Pfizer sent Buckley to the Mae Tao Clinic, a refuge for some of the world's most impoverished people, Burmese migrant workers, refugees and members of various ethnic groups, including stateless people, who can't afford basic medicine that many in the modern world take for granted.

With the support of international aid organisations, Mae Tao is run by Karen refugee Dr Cynthia Maung, the recipient of numerous international awards, including the Ramon Magsaysay. The clinic took in over 100,000 patients last year.

As he is Pfizer senior clinical education consultant and lecturer at the University of Connecticut School of Pharmacy, Buckley's expertise came in handy.

During his six-months stay working for the International Rescue Committee at the clinic, Buckley helped to establish a reference drug list, tried to satisfy the hospital's "wish list" for donated drugs and catalogued all the medical education materials.

Since infection control was a major problem for the clinic, Buckley also developed the Universal Precaution System for sterilising surgical units and set up a control team to carry out monthly inspections on each department.

One of the major restrictions was bureaucratic red tape. The clinic could only purchase medicines made in Thailand, which sometimes were not available in all the formulations needed, Buckley said. To help a clinic like Mae Tao cope with such restrictions, Buckley worked with Thai aid organisations to revise the Burma Border Guidelines to ensure the clinic got the most out of every baht.

Moreover, Mae Tao has recently launched a comprehensive programme for 20 HIV-infected people. Under an operating budget of US$100 (Bt3,415) per month per person, each patient will be given an anti-viral drug and treatment for infections resulting from their compromised immune systems, including fungal infections and TB.

The fact that the clinic had been able to operate with such limited resources and against many odds as well as Cynthia's fighting spirit had inspired him and the academic said he would return as a volunteer later this year.

But while Buckley sees himself as lending a helping hand to one of the world's most neglected people, such effort is not without controversy.

Pfizer, the firm that sponsored him, is accused of doing the right thing for wrong reason.

Director of Aids Access, Nimitr Tienudom, said he was not that impressed and did not believe the giant drug company had launched the project without the expectation of a business return.

"I'm sure drug companies know that the most important problem is drug access. Many people have been left behind and neglected just because they could not afford good medicines," Nimitr said, adding: "If they really want to help people, why don't they cut the price of their innovative life-saving drugs?"

Nimitr urged Pfizer to "demonstrate its sincerity" by making a commitment to those people with HIV/AIDS that it will support them with anti-retroviral drugs for the rest of their lives.

In 2005, Pfizer came in for criticism over one of its projects in the Dominican Republic in which the company provided Diflucan, a medicine to help HIV patients with fungus infection, but at the same time sold the medicine in the market at more than US$20 per pill.

Aid organisations said 90 per cent of Dominicans living with HIV/Aids do not have access to ARV treatment.

Indeed, striking a balance between a company's obligations and the need to turn a profit has long been the centre of debate between pharmaceutical firms and critics who insist the industry take on a clear, moral obligation above all else. The debate is likely to continue for the foreseeable future.

However, Pfizer is not a charity organisation but a pharmaceutical company that does charitable work, according to Buckley. Moreover, proper research and development, on average, costs about US$1 billion and only one out of every 2,000 drugs makes it to the market, he said.

The Pfizer Global Health Programme - started in 2003 - covered 100,000 employees world-wide. They compete for 20-30 fellowships to lend expertise to its partner 30-40 non-governmental organisations battling HIV/Aids, tuberculosis and malaria in developing countries.

Chatrarat Kaewmorakot,

Premyuda Boonroj

The Nation