The news never interested Nid before last week but recently she has been glued to the television.

The 34-year-old widow from Sri Satchanalai district in Sukhothai is one of more than 120,000 people relying on expensive drugs to stay alive.

She is an HIV/Aids sufferer and uses a treatment called Kaletra, the drug at the centre of an international controversy.

 The government angered Kaletra's maker, Abbott Laboratories of Chicago, when it invoked a special trade provision that allows it to ignore manufacturers' copyright patents.

Called compulsory licensing, the provision means it can manufacture generic versions of Kaletra and other drugs to make sure sufferers in this country are guaranteed affordable treatment. Abbott is incensed.

"It is very difficult for me to understand the whole of this complicated issue. What I do know is that the government is right and is helping people like me," Nid said.

Nid lives with her daughter and mother in rural Sukhothai. She found out she had contracted HIV nine years ago when she tested positive after becoming pregnant.

She thinks her husband, who has since deserted her and his daughter, infected her.

Meanwhile in Chiang Mai city, Prasert Dechaboon is watching the same news at a small hotel where he is attending a workshop. Prasert has lived with HIV/Aids for 17 years.

 "I understand drug companies need a return on their investment. They have spent huge sums to make each product. It is business. But why can't they make a little less profit from Aids drugs? It is a question of morality," Prasert said.

 "Don't they know they are playing politics with people's lives? Each baht cheaper an Aids drug becomes means more minutes alive for us. It means fewer people die," he said.

Prasert, 40, a former company manager, has been a full-time Aids activist for 14 years. He has been taking Aids treatments for eight years.

Nid and Prasert admit they are among the lucky ones. But that does not mean they are not struggling, they said. They still have to search for the best blend of drugs. Aids drugs are easily resisted, they said.

They note Aids treatments are different than those for other diseases because each individual needs a different combination, a unique treatment, that works best for him or her.

In 2000 the best treatment around for Nid was a blend of didanosine and zidovudine, or AZT. Later on that became the worst treatment for Nid.

Like watching the same movie over and over the best drugs sometimebecome the worst after severalyears.

Some combinations work for years while others work for a few months only. In seven years Nid has taken five different recipes. Today's cocktail is lamivudine, tenofovir and the controversial Kaletra.

 "Even if I could find the best combination for my symptoms it is not easy to take Kaletra. It has to be kept refrigerated," she said.

Prasert faces a similar experience. In eight years he has tried five different drug concoctions - ranging from didanosine to his latest mixture of AZT, 3TC and efavirenz.

"Drug efficiency is dependent on the timing of taking them. We have to be very strict on ourselves otherwise it won't work. I have to take it twice a day, at 9am and 9pm," he said.

 "Efavirenz is patented by Merck. It did not react as strongly [as Abbott] because it has just a few years left on its patent," Prasert said.

 "People living with HIV/Aids know very well each formula will one day no longer work for us. But we also believe new, better drugs will be discovered soon. I deeply believe I will die from old age like people not living with HIV/Aids," he said.

Nid prays Kaletra will continue working for her until a better drug is discovered.

"If we had a complete drug we could live and work like normal people. Otherwise, society has to shoulder our burden," she said.

Network of People Living with HIV/Aids (Upper North Region) leader Anan Muangmoolchai said Nid and others requiring Kaletra might be helped if more countries backed Thailand and invoked compulsory licensing.

"The good news is a new lopinavir/ritonavir protease inhibitor called Aluvia is being made. It is easier to take and does not need refrigeration.

"The bad news is Abbott is not going to release the product here because of the government's policy," Anan explained.

"It is like taking people living with HIV/Aids as hostages. Can't they spell humanitarian, morals or ethics?" he said.

Aids activist Chalermchai Phuenbuaphan said compulsory licensing was not only necessary for those depending on Kaletra but for patients needing new drugs after they build up resistance to the ones they are taking now.

The number of people needing Kaletra is rising, he explained. Of the 600,000 people with HIV/Aids, 120,000 require regular drug therapy and around 12,000 people need Kaletra.

"Due to the nature of the current Aids drugs, more people will require Kaletra due to resistance to their current drug usage. The latest forecast for this group is around 20,000 people a year," he said.

Prasert and Nid will monitor the situation patiently but will not waste this time. Each said they would do something useful for society.

Prasert is forming a multi-faith network fighting for Aids patients. Right now it involves 15 Protestant and Islamic groups and 30 Buddhist organisations.

 "The network will work closely with communities in combating Aids in every area," he said.

 Nid will help her mother raise her daughter and her brother's child and hope her story makes the public more aware of the scourge of HIV/Aids.

"I am happy to allow my life to be a lesson for others. To those who live with HIV/Aids, they can share my experience with drug treatments. Those not living with HIV/Aids should not put themselves at risk," she warned.

"I cannot join street protests because I am physically unable, but I send them my moral support and continue to organise the network of people living with HIV/Aids in Sukhothai," she said.

Kamol Sukin

The Nation