SINGAPORE, Dec 2 (AFP) - Singapore is Southeast Asia's most affluent country, but to AIDS activists in the city-state it might as well be a Third World nation where victims of the dreaded disease are marginalized by poverty and social stigma.
According to Singapore's only AIDS advocacy group Action for AIDS (AFA), more than 70 percent of patients cannot afford basic anti-retroviral drugs and less than 10 percent are on optimal treatment, despite living in a country with a per capita income of about 32,900 Singapore dollars (22,000 US).
Stigma and discrimination also remain very strong in the conservative city-state, 16 years after the first person was diagnosed with Acquired Immune Deficiency Syndrome (AIDS), caused by the human immunodeficiency virus (HIV).
"Singapore is considered Third World as far as HIV is concerned. We pride ourselves as a First World country but we don't behave as one," AFA honorary secretary Brenton Wong told AFP.
He said the island lags behind other developed countries in the fight against AIDS as "we always think about money first" even when dealing with human lives.
AFA administrator Benedict Jacob-Thambiah said: "The Singapore government is capable of greater compassion. It just needs to put that into practice."
According to the Ministry of Health (MOH), 1,547 Singaporeans, including 15 children, are HIV-positive, with 367 suffering from full-blown AIDS, out of a local population of about 3.2 million people.
But AFA president Roy Chan said many people, fearing discrimination, had not come forward for testing and the actual figure was closer to 5,000.
With approximately 200 new infections a year, AFA said Singapore's per capita AIDS growth rate was higher than that of other Asian countries like Japan, Hong Kong and China.
While Japan and Hong Kong subsidize anti-AIDS drugs and poorer countries like Malaysia and Thailand give some form of subsidy, Singapore does not have such a policy.
As a result, "cocktails" of imported anti-AIDS drugs costing 1,200 to 1,500 Singapore dollars a month, are often beyond the reach of patients, especially the unemployed.
Some are visiting Thailand for its cheaper drugs or simply skipping medication, AFA said.
"People are always shocked to find that the government does not even give any subsidies for any anti-retrovirals when they know it's such a rich country (with) the second highest reserves in the world," Wong said.
Jacob-Thambiah said the government wants Singaporeans to stand on their own two feet.
"That is good and proper but what happens when they can't?" he said.
"There has to be a social safety net in place."
Until one is in place, patients must turn to non-governmental organizations (NGOs) like AFA, which spends 60,000 dollars a year subsidising 20-30 patients, or draw 550 dollars a month from their limited pension funds to pay for treatment.
The MOH maintains there is no discrimination against HIV/AIDS patients who have access to subsidised in-patient and out-patient care like all other Singaporeans, but said non-standard drugs like anti-retrovirals were not cost-effective enough to be subsidised.
"Anti-retroviral drugs are expensive and, more importantly, not a long-term solution for HIV and AIDS patients. It is hence not prudent for the Government to use public money on such subsidies, as the drugs are not a cure for AIDS," it said in a statement to the Straits Times newspaper.
It added that more healthcare subsidies would mean higher taxes or less money for other public needs such as education and housing.
Wong said the government was neither negotiating for cheaper drugs nor considering parallel imports due to the patents held by pharmaceutical giants.
"And it is pointless for one NGO to negotiate with the pharmaceuticals as we don't have the clout the government has," he said.
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