thailand news aids 2006

Public health officials in Thailand and Laos will set up inspection teams to monitor the possible spread of infectious diseases by travellers after the opening of the second Thai-Lao Friendship Bridge. The new bridge over the Mekong river, linking Mukdahan province with Savannakhet province in Laos, will open for use next month.

Health officials fear the possible spread of diseases like malaria, dengue fever, diarrhoea, avian influenza, pneumonia, tuberculosis and sexually transmitted diseases, particularly Aids.

Mukdahan and Savannakhet health officials recently signed an agreement under the Communicable Disease Control Cross Border Cooperation pact to coordinate efforts to detect and fight the diseases.

"This bridge is rather a major obstacle preventing and controlling infectious diseases," said Thatchai Jaikhong, Mukdahan Public Health Office deputy chief.

A better transport system would lead to more people visiting the border province and other parts of Thailand from Laos and Vietnam.

This would facilitate the spread of infectious diseases in the border region, particularly among sex workers and their customers, he said.

The bridge, which was inaugurated last Wednesday, will be opened after the two countries agree on the rules and regulations governing its use. The bridge connects with Road 9 in Laos which runs all the way to neighbouring Vietnam.

Dr Thatchai said the main worry was an increase in the number of HIV/Aids-infected people in the province.

There were 826 HIV/Aids patients in the province receiving anti-retroviral drugs from the Health Provincial Office and the Mukdahan Hospital.

However it was believed there were many more carriers of the HIV/Aids virus who were either embarrassed about receiving medical treatment from the state or were unable to access treatment.

Dr Thatchai said about 270 public health officials had already undergone extra training and would work closely with the local networks.

Information on any disease outbreak in Thailand would immediately be passed by Mukdahan officials to their Lao counterparts so that proper measures could be put in place to check its spread.

Panom Phongmany, deputy director of the Savannakhet Provincial Health Department, said the spread of Aids in the Lao southern province was being taken very seriously.

Laos had deployed health volunteers to educate female sex workers and labourers about Aids prevention in the province. There were 939 people in Savannakhet known to have HIV/Aids

The patent holder of an anti-Aids drug has asked the Commerce Ministry to help initiate a dialogue between the company and the Public Health Ministry over the ministry's planned production of a local version of the anti-Aids drug Efavirenz. Puangrat Asavapisit, director-general of the Intellectual Property Department, said MSD Co, an agent of Merck Co, and the Asean-US Business Council want the ministry to act as a go-between.

The move comes after the ministry's recent announcement that it plans to apply for compulsory licensing to produce a local version of the anti-Aids drug Efavirenz to help the HIV-infected people.

Under compulsory licensing, the Health Ministry is required to pay the manufacturers 0.5% of the drugs' market price.

Christian Sellars, director for external affairs of MSD, said the firm will work constructively with Thai authorities to ensure the public can access the medicine.

The HIV/Aids infection rate is rising among military conscripts, particularly those stationed in Bangkok and Rayong provinces, according to an army medical report. Lt-Gen Boonlert Chanthapas, surgeon-general of the army's Medical Department, said the HIV/Aids infection rate is about 0.5% of conscripts nationwide. Draftees based in Bangkok and Rayong provinces had a higher rate of infection than those in other provinces, although the figures were not released.

He said new conscripts were required to undergo blood tests to check for HIV/Aids. The bills for the blood tests were footed by the Public Health Ministry, which documents the spread of Aids among various groups in the country.

Lt-Gen Boonlert said most of the infected conscripts had contracted the deadly disease before they were drafted.

The number of HIV-positive conscripts attached to the First Army has slightly increased while the Second, Third and Fourth Armies have reported a decline in the number of Aids infections among their draftees.

To prevent Aids from spreading, medical staff were sent out on a campaign to raise awareness about the danger of the disease among conscripts.

Lt-Gen Boonlert said it was necessary to provide knowledge about safe sex to soldiers and conscripts.

He said no figures were available of soldiers or conscripts having same-sex sexual encounters.

He also expressed concern over the problem of premature sex among teenagers, the most vulnerable group, Lt-Gen Boonlert noted.

He urged the Public Health Ministry to urgently launch a campaign to educate teenagers about safe sex.

Lop Buri - Today is World Aids Day and various activities are being held around the world to address the severity of the spread of the disease. But for members of the Ratprachanukroh 33 school football club, a young football team made up of children of HIV-positive parents, it will be another practice day as usual.

Every day after class, a group of these boarding school students in Lop Buri's Nong Muang district gather in the school yard for a four-hour-long training session.

"I hope that one day I will become a national football player. That would allow me to make enough money to take care of my parents," said Saranyu Guirum, a 15-year-old MS 3 student.

