Inter Press Service - October 31, 2003
Marwaan Macan-Markar

This week marked the first time that a Laotian with HIV/AIDS was treated with a cocktail of anti-AIDS drugs. The pioneer was a young woman, Kinoy, who was given the first dose of anti-retroviral (ARV) drugs in a hospital some 500 kilometres south of the capital Vientiane.

"Access to this treatment will allow her to lead a normal life in spite of AIDS and offers hope to others infected," states the medical relief agency Medecins Sans Frontier (MSF), which helped secure this course of treatment. "(Till now) people in Laos had no access to such life-prolonging medicines."

On Tuesday, MSF celebrated this medical milestone in Laos with a ceremony involving other agencies committed to combating the spread of HIV.

By contrast, it has been a few years since neighbouring Thailand crossed this bridge, followed thereafter by Cambodia. The triple-therapy ARV drug cocktail entered the world of health care in 1996.

Laos' provision of life-enhancing drugs years after its neighbours did brings to relief two sides of the HIV/AIDS story in this landlocked country.

For one, Laotians in need of the drug have been hampered by the economic woes faced by their country, one of South-east Asia's poorest. Politics has been another factor because Vientiane is governed by one of Indochina's two communist countries, the other being Vietnam, where individuals often have little space to advocate their cause.

"Giving ARV drugs to citizens is not something the government can easily do," says Paul Toh, an advisor at the South-east Asia office of the Joint United Nations Programme on AIDS (UNAIDS).

Often, those living with HIV are reluctant to come forward to demand the drugs due to the fear of being stigmatised, he added during an interview. "Unlike in Thailand, there is no collective voice to lobby for the drugs in Laos."

On the flip side, however, is the remarkable picture of how low the HIV prevalence rate is in Laos when compared with its eastern and southern neighbours, Burma, Cambodia and Thailand.

UNAIDS estimates that there are over 1,400 adults and children living with HIV/AIDS in Laos, out of population of 5.4 million people.

Cambodia has the highest prevalence of HIV/AIDS in Asia, with close to two percent of adults and children infected, or some 170,000 out of a population of 13 million people, states UNAIDS.

In Thailand, an estimated 670,000 adults are living with the disease out of a population of 63 million people. Even in this more affluent country, only an estimated 10 percent of the 200,000 people who need the anti-AIDS drug cocktail have access to it.

Over 300,000 people have died due to the pandemic, which was first detected in Thailand in the early 1980s.

Meanwhile Burma, according to unofficial estimates by U.N. health workers, has over 500,000 people with HIV/AIDS out of a population 0f 49.5 million people.

Laos' standing out as the exception to the region's HIV/AIDS trend has been attributed to factors such as communist regime's decision to avoid caving in to the temptations of free-market economic policies, to avoid encouraging mass migration within the country and also the government's effective prevention AIDS campaigns.

Health workers, in fact, give Vientiane high marks for identifying quite early the threat of AIDS as it felled neighbouring populations and launching programmes to increase condom use throughout the country.

They have ranged from advertisements on television during popular sporting events such as the 2002 soccer World Cup to mobile puppet shows that aim to reach villages in the hinterland. "Condom use is widely accepted," says Toh.

However, major development plans in the region to link the six countries that share the Mekong River - Burma, Cambodia, southern China, Laos, Thailand and Vietnam - have already raised concerns about how long Laos' healthy picture of HIV/AIDS control can last.

For instance, among the big infrastructure efforts planned to link the six countries under the Greater Mekong Subregion Economic Cooperation Programme (GMS) is a 1,500-kilometre long roadway. It will link the Burmese town of Mawlamyine, along the Andaman Sea, to the Vietnamese town of Da Nang, on the South China Sea.

This land route, which a key supporter of the GMS, the Asian Development Bank, has already dubbed the 'East-West Economic Corridor', will also cut through Thailand and Laos.

Already, one financial backer of this project, the Japan Bank for International Cooperation (JBIC), has decided to step in with a programme to stall the possible spread of HIV/AIDS in Laos due to the mobility and economic changes this new highway project would bring.

JBIC has begun laying the groundwork for an HIV/AIDS prevention drive involving the estimated 700 construction workers expected to build a 1,600-metre bridge where the new East-West land route cuts across the Thai-Laos border.

"We have learnt that the local people along the Laos border are concerned about what will happen if construction workers with little awareness about HIV move into their area to build the bridge," Taisuke Miyao, a JBIC representative, told IPS.

"Our plans include educating the construction workers about HIV and also giving assistance to the communities, including condom promotion," he added. (END/IPS/AP/HE/DV/MMM/JS/03) .

031031
IP031023

Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .