Yamada 1Honori YamadaTSEA, Period 33 December 2010HIV/AIDS in Thailand Aid in AIDS Since the first occurrence of Human Immunodeficiency Virus (HIV) in 1984, the globalepidemic has always been one of the leading issues in Thailand (“HIV & AIDS”). HIV ingeneral is known to be more contagious when the patients’ STD still exists (Prado). AcquiredImmune Deficiency Syndrome (AIDS) is a painful disease that occurs in humans’ immunesystem and is actually one of the excruciating stages caused by HIV. As HIV was one ofThailand’s leading causes of death, approximately 40 million people were living with HIV andmore than 3 million patients died annually in 1989 (Fuller). Furthermore, among those peopleliving with HIV, one-fifth of the patients were caused by unprotected sex. HIV is mostly infectedamong the common groups of sex workers, drug users, and teenagers. Interestingly, although oneof the more common groups who are infected by HIV are sex workers, in fact prostitution issupposedly illegal in Thai society (Brundtland). It was not until 1991 when Prime MinisterAnand Panayarachun planned to focus primarily for the fight against HIV/AIDS. Due to thenumerous movements enforced by the government, the number of HIV patients successfullyreduced from 143,000 in 1991 to 19,000 in 2003 (Fabian). Though some critics claim that thereis insufficient treatment and a possibility of resurgence of HIV, but in fact the Thai governmentis very successful in the fight against HIV because of the care for the people living with HIV andthe effective prevention programs.
Yamada 2 Supporters of the government’s HIV program claim that the government is making steadyprogress in providing care and treatment for the people living with HIV. In 2001, the governmentcreated a program known as the National Access to Antiretroviral Treatment for People Livingwith HIV/AIDS (NAPHA) which obligated to distribute free antiretroviral drugs to anyone inneed of vaccinations (“HIV and AIDS”). Antiretroviral drugs, or ARV drugs, are drugs thatdelay the people living with HIV from going onto the phase of AIDS. By the first month ofreleasing the program, more than 50,000 HIV patients were successfully able to receive thetherapy. In addition to the therapy, the NAPHA program mass produced cheap ARV drugs inorder to acquire vaccinations at a lower cost in many public pharmacies (“HIV and AIDS”).Another development on HIV treatments is the single dose of nevirapine which is usedspecifically for mothers in labor that reduces the chances of passing HIV to their own children.As for the result, mother to child transmission has significantly reduced from 50,000 to only8,000 cases in 2001. Having the same function as the nevirapine, a drug known as AZT has alsobeen provided for mothers living with HIV. After the use of AZT, the survey successfullyshowed a decreasing rate of mother to child transmission in Bangkok by 50% (Fuller). Withmany different developed drugs that have recently been created in order to reduce the rate ofHIV spread, the government has been working hard in the fight against HIV/AIDS. Although many believe that the care for patients living with HIV has improved, there aresome critics who argue that there is an insufficient treatment available for all patients. Thebiggest issue in the fight against HIV is the inability to produce the perfect vaccine which coversboth for the patients who currently have HIV and for those who are avoiding new infections(Fabian). Although scientists are still researching to create the best fit vaccine against HIV,“…vaccine development have failed in trying to counter the AIDS virus, and that developing a
Yamada 3vaccine against this pathogen remains one of the most daunting challenges facing biomedicinetoday” (Fuller). An additional issue in relation to treatments against HIV is the amountdistributed among the Thai citizens. Regardless of all the successful patients who receivedmedication during the NAPHA program, there were 39% of the patients who still did not receiveARVs. Furthermore, among the 61% of the patients who still received the free charge ARVs,half of them were either too late as they already had symptoms of AIDS or had a very low CD4or T-cell count, which ARV drugs were useless against (“HIV and AIDS”). Not only, but sincescientist have been realizing that most people living with HIV tend to lack the knowledge of theusefulness of the different HIV treatments, there were at times patients who misused theprovided treatment and medications. The director of Unaids, Peter Piot, stated during theInternational AIDS Conference with took place in Bangkok in July 2004, “It is clear that it willnever be enough simply to provide anti-H.I.V. drugs, but that a holistic approach attending tonutrition, hygiene, clean water …” (Fuller). Piot noted that there will never be enough to provideall patients with ARVs, and therefore the main objective of treatment would be have to beproviding the patients with clean water, hygiene, and nutrition. Although there are some issueswith treatments and care for the people living with HIV, the Thai government has had one of themost effective prevention campaigns. To defend their position, the government points to their many successful campaignswhich focus on prevention. The Thai government used many ways to spread HIV awareness andprevention such as by: mass media, workplace AIDS programs, training education for teenagers,and anti-discrimination campaigns (Brundtland). Perhaps out of all the public preventioncampaigns that were contributed to reduce the rate of HIV, the government’s creation with theprogram 100% condom program was most dynamically effective. The 100% condom program
