Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Bangkok Post - July 10, 2003
Aphaluck Bhatiasevi and Anjira Assavanonda
"The belief that we are successful in controlling the spread of Aids means we are still living in praise of the past and are forgetting the future," Kiat Ruxrungtham of Chulalongkorn University's Faculty of Medicine cautioned.
Effective control of new cases was needed and prevention against the disease should be given the highest priority as the availability of an effective anti-Aids vaccine cannot be expected in the near future, he added.
Vivat Rojanapithayakorn, a medical officer at the World Health Organisation office in Mongolia, expressed concern about the drastic cut in the Public Health Ministry's condom distribution budget, which could adversely affect the country's success in promoting condom use among sex workers.
The condom budget declined from 50 million baht per year during the peak of its campaign days in 1997-1998 to 20 million baht last year. The ministry now plans to switch from promoting condom use to placement of condom vending machines.
Dr Vivat disagrees with the decision for fear that it could once again increase the Aids infection rate among sex workers if the free distribution of condoms did not continue.
"By providing sex workers with condoms, they won't only be preventing the disease among the workers and their clients, but they would also be preventing housewives from being infected with the virus," he said.
Siriporn Sriphen, a sex worker who volunteers for Empower, a non-governmental organisation working with sex workers, pointed out that the main obstacle in encouraging the public to use condoms was the threat of arrest by members of the police force. "Even the police don't understand the government's policy, that is why they keep arresting women for only carrying condoms," she told the seminar.
About one million Thais have been infected by the deadly disease and about 23,000 new cases are found every year.
The ministry has, however, raised some hopes that an anti-Aids vaccine may only be five years away. A mass vaccine trial, involving about 16,000 volunteers in Rayong and Chon Buri, starts by the end of this year.
The trial involves the use of two vaccines, one of which is Aidsvax that was also being used in the Bangkok study.
Supachai Rerks-ngarm, principal investigator at the Department of Disease Control, said preparations have already been made for the trial, including the setting up of eight local vaccine injection units, and a standard vaccine storage facility to maintain the quality of the candidate vaccine to the day it is injected.
Relevant information has also been passed on to the local communities to make them understand what the project is all about and encourage their participation.
The process, he said, would be transparent and local people would be clearly informed of what would happen in their communities.
The ministry also plans to open hot-line centres in the two provinces to give the locals a channel to share their opinions.
According to Dr Supachai, the project will take 4-5 years to complete, with the first year given for recruitment of volunteers.
But Pannee Pitisuthitham, from the Faculty of Tropical Medicine, Mahidol University, said it is still too soon to talk about accomplishments, saying even an eight-year study on Aidsvax in Bangkok had not led to any real breakthroughs.
"We're still waiting for the data analysis, and it is still uncertain how it will come out," she said.
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