Sudjai Hassanam, 13, said she wants to be as good as Steven Gerrard - her favourite English football player. Saranyu and Sudjai are among three dozen boys and girls who belong to the Ratprachanukroh 33 football club, set up mainly to help sports-minded and talented students whose parents contracted HIV/Aids and cannot afford to support their children, said Pra Khru Alongkot Dikkapanyo, the abbot of Wat Phra Baht Nam Phu, a famous hospice for severely-ill Aids patients.

"Our club, however, is also serious about training these youngsters to become professional football players," said Pra Khru Alongkot, founder of the five-year-old junior football club.

In Thailand, most HIV-positive people still face discrimination in the workplace although the country has been campaigning for more than two decades to end the social stigma. Discrimination in the workplace has caused financial problems for the families of HIV/Aids patients.

This holds their children back from reaching their academic and sporting potential.

However, the football team was not only about sport, said the abbot. The team comprised both students whose parents are HIV-positive, and those who are not. The fact they trained and played together helped promote mutual understanding and awareness between children from normal families and those from families with HIV/Aids patients.

"The younger generation should know that people living with HIV/Aids can live a normal life. They can work and carry out any activity, just like us. We are starting to eradicate the Aids stigma from society," he said.

Headmaster Prawase Tangchandaeng, deputy school director, said educating children about Aids was an important part of the teaching at his school.

The school has also been holding study trips to Wat Phra Baht Nam Phu, about one hour's drive away by car, to give students a first-hand look at how the temple deals with Aids victims.

Temple Faces Challenge Of Helping More HIV/AIDS Patients: Shelter supplies food, medication for over 500 people with disease

Groups of emaciated HIV/Aids patients at Lop Buri's Wat Phra Baht Nam Phu will soon be a thing of the past. Instead, the country's hospice for severe Aids patients is now having to cope with an increasing number of people saved by anti-retroviral treatment but who still fall victim to the social stigma associated with the disease.

Unlike in the past, when 85% of patients were sent to the remote Buddhist temple to die, most of them now are treated and stay alive.

"The dead don't eat but the living do. That's why more people living with HIV/Aids at the temple means a mounting burden that we have to deal with," said Phra Khru Alongkot Dikkapanyo, the abbot who has run the shelter for serious HIV/Aids patients in the central province's Muang district for 15 years.

In the past the temple took care of hundreds of patients in serious conditions and cremated them when they died according to religious rites.

However, the temple currently has to supply food and medication for more than 500 people living with HIV/Aids.

These people are surviving by continuously taking anti-Aids medicine. The overall expenditure is costly - about three million baht each month, he said.

Over the past year, the government has introduced GPO-vir, a locally-made anti-retroviral treatment which costs about 1,200 to 1,500 baht a month.

Thai people living with HIV/Aids mainly depend on this generic version of the anti-Aids drug. The Government Pharmaceutical Organisation has distributed the medicine free of charge to nearly 80,000 HIV-positive people under the universal healthcare scheme.

As a result, HIV-positive people have had access to the medicine without having to pay huge medical bills.

However, the fact that healthy people with HIV/Aids are crowding the temple reflects the stigma deeply rooted in society, despite the success in providing access to treatment.

"Although people living with HIV/Aids could live longer with medical treatment and are not strongly discriminated against like in the past, they still lack the job opportunities necessary for a return to normal living," the abbot said.

Patients were medically treated so they could live longer, but they ended up struggling to integrate themselves into society because of discrimination, especially in the workplace.

Most of the healthy HIV-positive people at the hospice have their CVs and medical reports made up so employers will not know that they are HIV-positive.

However, less than 3% of them could seek work and the rest had to run their own businesses, mostly small shops, he said.

The abbot believes that the government should do more to overcome discrimination in the workplace in a bid to improve the quality of life for people living with HIV/Aids.

"Just producing low-cost anti-Aids medicine is not enough. Acceptance in the workplace and from colleagues is also required for HIV-positive people, so they will have a good quality of life and the burden of HIV will ultimately be reduced," he said.

Apart from the social stigma, Aids prevention campaigns seemed to be overlooked compared to the last two decades, when the epidemic hit the country hard, he said, adding that people coming to the temple for treatment tended to be younger. "Thailand is facing a gruesome situation of Aids becoming widespread, since the virus is shifting its target from sex workers to teenagers, who are our future," he said.

Mechai Viravaidya, founder of the Population and Community Development Association, has also continuously raised concerns over the weak prevention campaigns.

Figures have apparently begun to climb again as tackling the illness has become a lower priority for the government.

Known as Mr Condom for his successful family planning and Aids prevention campaigns through the promotion of condom use in the 1990s, he urged the government to review anti-Aids campaigns and sex education, which should also target teenagers, married women and young adults, since they are at risk of contracting HIV/Aids from their sexual partners.

