The document discusses HIV/AIDS in Thailand. It notes that while Thailand initially made progress in reducing HIV rates in the 1990s and 2000s through prevention campaigns like the 100% Condom Program, rates began rising again in the 2000s due to reduced funding and focus on prevention by the government. However, more recently the Thai government has renewed focus on prevention through new programs and partnering with NGOs, and HIV rates have begun decreasing again from 2005-2009. While some critics still argue the government could do more, overall it appears Thailand has had success in reducing HIV through prevention efforts.
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Honori Yamada
TSEA, Period 3
3 December 2010
HIV/AIDS in Thailand
Aid in AIDS
Since the first occurrence of Human Immunodeficiency Virus (HIV) in 1984, the global
epidemic has always been one of the leading issues in Thailand (“HIV & AIDS”). HIV in
general is known to be more contagious when the patients’ STD still exists (Prado). Acquired
Immune Deficiency Syndrome (AIDS) is a painful disease that occurs in humans’ immune
system and is actually one of the excruciating stages caused by HIV. As HIV was one of
Thailand’s leading causes of death, approximately 40 million people were living with HIV and
more than 3 million patients died annually in 1989 (Fuller). Furthermore, among those people
living with HIV, one-fifth of the patients were caused by unprotected sex. HIV is mostly infected
among the common groups of sex workers, drug users, and teenagers. Interestingly, although one
of the more common groups who are infected by HIV are sex workers, in fact prostitution is
supposedly illegal in Thai society (Brundtland). It was not until 1991 when Prime Minister
Anand Panayarachun planned to focus primarily for the fight against HIV/AIDS. Due to the
numerous movements enforced by the government, the number of HIV patients successfully
reduced from 143,000 in 1991 to 19,000 in 2003 (Fabian). Though some critics claim that there
is insufficient treatment and a possibility of resurgence of HIV, but in fact the Thai government
is very successful in the fight against HIV because of the care for the people living with HIV and
the effective prevention programs.
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Supporters of the government’s HIV program claim that the government is making steady
progress in providing care and treatment for the people living with HIV. In 2001, the government
created a program known as the National Access to Antiretroviral Treatment for People Living
with HIV/AIDS (NAPHA) which obligated to distribute free antiretroviral drugs to anyone in
need of vaccinations (“HIV and AIDS”). Antiretroviral drugs, or ARV drugs, are drugs that
delay the people living with HIV from going onto the phase of AIDS. By the first month of
releasing the program, more than 50,000 HIV patients were successfully able to receive the
therapy. In addition to the therapy, the NAPHA program mass produced cheap ARV drugs in
order 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 used
specifically 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 only
8,000 cases in 2001. Having the same function as the nevirapine, a drug known as AZT has also
been provided for mothers living with HIV. After the use of AZT, the survey successfully
showed a decreasing rate of mother to child transmission in Bangkok by 50% (Fuller). With
many different developed drugs that have recently been created in order to reduce the rate of
HIV 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 are
some critics who argue that there is an insufficient treatment available for all patients. The
biggest issue in the fight against HIV is the inability to produce the perfect vaccine which covers
both 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
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vaccine against this pathogen remains one of the most daunting challenges facing biomedicine
today” (Fuller). An additional issue in relation to treatments against HIV is the amount
distributed among the Thai citizens. Regardless of all the successful patients who received
medication during the NAPHA program, there were 39% of the patients who still did not receive
ARVs. 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 CD4
or T-cell count, which ARV drugs were useless against (“HIV and AIDS”). Not only, but since
scientist have been realizing that most people living with HIV tend to lack the knowledge of the
usefulness of the different HIV treatments, there were at times patients who misused the
provided treatment and medications. The director of Unaids, Peter Piot, stated during the
International AIDS Conference with took place in Bangkok in July 2004, “It is clear that it will
never be enough simply to provide anti-H.I.V. drugs, but that a holistic approach attending to
nutrition, hygiene, clean water …” (Fuller). Piot noted that there will never be enough to provide
all patients with ARVs, and therefore the main objective of treatment would be have to be
providing the patients with clean water, hygiene, and nutrition. Although there are some issues
with treatments and care for the people living with HIV, the Thai government has had one of the
most effective prevention campaigns.
