Later, in the year 2000, the Finance Ministry confirmed that the drug had made a profit, and the GPO agreed to raise investment in production to allow for the treatment of 20,000 patients, an increase from 5,000 patients.

Dr Krisana then moved ahead with work to produce a generic version of the well known HIV "cocktail" - three ARV drugs in one. This helps simplify the treatment, reduces the emergence of drug resistance and lowers the price.

Before the production of GPO-VIR, a patient had to take 6 pills a day at the cost of about US$85 a month for generic drugs, and $474 for the original patented drugs. With the GPO-VIR, the patient takes two pills a day at the cost of $27 a month (about 1,200 baht at that time), or $324 a year.

To ailing Africa
In 2002 Dr Krisana left the GPO to supply affordable HIV/Aids medications where she figured they were needed most - to Africa.

She says there were many many reasons for the decision. First of all, a high- ranking Thai official at the time announced at a World Health Organisation (WHO) forum that Thailand would help in the technology transfer necessary to produce HIV drugs in African countries.
Moreover, from 1999 to 2002, Dr Krisana had been invited to visit some African countries, and had already made plans and proposals for such a technology transfer, but there had been no progress.

She decided to resign from the position of director of the GPO Research and Development Institute to work in Africa on her own.
When asked why not just sell the African countries the GPO drugs instead of training them to produce their own, Dr Krisana said: "It is better to teach them how to fish than to give them fishes."

Mostly she provided countries training to make the drugs, but in her very first mission in the war-torn Democratic Republic of the Congo (DRC) she actually helped in the design of the laboratory and advised in its construction.
Even with the ongoing civil war in the country, Dr Krisana says she never thought of turning back, no matter how frightening the situation. The DRC started local production of ARVs in 2005.

While stationed in the DRC, she travelled to a number of other countries to provide technical expertise, among them Tanzania and Benin.

In the peaceful country of Tanzania, where a large part of the labour force lives with HIV/Aids, it was also decided that local production would be the best long-term treatment solution. Here Dr Krisana helped in training officials of Tanzanian Pharmaceutical Industries (TPI), a joint venture between the government and private entrepreneurs to produce HIV/Aids drugs, and also antimalarial and anti-TB drugs.

"Besides a severe problem with HIV/Aids, Tanzania is hard hit by malaria," she explained. Antimalarial drugs there had to be imported and the price was so high that most people could not afford them. Therefore the disease has traditionally had a high death rate.
Now there is successful production of antimalarial drugs at about $0.80 for 6 tablets, as opposed to around $10 for imported drugs, she said.

Dr Krisana stressed that other African countries, among them Mali, Gabon and Gambia, have a major malaria problem.

Therefore, along with the HIV/Aids drugs, local production of antimalarial drugs is essential.
She added that it is common knowledge that most transnational drug companies focus their research and development on the treatment of diseases which can yield the most profits. Malaria and other diseases common in undeveloped countries are not their interest any longer. Consequently, the local development and production of new drugs is also very desirable.
Last year, the Foreign Ministry asked Dr Krisana to participate in a technology transfer project to the five western African countries of Senegal, Burkina Faso, Mali, Gambia and Gabon.
However, her work will continue in the DRC, Tanzania, Zambia, Ethiopia, Uganda and elsewhere.

Several international organisations which agree with her ideological work coordinate and support Dr Krisana's efforts. For example, in the DRC and Tanzania she works in collaboration with the German medical aid organisation Action Medeo.

Dr Krisana says that despite the fact that drug patents are supposed to be strictly enforced worldwide under World Trade Organisation agreements by the year 2016, she will continue helping African countries to produce local generic drugs so that they can be independent in treating their sick and poor. She shows no sign of slowing down, and says she must spend her time wisely. The faster she can share her knowledge, the more lives can be saved.
Bio DATA

Dr Krisana Kraisintu was born on 21 February 1952 on the island of Koh Samui in Surat Thani province. She earned a Bachelor degree in Pharmacy from Chiangmai University in 1975. She then furthered her studies in England and received a doctorate degree in Pharmaceutical Chemistry from Bath University in 1981.

Dr Krisana taught a Pharmaceutical Chemistry course for three years at the Faculty of Pharmacy of Prince of Songkhla University. In May 1983 she started her work at the Government Pharmaceutical Organisation (GPO). In 1989 she founded the GPO's Research and Development Institute and she became the first director. She resigned in October 2002 to help African nations develop generic drugs for the treatment of life-threatening diseases.
She is single.

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My comment: I have seen Dr.Krisana once in the movie festival (name Dying for drug) at the Faculty of Pharmaceutical Science, Chulalongkorn University. She is a brave and excellent woman. She went to help many country in African continent to manufacture their own drug, therefore many patients can access drug and cure. She went there alone and had many trouble, but she can do it! I respect her so much.