The World Health Organisation also noted that the effect of past campaigns is waning, whereas high-risk behaviour is increasing. HIV prevalence among men having sex with men in urban areas is as high as 28%.

There are about 500,000 HIV-infected people in Thailand, around 200,000 to 300,000 in a serious condition who need to receive anti-retroviral drugs.Passakorn Akrasevi of the Aids, Tuberculosis and Sexually-Transmitted Infections Bureau accepted that the country was facing a budgetary balancing act between treatment programmes and prevention campaigns. More than two billion baht was set aside for treatment funds alone, whereas less than 10 million baht was earmarked for prevention campaigns.

"The budget for prevention efforts is upside down. Without understanding that Aids is everyone's responsibility and immediate action from top policy makers, we may expect to see an increase in infections and much more difficult Aids challenges in the near future," he said.

US Chamber: Thailand AIDS Drug Decision Sends 'Negative Signal' - December 01, 2006

The US Chamber of Commerce today criticized Thailand's decision to break the patent of Merck's antiretroviral treatment efavirenz. The chamber's Bangkok branch warned, "Surprise actions such as these send a negative signal to foreign investors in Thailand regarding transparency and support for intellectual property rights."

The Public Health Ministry's move, announced Wednesday, will allow the Government Pharmaceutical Organization to manufacture the drug generically. GPO already makes nevirapine generically, but thousands of HIV patients have developed resistance to it. The ministry contends many of these drug- resistant patients will die without access to a cheaper version of efavirenz, and the government cannot afford to import enough of the patented product.

While acknowledging Thailand's right to use a compulsory license to get the drug at a lower price, the US Chamber complained that the government took the step without first consulting Merck and seeking a mutual solution.

"We hope that surprise actions such as compulsory licensing do not deter Thailand's important efforts to continue to protect intellectual property and promote a positive investment environment," said Judy Benn, executive director of the chamber's office in Bangkok.

On Wednesday, the public health ministry of Thailand's military-backed government announced its decision to issue an immediate compulsory license to cut the cost of Merck's HIV/AIDS drug efavirenz from the current $67 per month to $38.50.

"We need to break the patent because the price is too high for the government to afford it as new AIDS patients increase every year by tens of thousands," said Thawat Suntrajarn, director-general of the department of disease control. He said the government is considering importing the drug from India, where three factories produce it.

In addition, the Thai government is developing its own ability to produce efavirenz next year. This could further cut the cost of the drug to about $22 per month, Tawat said.

For five years, Merck has had exclusive rights to import efavirenz for distribution in Thailand. Thawat said Merck "has been informally informed about the decision and they have a chance to legally challenge us."

Doctors Without Borders praised the decision. "Efavirenz is currently patent protected in Thailand, and the resulting monopolistic situation is limiting supply and affordability," said David Wilson, the group's Thailand medical coordinator. "The patent holder, Merck, has on several occasions been unable to supply efavirenz. This has resulted in treatment interruptions, forcing several hospitals to supply suboptimal dual therapy."

"This policy needs to be expanded to other HIV/AIDS drugs that are expensive and in short supply," said Nimit Tienudom, director of the AIDS Access Foundation.

Since 2002, when the Thai government's introduction of generic AIDS drug combination therapy resulted in an 18-fold decrease in price, the number of Thais receiving treatment has grown from 3,000 to 84,000. About 600,000 Thais have HIV/AIDS.

Thailand to Raise Awareness with Record Attempt for World's Longest Condom - December 01, 2006

Thailand is marking World AIDS Day today with the "Longest Condom Chain," a record-setting ribbon of 25,000 condoms intended to raise awareness about the disease. More than 1,000 activists and others are expected to take part in the event in Bangkok's Lumpini Park, said UNESCO, the UN cultural body that is co-organizing the festivities with several Thai nongovernmental organizations. Earlier today, hundreds of activists marched in a parade through downtown Bangkok that featured people dressed as condoms. According to UNAIDS, some 570,000 Thais are living with HIV/AIDS, about a third of them women. In 2006, the country saw some 15,000 new infections, said Health Ministry Permanent Secretary Praj Boonyaorwong.

Thailand is planning to produce a local version of the anti-Aids drug Effavirenz to help thousands of HIV/Aids patients who are resistant to the Government Pharmaceutical Organisation (GPO)'s drug GPO-vir. GPO managing director Mongkol Jivasantikarn yesterday said the agency planned to apply for the compulsory licensing of Effavirenz in January, to enable Thailand to produce the drug locally.

This would help several thousand GPO-vir users who are becoming resistant to the drug to afford the alternative Effavirenz at a much lower cost, said Lt-Gen Mongkol.

