Sharpened focus in Aids battle

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Sharpened focus in Aids battle

By CHULARAT SAENGPASSA 
THE NATION WEEKEND 

 

Activists attend an AIDS awareness campaign on the eve of World AIDS Day in Kolkata, Eastern India . : Photo EPA

 

THAILAND WORKS TOWARDS BANISHING THE VIRUS BY 2030, THOUGH POLICY TWEAKS NEEDED

 

THAILAND HAS made significant progress towards its ambitious goal of ending Aids by 2030 – something UNAids hopes to accomplish but for which few countries are on a good track.

 

Despite some 440,000 people still living with HIV in Thailand as World Aids Day 2018 arrives on December 1, the nation can take a bow for having built a solid foundation on which to continue building towards the dream of an HIV-free society. 

 

An estimated 98 per cent of people living with HIV in Thailand know their status. And 75 per cent of them have access to retroviral drugs, which have proven so effective that when a regular dose is taken, someone with HIV can live a normal, healthy and happy life for decades. 

 

Thailand’s success at diagnosing and treating is among the world’s best. UNAids has estimated that just 75 per cent of people living with HIV in the world know their status. And just 59 per cent of them have access to anti-retroviral drugs.

 

“Knowing your status is the first step to treatment and the end of Aids,” the Kingdom’s Disease Control Department (DCD) director-general Suwannachai Wattanayingcharoenchai said. 

 

DCD campaigns, therefore, have taken the theme of “Know Your Status”. 

 

The Thai Red Cross Aids Research Centre (TRCARC), meanwhile, has waged its campaign under the “Undetectable = Untransmittable” to communicate to the public that treatments can push down the presence of the HIV virus to an undetectable level that renders it untransmittable – and therefore makes treatment a form of preventing transmission.

 

 

“Studies show that unprotected sex between a person with undetectable levels of HIV and his/her partner who is HIV-free does not cause any transmission,” the centre’s director Dr Praphan Phanuphak said. 

 

He, therefore, emphasised that the key to ending HIV was to ensure people living with HIV regularly take antiretroviral drugs to stay healthy and to not spread the virus. 

 

 

“We have chosen the U=U or Undetectable Equates Untransmittable theme for our campaign so as to reduce the stigmatisation of people living with HIV. Without a stigma, those at risk will have the courage to come forward to get tests and treatments that will not only save their lives but also allow them to have a good quality of life,” Praphan said. 

 

In Thailand, HIV tests, anti-retroviral therapy, and related treatments are free. Campaigns to raise public awareness of HIV prevention have been solid. 

 

Several government agencies and non-governmental organisations have also been very active in fighting against Aids/HIV.

 

There are shelters for the HIV-positive who previously had nowhere to go. There are foundations that will connect the HIV-positive to necessary medication, schooling and jobs. 

 

Receiving support from the Global Fund to Fight Aids, Tuberculosis and Malaria, Thailand has become the first Asian country to bring the mother-to-child transmission rate to below 2 per cent.

 

 

Earlier this year, the World Health Organisation (WHO) certified Efavirenz Tablets (600mg) manufactured by Thailand’s Government Pharmaceutical Organisation (GPO). The certification makes Thailand the first Asean nation to have been certified in the WHO Pre-qualification Programme for HIV/Aids treatments. 

 

“This reflects the world’s trust in our drug’s efficiency,” GPO chairman Dr Sopon Mekton said. Efavirenz is a key drug in a cocktail of anti-HIV medications that have proved highly effective.

 

GPO deputy managing director Mukdavan Prakobvaitayakit said this success had saved the country’s budget. 

 

“It costs us just Bt180 to produce each box of Efavirenz. If we import the equivalent, we will have to pay more than Bt1,000 per box,” she said. 

 

The National Health Security Office’s (NHSO) secretary-general, Dr Sakchai Kanjanawatana, said the government had allocated Bt3 billion for HIV/Aids patients in the 2019 fiscal year. 

 

Of that, Bt2.8 billion is for the provision of anti-retroviral therapy and related services. Some Bt200 million is for HIV prevention. About Bt38 million is for the promotion of services for people living with HIV/Aids. 

 

Aids Access Foundation’s director Nimit Tien-udom has acknowledged Thailand’s many achievements in the battle against HIV/Aids. Yet, he has noticed some obstacles that could prevent the country from eradicating Aids/HIV by 2030. 

 

“In fact, if an HIV-positive woman seeks prenatal care within the first 15 weeks, there is no risk of mother-to-child transmission,” Nimit said. “But we can’t ignore the fact that hundreds of thousands of women and girls get unwanted pregnancies. And most of them are reluctant to seek prenatal services.” 

