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Bangkok Post
EDITORIAL: Absolutely no room for complacency

December 1, 2001
The latest United Nations report released ahead of World Aids Day today commends Thailand as a country where "strong political leadership and public commitment" has helped slash the incidence of HIV.

But the vote of praise, from the UNAids/World Health Organisation report, came with the sobering estimate that one in 60 Thais is infected with HIV, and that Aids is the leading cause of death in the country.

The Public Health Ministry yesterday confirmed the view by saying that about a million Thais were infected with HIV, with another 181,484 suffering full-blown Aids. The ministry put the rate of new HIV infections at about 55,000 a year.

Thailand earned its good reputation from the active public information campaigns in the early 1990s when hourly radio and television spots were mandatory. But the economic crisis in 1997 caused cuts in public spending on national Aids programmes by about 28% and the prevention budget by about 50%. Private organisations last year lamented budget cuts for condoms, education and media campaigns.

The trend now seems to be changing, with a budget of 1.7 billion baht earmarked for the national Aids programme next year, which marks a significant increase on this year's 1.5 billion baht.

But this government has been slow to respond to urging from non-governmental organisations and the network of people living with Aids, to include HIV/Aids sufferers in its 30-baht medical scheme.

Public Health Minister Sudarat Keyuraphan only yesterday agreed to include anti-retroviral drugs in the scheme, and the NGOs and the network no doubt will have to keep up pressure to ensure delivery of it. The availability, starting this month, of a cheaper form of the drugs produced by the Government Pharmaceutical Organisation should help. But experts remain in two minds about the cost-effectiveness of these drugs, citing the limited number of physicians who know enough about them, the small percentage of HIV sufferers using them, and the likelihood of their developing an immunity to them within a matter of two years.

The National Aids Committee is due to renew efforts to plug two main sources of the disease - commercial sex and intravenous drug users - through campaigning for condom use, and behaviour change. Intravenous drugs users have not been, and should become, a priority target group because they are believed to account for about a quarter of the new adult infections. Even lower on the priority list are the migrants from neighbouring countries who contract HIV/Aids through being drawn or forced into commercial sex and drugs as part of their limbo existence, which begins in border areas and moves where employers take them. These people constitute a sizeable population, probably in the hundreds of thousands, and the danger they pose is clear by virtue of the extent of their outreach and movements.

At a recent meeting in Brunei, Prime Minister Thaksin Shinawatra joined nine other leaders of the Association of Southeast Asian Nations in identifying HIV/Aids as a priority problem for Asean.

The leaders rightly agreed to put the accent on education as the hundreds of thousands of people on the move around the region must know the risks they face, and the dangers they may carry.

With porous borders all around the country, Thailand cannot be slow to translate this into practice. As memories fade fast, and economic problems continue to push people to the brink, the government must renew public information campaigns for Thais throughout the country and migrants on borders, and sustain them on a long term basis.

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