Thailand Struggles With AIDS Burden

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Thailand struggles with AIDS burden

BANGKOK: As one of the first Asian nations to be hit with HIV-AIDS, Thailand is now struggling to bear the burden of caring for hundreds of thousands of dying victims and the families they leave behind.

Despite winning plaudits for its successful campaign to curb the spread of the virus, Thailand is stretched to the limit treating people infected a decade ago when the crisis was at its height.

Its problems are a sobering tale for countries like India and China who are accused of failing to do enough to halt HIV and where transmission rates are still rising.

"It's definitely a burden having so many people with HIV," said Pawana Wienrawee of activist group PATH (Program for Appropriate Technology in Health).

The new national healthcare system which entitles Thais to pay just 30 baht (75 cents) for medical treatment is already facing massive funding problems, which will only worsen as more HIV-infected people develop full-blown AIDS.

"The whole healthcare system is already in trouble with the universal coverage that was just introduced," said Pawana. "A few years ago it was estimated that only one third of infected people knew they were HIV positive... and as they identify more people, more and more will need treatment."

HIV-AIDS is also wreaking havoc in poor rural communities where many households have been left with only the elderly and the young, and no breadwinner to provide for them.

According to United Nations figures, from a population of 63 million at least 289,000 Thai children have lost one or both parents to AIDS and 21,000 children are infected themselves.

Richard Bridle, regional deputy director for the UN Children's Fund, said Asia was poorly prepared to look after its AIDS orphans and had so far followed the "horrible" Western model of institutionalising them.

"You've seen the kind of impact there is in Africa of kids living without both parents or any adult care at all," he said. "We do need to prepare for some potentially horrific scenarios."

Some one million Thais have been infected with HIV-AIDS over the past 20 years and more than a third of them have died, leaving the kingdom with an epidemic second only to India in the region in terms of sheer numbers.

For the estimated 600,000 Thais living with the disease, the government has set the ambitious goal of supplying modern anti-retroviral (ARV) medicines to everyone who needs them within the next two years. "Thailand has made a commitment to take care of its AIDS patients in every respect," said World Health Organisation resident representative in the kingdom Bjorn Melgaard.

"Thailand is much better off both in terms of long-term experience with the epidemic and in terms of treatment which is something that still needs to happen in countries like India."

Faced with the huge cost of buying ARVs from western pharmaceutical firms, Thailand has led the charge for patents to be dropped and developing nations to be allowed to manufacture their own life-saving drug regimens.

It now manufactures an AIDS cocktail which costs less than a dollar a day, making it the world's cheapest drug therapy.

Treatment of AIDS patients is just the latest success in Thailand's history with the epidemic. It also won high praise in the 1990s for its pragmatic and effective campaign to halt the spread of the virus. While other nations dithered and rowed over the moral and religious implications of responses to the disease, Thailand launched a high-profile and no-nonsense campaign for sex workers and their customers to use condoms.

As a result it managed to slash infections by 80 percent from 143,000 in 1991 to just 20,000 in 2002. Robert England, the chairman of a United Nations regional working group on HIV-AIDS, said Thailand is a relative success story that has plenty to teach its neighbours who have been much slower to address the epidemic.

Its achievements were due to "strong leadership, major public spending during the 1990s, a broad-based mobilisation of all sectors of the economy, a very successful brothel-based prevention program for commercial sex establishments," he said.

--AFP 2003-11-27