To defend their position, the government points to their many successful campaigns
which focus on prevention. The Thai government used many ways to spread HIV awareness and
prevention such as by: mass media, workplace AIDS programs, training education for teenagers,
and anti-discrimination campaigns (Brundtland). Perhaps out of all the public prevention
campaigns that were contributed to reduce the rate of HIV, the government’s creation with the
program 100% condom program was most dynamically effective. The 100% condom program
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aimed 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 in
Thailand, 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 television
networks…” (“HIV and AIDS”). Mechai also required all public schools in Thailand to receive
education 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 for
both men and women specifically for brothels, massage parlours, and sex workers who were
living with HIV (Brundtland). Clean needles were also distributed specifically to intravenous
drug users who could receive HIV from sharing needles. The government has done many more
contributions 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 of
HIV enhanced population by delivering prevention messages through joining with other
organizations such as Empower, Swing, and Issarachon (“HIV and AIDS”). Although HIV
prevention campaigns which were funded by the government were successful before, some may
say that the government recently has been complacent with the idea of focusing on the
preventions.
Despite successful prevention campaigns run by the government, there may still be
resurgence of HIV now. Recently at the International AIDS Conference in 2004, ministers
discussed how due to the government becoming complacent with the idea of focusing on
prevention, the HIV may reappear after 12 years of success. During the years when Thaksin
Shinawatra was the Prime Minister, he created a plan in which focused primarily on providing
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therapies, drugs, and health care for those with HIV (Cumming). Just as Piot stated during the
International AIDS Conference, a real solution in need is to provide legit sex education and
health care instead of providing patients with free condoms and clean needles, Unaids reported
that now the Thai government spending budgets on HIV prevention and awareness has decreased
by 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 to
a dramatic increase in the rate of HIV in Thailand by 30% in 2000 (Pathan). Mechai later
predicted a resurgence of HIV in Thailand due to the lack of preventions and public awareness of
the government. According to the survey, the recent increase in the number of HIV patients was
primarily due to the effect of teenagers starting sexual activities in an earlier age without feeling
the necessity to use condoms (Fabian). In addition, other groups such as the infected HIV
patients among bisexual men and intravenous drug users has also increased theatrically. Due to
the lack of effort that the Thai government is contributing on AIDS preventions, some opposing
entities state that the Thai government is recently not doing enough in the fight against
HIV/AIDS compared to 10 years ago. Some opponents state that there might be a resurgence of
HIV due to the lack of governmental fundings; however more recently, the Thai government has
restarted again in focusing on preventions.
Recently, there have been many effective campaigns which have been designed by the
Thai government that focus primarily on prevention of HIV. Successful previous programs
designed by the government, such as the 100% condom program, was able to vividly decrease
the rate of HIV due to the varieties of preventions and awareness programs supported by the
government. For example in 1998, the Thai government funded the National AIDS program for
more than $80 million annually (“HIV and AIDS”). As for some examples of the previous
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successful programs, the government has recently been creating numerous effective programs
focusing on the preventions. In year 2007, the government carried out their 3rd National Plan for
preventions of HIV/AIDS where they worked to reduce the risks of the HIV reoccurrence by
providing care and support for more than 80% of the patients living with HIV. As a result by the
end of 2007, the HIV prevalence showed a decreasing percentage from 2% in 1997 to 1.8% in
2003 and finally to 1.4% in 2009 (“HIV and AIDS”). Furthermore, an NGO corporation known
as the Global Service Corporation has partnered with Path to create a campaign known as
English for Life (EFL). This program aims to focus on teaching sex education and awareness for
the public Thai students in English (Fabian). Moreover, in 2005, Thailand’s first homosexual
program known as the Rainbow Sky Association was also designed by the government to
educate homosexual men for safer sex with free distribution of condoms. Due to the several new
campaigns that have been designed recently to avoid a resurgence of HIV, the Public Health
Minister, Sudarat Keyuraphan stated that a progress can now be seen, and Thailand is again more
focused 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 HIV
preventions, there has been a recent increase in the number of campaigns and programs which
are working hard in reducing back the rate of HIV. From the successful campaigns and programs
that were recently created, the Thai government is now supporting the fight against HIV/AIDS
once again.
Along with many other countries such as South Africa and Brazil, the Thai government
appears 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 and
awareness, there are numerous new campaigns generated by the government which focuses
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mainly on the public awareness. With the compelling prevention, treatment, and care from all the
adjoining partners of NGOs and other business communities, now the Thai government has once
again emerged towards the fight against the issue of HIV and the reporters have reported how
progress can gradually be seen (Fabian). Recently, the rate of HIV since 2005 to 2009 shows a
significant decrease as the Thai government is once again playing action in order to reach its
objective (Pathan). Hence, the steady decrease in the rate of HIV thoroughly proves the hard
work the Thai government has worked up these couple of years, therefore this shows that the
government is undeniably doing enough in the fight against HIV/AIDS.