InterPress News Service (IPS); Tuesday, December 30, 1997
Prangtip Daorueng

Supporters of the HIV test requirement say it would help prevent the spread of the virus that causes Acquired Immune Deficiency Syndrome (AIDS) from doctors, dentists or nurses to patients.

Tienchai Keeranand, rector of Chulalongkorn University, one of Thailand most respected public universities, says that although the Constitution protects the rights of university students, patients' rights to health should be protected as well.

"The point is no patient knows whether his or her doctor is HIV-positive. Therefore they should be protected from the infection in advance. It is not worth taking the risk of having HIV spreading to patients during the medical process," Tienchai said.

The rector of Thammasat University, Noranit Setabutr, says the rule was not initiated to limit the rights of medical students. Instead it could be useful to them because they could get proper advice, if needed, to change to courses where the risk of inefction is lower, he said.

At the same time, he conceded that students found to be HIV- positive might be discriminated against and that universities would be open to attacks from the public about violating their rights.

Still, he assured: "Those who proposed this idea are neither biased nor aiming to discriminate against HIV infected people. They are professors and they also want fairness in society."

Soon after the public universities' plan was reported in media, the issue fired a controversial debate among educators, health professionals and activists, some of whom believed the HIV tests violated the human rights protection clause of the Constitution.

In a way, the debate was unusual. Although legally operating under the Ministry of University Affairs, Thai public universities are free to make their own decisions in terms of management and academic plans. Very rarely have they come under strong criticism by the public.

Likewise, the controversy reflects the broader question of human rights and other issues that Thailand has to come to grips with, as a society with a sizable HIV prevalence rate and which will continue to face growing number of AIDS cases.

Estimated HIV prevalence in adult Thais aged 15 to 49 are said to be at 2.3 percent of the population, according to World Health Organisation data. At present, the National AIDS Bureau has rules against using HIV/AIDS testing as a tool for discrimination. A Cabinet order also says public and private organisations cannot use HIV/AIDS tests as a reason to discriminate against people with HIV.

Wanchai Sirichana, general secretary of the Ministry of University Affairs, said: "The Constitution clearly says that no differences on health can be used to discriminate against rights of people. Therefore, universities must find the way to go on with this without violating the Constitution."

Many medical professionals disagree with the idea of testing medical students before they can continue studying. Dr Jirasak Nopakul, dean of the dental faculty at Chulalongkorn University, says the more important qualification for selecting medical students is their attitude toward the profession.

In any case, he says medical students are taught about how the virus is transmitted and how to handle patients. "So there is nothing to worry about this," he pointed out.

Dr Chaiyos Kunnuson from the AIDS department of the Public Health Ministry doubts that blood tests are really useful. HIV transmission can happen any time and there is no guarantee that students who tested negative for HIV the day they entered university will remain so till they graduate.

"What we have to think is where HIV-positive kids would go if they are rejected from medical departments. Universities must think for them and help them to use their potential in the right direction," Chaiyos pointed out.

"I can't say no to rules or regulations that each institution initiates, because it has the right to do so, although some rules are questionable," he said. In the same way, he says, nursing colleges have a rule that students have to be more than 150 cms in height though "there is no proof that taller nurses can take better care of patients than shorter nurses".

Some critics, like Dr Chumsak Pruksapong, deputy secretary general of the Thai Medical Council, argue that any testing rule for medical students should apply to practising doctors too.

John Ungpakorn, director of ACCESS, an NGO working on AIDS, wants universities to explain the basis for the HIV tests, adding he had not heard of a case in Thailand where doctors and nurses transmitted the virus to their patients. He says there are some doctors and nurses who had gotten HIV after graduation, but continue to work in the medical field. If here are to be blood tests for doctors and nurses, he says they should be done every three months to make sure they are continuously monitored.

Meantime, some plan to challenge the legality of the HIV tests. "I don't understand why such an idea came from university people who should have guided the public to the direction that supports human rights and social justice," said Sompong Jitradab, a lecturer at Chulalongkorn University who plans to ask the courts to judge if HIV testing goes against the Constitution.

"The rule was created from the idea of discrimination and market investment, rather than anything else. If accepted, it will lead to human abandonment and the most serious discrimination problems," he said. (END/IPS/AP-HE-HD/PD/JS/97)

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