According to the Public Health Ministry, about 5,000 GPO-vir users have become resistant to the drug so far, so they have had to switch to imported drugs.

HIV/Aids patients resistant to GPO-vir needed to take Effavirenz or Kaletra, which costs a patient about 20,000 to 24,000 baht a month, while GPO-vir users pay only 1,200 baht a month for the dose.

Lt-Gen Mongkol said the GPO-made Effavirenz would be much cheaper than the imported drug, costing a patient only 700 baht per month.

The agency has been working with Siriraj Hospital's faculty of medicine to conduct bioequivalence studies to ensure that the locally-made Effavirenz would have similar properties to the first-line drug.

However, he said, under the compulsory licensing requirement, the GPO is obliged to return 1% of the sales price to the US-based Bristol-Myers Squibb, the patent holder of the Effavirenz drug.

Other anti-Aids drugs the GPO expects to produce in the next two years include Indinavir, Saquinavir, ddI and Lopinavir, the GPO chief added.

Lopinavir is the second-line drug of Kaletra, which is still relatively expensive and mostly used by patients experiencing resistance to GPO-vir.

GPO deputy director Pisamorn Klinsuwan added that the first batch of 400,000 capsules of a Thai version of the anti-influenza drug oseltamivir would be produced within next January in a bid to prepare for a possible global flu pandemic

Golden Triangle Clinic Offers Hope to Foreign HIV/AIDS Patients - November 28, 2006

The Chiang Saen hospital is five miles from the center of the opium-producing Golden Triangle, where Laos, Myanmar, and Thailand meet and where drug use and sex work are rife. The pioneering Thai clinic is famous for miles around for its treatment of HIV/AIDS patients regardless of their nationality.

While the majority of boats along the Mekong river carry tourists, every month from Myanmar and Laos, boats carry men, women, and children to the only two clinics in Thailand that offer antiretroviral drugs.

"In Laos there are no facilities, no medicine, so I had to come here," said Arun Petchawong, a 43-year-old subsistence farmer with three children. In her country, HIV rates are increasing, and more than 18,000 people could have HIV by 2015, said UNAIDS. In Myanmar, some aid workers estimate the country has double the official figure of 333,000 infections.

In 2004, Doctors Without Borders (DWB) offered to finance two border clinics, including in Chiang Saen, to dispense ARVs to patients excluded from the public health system in Thailand. A Myanmar-Thai border clinic treats 56 mostly ethnic minorities, with transportation assistance from Norwegian Church Aid. Three to five patients, most Laotian, arrive each month, said A. Kace Keiluhu, head doctor at the clinic.

"In the long term, the Laotian hospitals should be able to manage their patients," said Paul Cawthorne, DWB's Thailand mission chief. He lauded Laos' Ministry of Health for its openness to building the knowledge and skills necessary for clinics to dispense ARVs. The program should be operable within months.

But "it is impossible to have any relationship with the central government in Myanmar," Cawthorne said. The clinic is advised not to over-enroll Myanmar patients, since it has no long-term strategy for funding. Cawthorne asked, "How do you say 'I'm sorry, you're Burmese, so we've not got a long-term strategy so we're not going to treat you'?"

HIV/AIDS: WHO finds prevention programme in SE Asia poor - November 1, 2006

Southeast Asia's Aids prevention programme is failing due to a lack of commitment to fighting the epidemic across the region, the World Health Organisation (WHO) said yesterday. "The Southeast Asia region is not an exception to the documented global low coverage in prevention services," Thierry Mertens, special adviser to the WHO Regional Office for Southeast Asia, said in a regional meeting attended by medical experts from 11 countries yesterday.

"Despite effective interventions such as condom use, the coverage of these prevention interventions across the region has been poor."

Southeast Asian countries still face high risks of a massive spread of the HIV virus, mainly due to people's ignorance about condom use and the high prevalence of sexual transmission of the disease, he said.

According to a WHO report from 2005, there are an estimated 6.7 million people living with HIV/Aids in the Southeast Asian region. This year's figures will be released on World Aids Day on Dec 1.

A recent survey of more than 1,000 people carried out by a Thai non-governmental organisation suggested that up to 17% of male homosexuals living in urban areas were HIV positive.

Dr Mertens said a lack of political commitment, weak healthcare services and insufficient human resources were hampering efforts to fight the spread of HIV and other sexually-transmitted diseases such as tuberculosis and hepatitis C across the region.

Public health permanent secretary Prat Boonyawongvirote said yesterday that condom use had to be boosted as a part of the national HIV prevention campaign.

Health officials will also focus on scaling up access to the current antiretroviral treatment programme, he said.

Another 30,000 HIV-positive patients will be placed on the programme to receive the locally made generic antiretroviral drug GPO-vir, he said.

