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The Rising East

BY RICHARD HALLORAN

Sunday, September 29, 2002


Quick action helped
Thailand turn back
deadly tide of HIV/AIDS


Thailand, once a festering sore of people infected with the HIV/AIDS virus because of illicit drugs and a notorious sex trade, has made remarkable headway in beating back that deadly scourge. The Royal Thai Army has led the charge as the Thais forged a consensus that HIV/AIDS was not just a medical issue but one of national security.

"This perception of HIV/AIDS as a national threat was the turning point in our fight," Maj. Gen. Suebpong Sangkharomya, a senior medical officer, told a recent conference here. "It was as if everybody suddenly woke up to the fact that our house was on fire and it was everybody's business to pitch in and help put out the fire."

Suebpong said that critical to the campaign had been educating drug users about the danger from dirty needles and persuading prostitutes to insist that their customers use condoms.

"From the outset," he said, "we had to accept the fact that we can't stamp out the sex trade. So, we encouraged the 100 percent use of condoms to prevent the spread of the virus. Now, anyone who refuses to use a condom is refused service."

The general asserted that without intervention, Thailand would have suffered 8 million cases of HIV/AIDS since 1984 instead of 1 million cases. He said the Thai army had seen a drop in the number of men entering the army who had symptoms of HIV/AIDS to 0.7 percent last year, down from 3.7 percent in 1993.

An estimated 40 million people worldwide suffer from HIV/AIDS today, about the same number as all the people of every nation who died in World War II. Another 25 million have already died. Some 28 million of the living victims are in sub-Saharan Africa and 7 million are in Asia. With the exception of Thailand, the spread of HIV/AIDS is accelerating in Asia.

Jack Chow, the U.S. State Department's senior official dealing with HIV/AIDS, told a gathering recently at the University of Hawaii that the world faced "a disaster of unimaginable proportions" as HIV/AIDS is moving and mutating at a frightening pace. He estimated that as many as 75 million people could be infected by the end of this decade.

HIV, or human immunodeficiency virus, is an affliction that often leads to AIDS, the Acquired Immunodeficiency Syndrome; they are increasingly linked as HIV/AIDS. So far, no cure has been discovered and AIDS usually ends in death. Chow said that it had become pandemic, an epidemic everywhere.

After the first cases of HIV/AIDS were found in Thailand in 1984, General Suebpong said, "the official policy was generally to hush up the problem for fear of losing tourists and causing public panic." Five years later, however, "enough alarms had been raised to make people sit up and take notice of the disaster in the making."

The first action, as might be expected of military leaders, was to gather intelligence to determine the prevalence of HIV/AIDS. Having noted the incidence among soldiers, the Thais gathered information on other groups at risk, such as students, factory workers living away from their families, and seafarers.

"From these findings sprang the perception of HIV/AIDS as a threat to the national security of Thailand," the general said. The spreading illness endangered economic development, could overwhelm health-care facilities, burdened the educational system and hampered industrial production through time lost by skilled labor. It further undermined military readiness with the strain on funds and facilities.

Thailand set about preventing new infections, treating those already infected, seeking help from abroad and initiating new research. Classes on AIDS were included in all military training and warnings were directed at other groups. Testing was expanded. Leaders sought to foster a supportive attitude among the public to avert discrimination against those with HIV/AIDS.

The Thai army doctor suggested four lessons that might apply to other nations. "Prompt assessment and response is essential," he said. Seeing HIV/AIDS as a national security threat was a key to success. All agencies in a nation must coordinate their anti-HIV/AIDS actions.

"And the resources of the armed forces can be used effectively to help a country respond," he said. "I would like to point with pride the significant role the Thai army played" in his nation's campaign against HIV/AIDS.




Richard Halloran is a former correspondent
for The New York Times in Asia and a former editorial
director of the Star-Bulletin. His column appears Sundays.
He can be reached by e-mail at rhalloran@starbulletin.com



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