Yamada 4aimed to reduce the transmitting rate of HIV by awareness, using mass Medias such as TVs,radios, and national newspapers. A well-known activist in the fight against HIV/AIDS inThailand, Mechai Viravaidya, organized a massive public awareness of HIV by spreading “Anti-AIDS messages aired every hour on the country’s 488 radio stations and six televisionnetworks…” (“HIV and AIDS”). Mechai also required all public schools in Thailand to receiveeducation on safer sex that mostly focuses towards young women to demonstrate gender equality(Fabian). During the 100% condom program, free distribution of condoms were acquired forboth men and women specifically for brothels, massage parlours, and sex workers who wereliving with HIV (Brundtland). Clean needles were also distributed specifically to intravenousdrug users who could receive HIV from sharing needles. The government has done many morecontributions towards the fight against AIDS as they partnered with other business communities,religious leaders, World Health Organizations (WHO), President G. Bush, Global Funds, Unaids,and other NGOs. Many NGO corporations has also impacted in decreasing the growth rate ofHIV enhanced population by delivering prevention messages through joining with otherorganizations such as Empower, Swing, and Issarachon (“HIV and AIDS”). Although HIVprevention campaigns which were funded by the government were successful before, some maysay that the government recently has been complacent with the idea of focusing on thepreventions. Despite successful prevention campaigns run by the government, there may still beresurgence of HIV now. Recently at the International AIDS Conference in 2004, ministersdiscussed how due to the government becoming complacent with the idea of focusing onprevention, the HIV may reappear after 12 years of success. During the years when ThaksinShinawatra was the Prime Minister, he created a plan in which focused primarily on providing
Yamada 5therapies, drugs, and health care for those with HIV (Cumming). Just as Piot stated during theInternational AIDS Conference, a real solution in need is to provide legit sex education andhealth care instead of providing patients with free condoms and clean needles, Unaids reportedthat now the Thai government spending budgets on HIV prevention and awareness has decreasedby 2/3 from 21.7% to 13.7% which are ¼ less than the amount spent in 1997 (Fuller). As a result,condom use between men and women teenagers has also dropped by 20%, which overall lead toa dramatic increase in the rate of HIV in Thailand by 30% in 2000 (Pathan). Mechai laterpredicted a resurgence of HIV in Thailand due to the lack of preventions and public awareness ofthe government. According to the survey, the recent increase in the number of HIV patients wasprimarily due to the effect of teenagers starting sexual activities in an earlier age without feelingthe necessity to use condoms (Fabian). In addition, other groups such as the infected HIVpatients among bisexual men and intravenous drug users has also increased theatrically. Due tothe lack of effort that the Thai government is contributing on AIDS preventions, some opposingentities state that the Thai government is recently not doing enough in the fight againstHIV/AIDS compared to 10 years ago. Some opponents state that there might be a resurgence ofHIV due to the lack of governmental fundings; however more recently, the Thai government hasrestarted again in focusing on preventions. Recently, there have been many effective campaigns which have been designed by theThai government that focus primarily on prevention of HIV. Successful previous programsdesigned by the government, such as the 100% condom program, was able to vividly decreasethe rate of HIV due to the varieties of preventions and awareness programs supported by thegovernment. For example in 1998, the Thai government funded the National AIDS program formore than $80 million annually (“HIV and AIDS”). As for some examples of the previous
Yamada 6successful programs, the government has recently been creating numerous effective programsfocusing on the preventions. In year 2007, the government carried out their 3rd National Plan forpreventions of HIV/AIDS where they worked to reduce the risks of the HIV reoccurrence byproviding care and support for more than 80% of the patients living with HIV. As a result by theend of 2007, the HIV prevalence showed a decreasing percentage from 2% in 1997 to 1.8% in2003 and finally to 1.4% in 2009 (“HIV and AIDS”). Furthermore, an NGO corporation knownas the Global Service Corporation has partnered with Path to create a campaign known asEnglish for Life (EFL). This program aims to focus on teaching sex education and awareness forthe public Thai students in English (Fabian). Moreover, in 2005, Thailand’s first homosexualprogram known as the Rainbow Sky Association was also designed by the government toeducate homosexual men for safer sex with free distribution of condoms. Due to the several newcampaigns that have been designed recently to avoid a resurgence of HIV, the Public HealthMinister, Sudarat Keyuraphan stated that a progress can now be seen, and Thailand is again morefocused on preventions as they agreed to work together with Unaids for another few years(Pathan). Although there might have been a decrease in the Thai government’s spending on HIVpreventions, there has been a recent increase in the number of campaigns and programs whichare working hard in reducing back the rate of HIV. From the successful campaigns and programsthat were recently created, the Thai government is now supporting the fight against HIV/AIDSonce again. Along with many other countries such as South Africa and Brazil, the Thai governmentappears to be showing one of the most successful developments in the fight against HIV/AIDS.Though some say a resurgence of HIV might reoccur again due to the lack of preventions andawareness, there are numerous new campaigns generated by the government which focuses
Yamada 7mainly on the public awareness. With the compelling prevention, treatment, and care from all theadjoining partners of NGOs and other business communities, now the Thai government has onceagain emerged towards the fight against the issue of HIV and the reporters have reported howprogress can gradually be seen (Fabian). Recently, the rate of HIV since 2005 to 2009 shows asignificant decrease as the Thai government is once again playing action in order to reach itsobjective (Pathan). Hence, the steady decrease in the rate of HIV thoroughly proves the hardwork the Thai government has worked up these couple of years, therefore this shows that thegovernment is undeniably doing enough in the fight against HIV/AIDS.