The recommendation was stated in the bank's new report, "The Economics of Effective Aids Treatment: Evaluating Policy Options for Thailand", released on Wednesday at the 16th International Aids Conference in Toronto.

As the drugs in second-line therapy for people living with HIV/Aids are patented, the bank suggested that the Thai government should not relinquish its rights to grant compulsory licences for Aids drugs in exchange for proffered trade advantages from a bilateral trade agreement with the United States.

By exercising compulsory licensing, the paper said, the government could reduce the cost of second-line therapy by 90 per cent and would cut by more than half the cost per life-year saved under the National Access to Anti-retrovirals Programme for People Living with Aids, from US$2,145 to $940 (from Bt85,800 to Bt37,600).

The bank encouraged Thailand to enhance its bargaining power with the multinational pharmaceutical industry by coordinating its negotiations with other middle- and low-income countries.

The recommendation was welcomed by civic groups in Thailand and internationally.

Kannikar Kijtiwatchakul of FTA Watch, a Thai group that works against unfair free-trade deals, especially in regard to intellectual property rights to life-saving drugs, said the recommendation showed that the World Bank realised that patents were a big barrier to saving the lives of people with HIV.

"It is a clear message to the Thai government to exercise its rights right now," she said.

The World Bank report also held Thailand up as an example for other developing states, saying Thai programmes showed that even countries with few resources may be able to hand out crucial ARVs on a vast scale, at low cost. Its effort to help HIV sufferers has been boosted by domestic manufacture of an affordable anti-retroviral therapy, which costs only $30 per month, the report said.

"We conclude Thailand can afford universal treatment, and is rightly in the vanguard of developing countries seeking to provide anti-retroviral therapy as the standard of care to large numbers of people with symptomatic HIV disease," said bank economist Ana Revenga.

About 6.8 million of the estimated 38.6 million people living with HIV worldwide need antiretroviral therapy, the World Health Organisation (WHO) said on Wednesday. Only 1.66 million, or 24 per cent of those in need, were getting the treatment, the UN agency said.

But Thailand has bucked the trend. By May this year, it was providing treatment for 78,000 Aids patients - more than 90 per cent of those who need it, according to the report, co-authored with the Thai Ministry of Public Health.

Thailand has long been regarded as one of the most successful nations in fighting HIV. The sharp drop in deaths was attributed to the increasing availability of anti-retroviral drugs.

The World Bank said more than one million Thais had been infected with HIV since the first case was reported here in 1984.

The Nation,

Agence France-Presse