So far, 82,000 out of a total 304,265 Thai people registered as living with HIV/Aids have been placed on the programme.

Thailand's temple for AIDS victims is haven for the living - October 22, 2006

LOP BURI, Thailand -- Thailand's primary AIDS hospice at a Buddhist temple here, once a place of certain death, is now becoming overcrowded with people whose lives have been saved by medication but who are rejected by their families or neighbors

Already an international leader in programs for prevention of HIV infection, Thailand has become a pioneer in the past year in distributing low-cost antiretroviral drugs, which are available to all who need them for less than $1 a treatment.

At the same time, Thailand has made little headway in easing a harsh stigma that was fed by its successful campaign against the horrors of the disease.

As more people live longer, more are becoming outcasts in a family based society where it is difficult to blend into the crowd.

Since the onset of the AIDS epidemic, Thailand has been on the front lines, first in the 1980s, when it was hit hard, and then in the 1990s, when it became a model of prevention with public education campaigns. Illustrating what specialists say could be one of the next challenges as low-cost treatments spread around the world, the AIDS temple and a small satellite village have become, in effect, a sort of leper colony.

"This is our new problem," said the temple's abbot, Alongkot Dikkapanyo, 53, who founded the hospice 14 years ago. "What should we do with a healthy person who is rejected by their family and can't work? This will be a big burden on society in the future."

In a special annex, the temple stores thousands of white cotton sacks of cremated remains that were never claimed by relatives.

Cremations are fewer now, and in their place, hundreds of homeless survivors wander the grounds, sweeping the footpaths, doing their laundry and helping to care for the sick.

Thailand's successes in both prevention and treatment have brought with them another, perhaps predictable, problem: the loss of a sense of urgency that has caused a slackening of prevention campaigns and the beginnings of a rise in new infections.

In addition, specialists say about 5 percent of drug recipients each year will develop a resistance and need to switch to much more expensive "second line" drug treatments, which are covered by patents and will strain the government's budget for cheap medications.

Since the epidemic arrived in Thailand in 1984, 1 million people have been infected, and 400,000 have died. In a report on AIDS in Thailand, published in August, the World Bank estimated that without the vigorous prevention program, 7.7 million people would have become infected.

Fewer than 17,000 new infections are expected this year, said Patrick Brenny, Thailand's coordinator for UNAIDS, the United Nations agency dealing with AIDS. That compares with 143,000 new infections in 1990, according to the World Bank.

The drug distribution program will save still more lives. The bank estimated that the medications are now reaching 80,000 people, or 90 percent of those who need them, although other estimates say the percentage is somewhat lower. That number compares with about 5,000 people who were receiving the treatments just two years ago.

The infection rate in Thailand peaked in 1994, the report said, with 4 percent of military conscripts testing positive.

The infection rate has been cut to about 1.4 percent, but Brenny said this figure was less meaningful now that many more people are surviving, adding to the overall total.

Some of these numbers have apparently begun to climb again as the epidemic has become a lower priority for the government.

"Public education has basically fallen asleep at the wheel," said Mechai Viravaidya, who heads the privately run Population and Community Development Association.

"HIV infections are going up, I believe 30 percent more than before," he said. "Mostly it's young people who are asking, `Is AIDS still around? There was talk about it before but now there's nothing.' "

The World Bank study also noted that the effect of past campaigns is waning and that risky behavior is increasing.

Quoting a recent survey, it said that only one in four male army conscripts reported using a condom with nonregular female partners who are not sex workers.

As a result, Thailand faces the need for two seemingly contradictory campaigns, one to reeducate the public about the horrors of the disease, the other to reassure it that infected people are not dangerous to be around.

The two programs prevention and treatment are closely linked, the World Bank said. The distribution of low-cost medicine has been made possible by the saving, through prevention, of an estimated $18.6 billion in potential medical costs.

"Prevention efforts allowed Thailand to become one of the few developing countries giving life-prolonging antiretroviral therapy to people living with HIV," the bank report said.

Some of the results can be seen here at the Phra Baht Nam Phu Temple, 120 kilometers, or 75 miles, north of Bangkok.

The intensive-care ward is now treating 33 patients, some of them dying, some growing healthier with medication.

At the same time, the sprawling temple grounds and its village annex are home to more than 500 people who are living with AIDS.

Ninety percent of patients who come here survive, the abbot said. But he also said 90 percent of these survivors are unable to return to their homes or to find a place to live where nobody knows them.

"In the past they would come here and die and we would cremate them," he said, referring to some 10,000 cremations over the years. "The new ones may really stay a long time, a lifetime."

"If they stay here, they are happier. They are with friends. We understand each other. Nobody discriminates against each other."

