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Thailand praised as model in fight against AIDS

Thailand praised as model in fight against AIDS

Elayne Clift
The challenge of ending the HIV/AIDS pandemic remains huge, experts at the 16
th International AIDS Conference agreed in Toronto, Canada last week. Since first emerging 25 years ago, the disease has become a global threat as serious as terrorism and global warming. An estimated 40 million people are currently living with HIV around the world and four million of them were newly infected in 2005. During the same year nearly three million people died from AIDS, which some experts say threatens to make women, who bear a disproportionate burden of the epidemic, “an endangered species.”
“The AIDS pandemic is a serious threat to humanity’s prospects for progress and stability,” says Peter Piot, executive director of UNAIDS. “It is exceptional in its scale, complexity and the consequences across generations, in severity, longevity, and its impact. It can only be defeated with sustained attention and the kind of ‘anything it takes’ resolve that [United Nations] Member States apply to preventing global financial meltdowns or wars.”
One of those member states is Thailand, and it is often cited as a model in its attempts to respond to the AIDS emergency. Recognised for its adjustments to health financing policy, so that user fees for HIV treatment have been eliminated at the point of service, the country has also been notable for its models of community level prevention, care and service delivery programs.
Thailand is also among the countries demonstrating that vulnerable groups such as commercial sex workers have sexual and reproductive rights, and that successful AIDS responses reside in that recognition. Improved access to sexual health services for sex workers within the context of prevention strategies has proven to be effective in reducing infection rates. New HIV infections have dropped in Thailand from 143,000 in 1991 to fewer than 20,000 in 2003, in part by expanding sex workers’ access to prevention and treatment services for sexually transmitted diseases, including HIV.
According to UNAIDS, the country has now set even more ambitious goals for universal access to care and prevention in view of signs of a resurgence of HIV there, especially among female spouses. With 570,000 adults and children currently living with the infection, Thailand has accelerated access to treatment by integrating treatment and prevention of parent-to-child transmission through its primary health care and hospital system. The country has also redoubled its prevention efforts, particularly among men who have sex with men and intravenous drug users, committing in February this year to cut anticipated new infections to 6000 in 2010, down from the current estimate of 17,000 new infections annually.
The government and the health sector are not the only entities dealing with the problem of HIV/AIDS in Thailand. The religious community, commercial sex workers, and people living with HIV/AIDS are also contributing to education and advocacy efforts. For example, Buddhist monks started The Sangha Metta Project in order to play a more active role in HIV/AIDS prevention and care. The project teaches monks, nuns and novices about the disease and gives them skills to work effectively within their communities. In another project in the Chiang Mai area, Buddhist monk Phrakhru Thanawat Wannali has devoted himself to teaching people about the AIDS virus and how to protect themselves, as well as ensuring that they do not isolate those affected. Wannali says he promotes protection and compassion. His efforts are supported by the new Southeast Asia Buddhist Monk Network that connects monks in Thailand with their counterparts in Vietnam, Laos, Cambodia, and Myanmar (Burma).
The Thai Network of People Living with HIV/AIDS was formed in 1998 in recognition of the need to coordinate the activities of existing groups of people living with HIV/AIDS throughout the country. TNP+, as it is known, aims to ensure equitable access to an acceptable standard of all aspects of health care, to see that people living with the infection are free from stigma and discrimination within their communities, and that groups work together cooperatively. Noted for its advocacy and lobbying, TNP+ has worked to make antiretroviral (ARV) therapy cheaper and more widely available and to ensure that the Thai government’s public health system does not exclude ARV treatment.
Empower, with offices in several Thai cities, is a sex worker rights organisation founded in 1985. A support center for sex workers, Empower offers computer training, Thai and English literacy classes, counseling, health information, translation, and other support services to sex workers. “Empower is a place where sex workers meet for friendship and to share their daily experiences and ideas about work, dealing with health issues, safer sex, HIV/AIDS, survival and new opportunities,” says its brochure. A member of Networks for Sex Workers’ Rights, Human Rights, and Women’s Rights, Empower helps to define common problems and work for solutions at all levels from local to international. It works to ensure that “every woman has the right to choose her job and work safely, without exploitation, with a living wage, and without harassment.”
As UNAIDS points out, “AIDS is both a short-term emergency and a long-term development crisis.” Thailand is clearly among those countries demonstrating a serious commitment to dealing with the pandemic across all sectors.
Elayne Clift, a journalist and adjunct professor of gender issues, has just returned to the US after teaching for a year in Chiang Mai. Her book about the experience, Achan: A year of Teaching In Thailand, is forthcoming.