Inter Press Service - September 30, 2005
Marwaan Macan-Markar

Such hope stems from the Thai government's decision to offer access to anti-retroviral (HIV is a retrovirus) medication to all those who need it under the country's, still young, universal healthcare scheme.

Oct.1 marks the beginning of this initiative, where 10,000 people will have access to GPO-VIR, the locally-produced generic anti-AIDS drug. Prior to the expansion of this life-line for HIV patients, an estimated 50,000 Thais were receiving their regular dose of the medicine on a quota system.

"This shows that the government is committed to help people with HIV," Nimit Tienudom, director of AIDS Access Foundation, an advocacy group, told IPS. "The people are finally getting their right to medicine".

Under the healthcare system, which was introduced in Thailand soon after Prime Minister Thaksin Shinawatra's government won its first term in office in 2001, a patient pays 30 baht (0.75 US cents) for every visit to the hospital, no matter what his or her ailment is.

During last year's 15th International AIDS Conference, the government promised to expand coverage to include all those who needed the life-prolonging anti-retroviral drugs.

But such a commitment -- removing the economic burden that had prevented those afflicted with AIDS from gaining treatment to live longer lives --was not the product of benevolence.

"We campaigned for this for four years," adds Nimit. "The pressure on the government has worked."

In achieving this milestone, Thailand races ahead of other countries in Asia in caring for people with HIV. It comes at a time when developing and middle-income countries in this region and other parts of the developing world are struggling to deliver the desperately needed anti-AIDS drugs to their citizens.

Just what the world is up against was revealed during World AIDS Day in 2003, when the World Health Organisation (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the '3 by 5' campaign.

The objective was to accelerate the access to affordable anti-AIDS drugs by ensuring three million people would be on antiretroviral (ARV) treatment by 2005.

The year this campaign was launched, there were only 440,000 people across the developing world who were on ARV treatment, out of the six million people who needed it. The numbing death toll due to AIDS--three million people every year--was because of a lack of access to the available drugs.

In Africa, for instance, where live nearly 70 percent of the world's 40 million people with HIV, less than four percent of those who needed anti-AIDS drugs had access to it, states the WHO.

With only three months left for the '3 by 5' campaign deadline, countries in Asia with high HIV incidence rates are still far from meeting their respective targets. But the WHO admits that coverage has increased, from 50,000 people on treatment in June 2004 to nearly 155,000 people in June this year.

In Cambodia, which has some 123,000 people with HIV, of whom 22,000 need treatment, the WHO was hoping that 10,000 people would be on the life-saving medication. But a mid-year review revealed that only 7,217 people were on ARVs.

In Burma, which has between 170,000 to 620,000 people with HIV, only 1,500 were receiving treatment of an estimated 46,000 that need it. The WHO was hoping that 10,000 people would be on medication by December this year.

Asia's giants China and India also have much road to cover to meet the end of the year target. China, which has between 430,000 to 1.5 million people with HIV, needs ARV for some 122,000 people. Of that, only 12,219 people were receiving the drugs and the WHO had set its sights on between 30,000 to 50,000 people to be on treatment by the end of the two-year campaign.

"The main reason for Thailand doing so well is that it produces its own drugs," says Paul Cawthorne, country coordinator of the humanitarian agency Medecins Sans Frontieres (MSF). "The drugs are cheap and affordable."

Thailand's public health infrastructure is geared to meet the new challenge, he added during an interview. "Close to 800 government hospitals will be involved. But some hospitals in the north will have bigger burdens because of more HIV cases than those in the south."

Thailand currently has over 600,000 people with HIV, out of a population of 64 million. Over 300,000 people have died from AIDS-related disease since the pandemic hit this South-east Asian country in the early 1980s.

But for activists like Nimit, success is never permanent when battling a killer like AIDS. He is already setting his sights on more lobbying to get the Thai government to start producing a new line of cheap, generic ARVs that would be necessary in three to five years.

By then, say public health experts, many people on the current regimen of GPO-VIR would have developed a resistance against the drug and would need a stronger course of treatment.

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