The discrimination is just a short walk away through the temple grounds, among the visitors who come here to worship and the vendors who sell them food and souvenirs.

Patients here say that the vendors have a rule for them "You touch it, you buy it," sometimes accompanied by a shout of, "Stand back! Don't touch anything!"

Though Thailand has saved billions of dollars through its pioneering policies, one result has been a greater financial burden on the AIDS temple here. In the long run, it is a much more expensive proposition to live than to die.

"The sick patients cost much more per day, of course," the abbot said, sitting in his rust-brown robe before a large statue of Buddha. "But generally they would just stay for a month or so and die."

It is good news that lives are being saved now, he said. "But long term, the person who is healthy costs more. He lives longer, he eats more, and he keeps on living and eating."

HIV-positive Thai women will be among participants in a safety and efficacy trial of a vaginal gel designed to block HIV transmission. The Viva Gel microbicide, made by the Australian firm Starpharma, proved safe in a trial among 24 HIV-negative Australian women more than a year ago, said Professor Praphan Phanuphak, director of the Thai Red Cross Society's AIDS Research Center.

One in three HIV-positive Thai women is in a serodiscordant relationship, Praphan said. "Many of these women decide to tell their partners that they have HIV, yet fail to convince them to use condoms as the men simply do not believe them," he said. Other infected women may fear disclosing their status, making it harder to negotiate protected sex, he added.

The Viva Gel trial will be of short duration, lasting just one to two weeks. Each Viva Gel recipient will receive a daily 10cc dose of the gel. In addition to assessing any side effects, researchers will check whether the gel reduces the level of HIV in the vagina.

Chiang Mai - A new herbal medicine has shown some promise as an alternative treatment for people with HIV/Aids who are not eligible under the 30-baht healthcare scheme to receive the anti-Aids drug GPO-VIR.

Known as SH, the medicine is a combination of two local herbs - Cortex Mori and Flos Carthami - and three from China - Radix Astragali, Radix Glycyrrhizae and Herba Artemisiae Scopariae.

Registered as a traditional medicine with the Food and Drug Administration (FDA), it is the first to have shown preliminary scientific evidence of boosting the immune system of HIV-positive people.

"The research results showed that the herbal medicine can improve the level of antibodies in HIV-positive people who have not yet shown symptoms [of Aids]," said Virat Klinbuayaem, a doctor at Sanpatong Hospital in Chiang Mai and leader of the research project.

Following one year, small-scale clinical trials in Chiang Mai and Lamphun ending in August 2003, the study showed that the traditional medicine was effective when used in combination with anti-retroviral treatment, he said.

The research project was jointly undertaken by Thailand's Department of Medical Sciences and China's Kunming Institute of Botany to support national policy in combating HIV/Aids.

Despite having conducted the scientific study on the effectiveness of the herbal medicine, Dr Virat said the scale of the study was still too small and that further experiments were required to confirm that herbal medicines could really boost the immune systems of HIV-positive patients. Research and development of herbal medicines in the country also needed to be enhanced.

However, he believed there was no harm in HIV-positive patients taking traditional herbal remedies if they were unable to obtain GPO-VIR, a generic anti-retroviral treatment.

"Although there is no sound scientific proof of the effectiveness of herbal medicine in curing HIV/Aids, at least it can be an alternative for HIV-positive people thinking about their survival and seeking medicinal treatment to boost their physical and mental health," he said.

In line with Public Health Ministry requirements, only HIV-positive patients with a CD4 count (a measure of the amount of HIV in the blood) of less than 200 are eligible to get free anti-Aids medicine under the 30-baht health scheme.

The local generic cocktail, GPO-VIR, costs between 1,200-1,500 baht depending on patient symptoms. The Government Pharmaceutical Organisation has distributed it free of charge to about 50,000 HIV patients. The drug consists of Starvudine, Lamivudine and Navirapine.

There are about 800,000 HIV-infected people in Thailand, around 200,000-300,000 of whom are in serious condition who need to be treated with anti-retroviral drugs.

The rate of HIV infections is on the rise among married Thai women, health authorities have warned. Sombat Tanprasertsuk, director of Aids, Tuberculosis and Sexually Transmitted Diseases Bureau, yesterday said the rise in HIV infections among the "indirect risk group" prompted the public health authorities to review its HIV/Aids prevention strategy.

Officials believe the reason the disease was infecting more married women was because they were engaging in unprotected sex with their infected husbands, he said.

More than 30% of the estimated 17,000 new HIV cases last year were married women, followed by the men having sex with men group (20%), intravenous drug users (10%), with the rest being teenagers and buyers of sex services, according to the Public Health Ministry's latest report.

Lack of abstinence, faithfulness and condom use (ABC) was the major cause of increase in the infection rate among married women, Dr Sombat claimed.