 

The Aids activist, moreover, expressed concerns that the Public Health Ministry’s drug procurement plan has required patients to pick up anti-retroviral medicines in smaller lots.

 

“When NHSO was in charge, people living with HIV could take the medicines once every three months. But now, they have had to pick up the medicines almost on a monthly basis. It’s not easy for them to take leave from work this frequently,” Nimit pointed out. 

 

He also recommended that campaigns be created to help educate people from thinking that those living with Aids/HIV would appear to be really ill and with ugly wounds. 

 

“Those who have been on anti-retroviral therapy are perfectly healthy. We need to send this message across the society,” he said. 

 

Moreover, Nimit suggested that free blood tests should cover more groups of people, not just those deemed to be at higher risk, as some people might have become infected despite not having risky behaviours.

 

He also said the distribution of free condoms should receive a strong emphasis because it could prevent the spread of many sexually transmitted diseases, not just HIV. 

 

“Don’t let anyone steal the condom-procurement budget,” he said, as he suspected that some condoms had gone missing. 

 

 Thanutkan Thanutamornthanasiri, Aids Network coordinator based in the Northeast, said she had seen the immense improvement on Thailand’s Aids/HIV front lines during the past two decades. 

 

“I must say that had the system been this good 20 years ago, my first two children would still be alive today,” the 49-year-old woman said. 

 

Despite living with HIV for decades, she is now the mother of an HIV-free son. The virus has not been passed on to her third child due to the availability of free and effective medication. 

 

 

Source: http://www.nationmultimedia.com/detail/national/30359629

 

 

-- © Copyright The Nation 2018-12-01

[Samui Bodoh]

I criticize Thailand on a number of issues, but not on AIDS.

 

The first time I ever saw condoms (openly) on sale was at a Thai 7-11 by the check out counter; it was a long time before I saw the same in my native, 'developed' Canada.

 

Kudos to Thailand for its long-term response to AIDS; things in the Kingdom could have been so, so much worse if it had tried to sweep it all under the carpet.

 

Well done and keep it up.

 

 

[MythBusters]

A couple of clarifications...

 

As I recently commented in a previous article written by the same Nation Wide journalist and the choice of terminology used in the article, I feel it is important to clarify any terminology that may lead to confusion or misunderstanding about such and important subject.

 

Again in today's article, I feel more clarification is required mainly regarding this quote..

 

Quote

And 75 per cent of them have access to retroviral drugs, which have proven so effective that when a regular dose is taken, someone with HIV can live a normal, healthy and happy life for decades. 

 

To clarify once a hiv positive person who is already healthy and taking continuous treatment and the virus is 'undetectable' due to the treatment, it literally means the virus cannot be transmitted by that person in any way whatsoever. It also means life expectancy is normal just like someone who didn't have hiv (the article mentioned 'decades' which although is likely true could also be misunderstood or misinterpreted as 'not normal life expectancy').

 

The details are so important if we are ever to reduce the confusion and misunderstanding about hiv.

 

Another choice of word used in the article above by a Doctor of all people (maybe this was lost in translation or misinterpreted by a journalist maybe!) is the use of the word 'cocktail of drugs' when in fact usually it is simply three or in future possibly maybe even only two drugs needed to manage the treatment hiv.

 

In my opinion the word 'cocktail' is rather an unusual word of choice to describe 2 or 3 drugs and should be reserved maybe for the bar tender to serve drinks at the bar rather than be used by a medical doctor talking about prescribed hiv meds.

 

Just saying.

 

 

 

[Krataiboy]

A key statistic is missing from this "success story" - one which theatens to make a mockery of Thailand's laudable ambition to be HIV-free by 2030.

 

For while new infections among some groups have been reduced, the rate among the minority community of men who have sex with men (MSM) is disproportionately high - and still rising.

 

This transmissionh route now accounts for an astonishing 44 percent of new infections, and is projected by HIV-AIDS agency Avert to reach half of the total number next year. So what is going wrong?

 

Ironically, Thailand's success with the widespread take-up of anti-viral drugs appears to have undermined the simultaneous ongoing campaign to re-popularise use of the condom- the cheapest and best defence against HIV, as well as other serious sexually-transmitted diseases.

 

Many gay and bi men, it seems, would rather "risk it "than use a "meechai", even for potentially dangerous liaisons involving what Avert describes as "multi-partner sex fuelled by performance-enhancing drugs".

 

Clearly, one of the toughest tasks facing Thailand will be to foster a sense of greater personal reponsiblity among its freewheeling vulnerable post-millenials. Otherwise, that 2030 target will remain pie in the sky, and more young lives will needlessly be damaged.