In sobering lesson for Asia, Thailand struggles to care for AIDS

In sobering lesson for Asia, Thailand struggles to care for AIDS
victims

Sarah Stewart
Agence France-Presse
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 (Human
Immunodeficiency Virus) 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 U.S. cents) for medical treatment is already
facing massive funding problems, which will only worsen as more
HIV-infected people develop full-blown AIDS (Acquired
Immunodeficiency Syndrome).

"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 (Unicef), said Asia was poorly prepared to look after its
AIDS orphans and had so far followed the "horrible" Western model
of institutionalizing 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 Organization (WHO)
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 neighbors 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 mobilization of all
sectors of the economy, a very successful brothel-based
prevention program for commercial sex establishments," he said.

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