The finding should be a wake-up call for authorities handling the HIV/Aids prevention campaign.

It is now clear that the changing situation is creating new challenges for those involved in fighting the disease. Health authorities usually regard sex workers as the direct risk group. They have been promoting the 100% condom use campaign to prevent Aids and other sexually-transmitted diseases.

Dr Sombat said the ministry has also urged hospitals nationwide to run the Partner Notification project, which encourages married couples to have their blood regularly tested and promotes the ABC principles.

Under the project, five million condoms would be distributed to married couples by the end of this year in a bid to control the transmission of HIV between husband and wife, he said.

Nimit Tien-udom, director of the Aids Access Foundation, blamed the government's discontinuation of the campaign to promote condom use as a reason of an increase in HIV infections.

He said the campaign had been frozen over the past seven years and it should be revived to educate not only the high-risk groups, such as sex workers, but also the public as a whole, he said.

Mr Nimit called on the government to show its political will to fight Aids by stepping up sex education and the condom use campaign.

"You cannot solve this chronic problem by only providing anti-Aids drugs to the patients," he said.

Finland is set to see a two-fold increase over five years in HIV cases, due in part to men contracting the disease while on holiday in Thailand, the Finnish government said yesterday.

More than 100 new HIV cases are expected before the end of 2006, compared with 53 in 2001, out of a population of 5.2 million, according to a report published by the Finnish ministry of health.

"In a growing number of cases, people contract the disease abroad, particularly in Thailand," a favourite holiday destination of Finnish holidaymakers, health ministry adviser Merja Saarinen said.

"What is especially worrying is the number of new cases transmitted sexually," Saarinen said.

Around three out of four of the carriers are male, a figure that has remained unchanged since the beginning of the 1980s, while the average age of infected men has risen from 33 to 40 since 2001.

A drop in the number of cases contracted through sexual contact in those below 25 was an "encouraging" trend, according to Saarinen.

According to the UNAIDS's 2006 Report on the global Aids epidemic, an estimated 38.6 million people are living with HIV worldwide. Approximately 4.1 million people became newly infected with HIV.

The Thai government has been combatting against the disease for over a decade, but the number of people living with HIV/Aids keep on rising.

There are about 800,000 HIV-infected people in Thailand, with more than 17,000 new HIV/Aids infections last year.

It plans to cut the number of new infections to 7,500 in 2008 and to less than 6,000 in 2010.

The rate of infection is highest in northern provinces, which are also popular tourist destinations.

The Department of Disease Control recently expressed concern over the effectiveness of the country's HIV/Aids prevention campaign due to budget constraints.

This year's Aids prevention budget has been slashed from last year's allocation of about 300-400 million baht to just 180 million baht, according to the department.

US-based pharmaceutical firm Gilead Sciences has offered to cut the price of its bestselling anti-Aids drug Tenofovir in the Thai market after learning that HIV/Aids patients have developed resistance to a locally-made drug. Tenofovir will now cost less than 40 baht a tablet, thus greatly reducing the burden of people living with HIV/Aids who are suffering from drug resistance, said director of the Thai Red Cross' Aids Research Centre Praphan Phanuphak.

The Food and Drug Administration licensed the drug last week to allow it to be sold on the local market.

A patient taking Gilead's Tenofovir currently has to pay around 19,000 baht per month, while a patient taking GPO-VIR, the local generic version of an anti-Aids drug, pays only 1,200 baht a month.

But with the reduced price, patients would have to pay only 2,000-5,000 baht a month for Tenofovir and other drugs which were needed in the treatment course, he said.

At present, people living with HIV/Aids depend mainly on GPO-VIR. The Government Pharmaceutical Organisation has distributed the drug free of charge to about 50,000 HIV-positive people.

However, about 5,000 HIV-positive people taking GPO-VIR have become resistant to the drug, so they have to switch to Efavirenz and Kaletra, which cost up to 24,000 baht per month.

Dr Praphan claimed that Tenofovir could help those having problems with drug resistance. Patients could experience nausea as a side-effect during the first period of use. However, most appear to have tolerated the drug well, according to an initial study carried out on 600 HIV-positive people in the country.

Nimit Thien-udom, director of the Aids Access Foundation, said the price reduction was good news for people living with HIV/Aids.

However, the price was still too high, particularly for poor patients to be able to afford the drug, he said.

There are about 800,000 HIV-infected people in Thailand, and around 200,000-300,000 are in serious condition and needed to be treated with anti-retroviral drugs.

But it is estimated that only 10% of this group can afford the drugs through the National Health Security Office (NHSO)'s 30-baht universal healthcare scheme.

Tenofovir had not yet been included on the NHSO's list of anti-retroviral drugs available under the scheme, he said.

