The [him] moderator finds it amusing that anyone would call the Mae Tao clinic 'destitute'.

Six months ago Thomas Buckley left his state-of-the-art laboratory
in the world's largest pharmaceutical company for a destitute border
clinic on the Thai-Burmese border.

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