Thailand’s gypsy pharmacist: a champion of affordable drugs

Dr. Krisana Kraisintu-main
Dr Krisana Kraisintu, known as the 'Gypsy Pharmacist', is an advocate of cheaper medicines in Asia and Africa. Copyright: Trudy Harris

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  • Generic medicines can be many times cheaper than branded versions
  • Everyone should have access to affordable medicines and treatment
  • Local production of generic drugs is a 'long-term solution'

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Krisana Kraisintu’s affordable generic medicines have saved innumerable lives in Asia and Africa.

[BANGKOK] War, poverty, disease and inequality are just some of the challenges Krisana Kraisintu has faced throughout a career creating generic medicines that benefit poor patients in Asia and Africa.
The 67-year-old Thai pharmacist, whose medicines against HIV/AIDS, malaria and other diseases have been used to treat millions of people, was educated at Chiang Mai University, Thailand and the Universities of Strathclyde and Bath in the UK. She has led Thai government initiatives to manufacture generics for public health programmes.

“If you cannot get access to healthcare, how can you live your life? This is my belief and I had to do something”

Krisana Kraisintu

In 1995, after months of working alone in a lab, she successfully developed a generic version of the drug AZT (azidothymidine), which treats advanced HIV infection and reduces the risk of mother-to-child transmission. She and her team later developed the first generic “cocktail” or combination HIV drug, endorsed by the World Health Organization as a first-line treatment for patients in poor countries.

In 2009, Krisana won the prestigious Ramon Magsaysay Award, Asia’s equivalent of the Nobel Prize, for public service. Today, through her foundation, she continues to lead a string of projects, including helping poor communities in southern Thailand grow and harvest medicinal plants.  

Known as the ‘Gypsy Pharmacist’, Krisana is guided by her belief that affordable healthcare is a basic human right. “Everybody should have access to treatment, rich or poor, black or white,” she tells SciDev.Net in an interview.

Why did you focus your work on generic HIV/AIDS drugs?

In those days, in 1992, only rich people really could get the drugs, because the cost of treatment at that time was so expensive. But if you cannot get access to healthcare, how can you live your life? This is my belief and I had to do something. Once we could manufacture generic drugs in Thailand, it became 20 to 22 times cheaper and Thailand could export these to neighbouring countries which needed them.

I wanted to transfer this technology to Africa to those poor people there because I always believe that local production is a long-term solution, you need to be able to manufacture in your own country. It was difficult because I had to fight on my own sometimes, but at least there was somebody fighting for them.

What were your biggest challenges while working in a dozen African countries during 2002—2009?

It can be very difficult because of war, poverty and many other things, so living and working in Africa really tested my stamina, tested my everything. It was like walking in a dark wood on a moonless night. Sometimes it was a frightening experience, and there was sometimes no electricity or water or infrastructure. But how could I fail these people? I promised to help, and a promise is a promise.

For three years, I was in the Democratic Republic of the Congo, and we could not communicate with each other. I was there to provide technical assistance and expertise to a local drug company to set up a plant to manufacture an antiretroviral fixed-dose combination. They spoke French and Swahili and I spoke neither. So I would demonstrate first and they would write everything down. Then they would repeat what they wrote down, and I would watch, and then we would do it again, until it was right.  

In Liberia, there had been years of civil war. I went there four times to try and start production with the [Bill and Melinda] Gates Foundation but there was no factory, no infrastructure. I could only go to the hospitals and help prepare the drugs in a small laboratory.

How did your childhood influence your career?

My grandmother was a Buddhist nun and I used to go to the temple when I was very young and see her kindness, see how she helped everyone as best she could. My father was the doctor on Samui Island and my mother was a nurse, so I was surrounded by my parents treating patients, helping them.

I saw my father treating them with modern drugs, modern medicine, but my grandfather was a traditional doctor on the island. He used traditional (herbal or plant-based medicines and remedies) and so I saw both ways, modern and traditional. When I studied pharmacy at university, I knew that I could apply both ways, so that they complemented each other, worked hand in hand.

What is your advice for young researchers and scientists, especially women, facing professional challenges?

If you face a problem, it’s not a problem really, it’s an exercise. And the more exercises you have, the more experience you have, and the further you can go. You have to find your own way and not give up. I think this is my grandmother’s philosophy that she instilled in me; perseverance against all odds, the “never give up” principle.
This piece was produced by SciDev.Net’s Asia & Pacific desk.