"A better way to help people living with HIV/Aids is for the pharmaceutical companies to allow developing countries to produce a generic version of anti-retroviral drugs, so people living with HIV/Aids will have more opportunities to have access to proper treatment," he said.

GPO loses Global Fund budget for developing Aids drug - August 19, 2006

The Global Fund has slashed a budget worth billions of baht earmarked for helping the country produce a Thai version of the anti-retroviral drug GPO-Vir for people living with HIV/Aids. Caretaker Deputy Public Health Minister Anuthin Charnveerakul yesterday said the organisation had stopped funding the GPO-Vir production project because the Government Pharmaceutical Organisation (GPO) plant, located on Rama VI road, did not meet the standard required by the World Health Organisation (WHO).

"It is such a disappointment that the country has lost an opportunity to develop the anti-Aids medicine and make it internationally reputable and useable," he said after returning from the 16th International Aids Conference in Toronto, Canada. He repeated his demand that GPO improve its act, or face the sack.

The Global Fund is an independent agency financing the fight against Aids, tuberculosis and malaria, which kill over six million people each year.

Over $138 million in funding has been granted to the Public Health Ministry and the Rak Thai Foundation, a non-profit organisation working on social issues, since 2003 to develop infrastructure and essential medicines.

Mr Anuthin yesterday told the GPO to urgently improve its drug production process and seek certification of good manufacturing practice (GMP) for its plant by June next year, to allow the agency to sell the GPO-Vir on the global market.

He also told the state-owned agency to speed up the bidding process for construction of a new anti-Aids drug plant in Pathum Thani by October, or its board would be sacked.

Bidding for the 940-million-baht plant in Pathum Thani has been delayed for more than three years due to alleged irregularities surrounding the process. The delays have upset the government and advocacy groups.

Kamol Uppakaew, adviser to the Network for People Living with HIV/Aids, said the budget cut stemmed from bureaucratic red tape and transparency problems in the GPO's drug production business.

"Actually, the GPO-Vir is of good quality. But the government failed to use the Global Fund's donations to develop the plant to meet the GMP standard," he said. "The government let a golden opportunity slip away."

It expects to increase the output to 500,000 tablets a day once the new Pathum Thani plant is approved by the WHO.

The GPO earns more than one billion baht a year from the sale of GPO-Vir to state-run hospitals.

The Network for People Living with HIV/Aids, which successfully campaigned for the introduction of anti-retroviral treatment into Thailand's public health system, was honoured with the newly-launched Red Ribbon Award at the conference in Canada for its outstanding contribution to the frontline response to HIV/Aids.

TORONTO - Developing countries with few resources to fight AIDS could take their lead from Thailand's prevention programs of recent years, which have allowed it to provide nearly free drug treatments to patients, the World Bank said in a report on Wednesday.

A former hot spot for the virus, Thailand has more than halved the number of new HIV infections over the past decade, and has won praise for its National Access to Antiretroviral Programme for People Living with HIV/AIDS (NAPHA). The program, started last October, provides antiretroviral drug treatment for nearly 80,000 Thais, more than 90 percent of those who need it.

But the seeds were planted about a decade earlier when Thailand made AIDS prevention a top priority. It introduced initiatives such as the 100-percent Condom Program, which promoted usage among sex workers.

This and other programs, combined with a wide network of district level hospitals and rural health clinics, have enabled it to control infection levels and allowed it to implement the NAPHA program, the bank said.

Without the prevention campaigns, Thailand would have had 7.7 million HIV cases and 850,000 AIDS cases in 2005, about 14 times more than today, the bank estimated in a report during the 16th International AIDS conference in Toronto.

"What we figured is that for every dollar they spent on prevention, they saved about $43 in treatment costs. That makes a benefit-cost ratio of 43-to-1, which is unheard of," Mead Over, a World Bank economist and co-author of the report, told Reuters.

The bank estimates Thailand has avoided the need to spend an extra $18.6 billion on treatment over the decade through 2012.

It says countries such as China and India, where the epidemic is at an earlier stage, could take lessons from the Thai programs

"Thailand's past success with prevention is the most important reason the country can afford universal access to (AIDS treatments) today. Furthermore it is an essential condition of its continued ability to afford treatment in the future," said Over.

Under the NAPHA program, a patient can walk into a hospital or rural clinic and pay 30 baht (80 U.S. cents) for treatment.

In the report, the bank says that 5 million or 6 million people worldwide could immediately benefit from similar treatment, but only 700,000 are receiving the therapy.

However, the bank warns that Thailand's costs will rise as an increasing number of surviving patients -- the bank estimates 572,500 Thais were living with HIV/AIDS in 2004 -- turn to so-called second-line drugs, which are seven to 28 times more expensive than those given as the first course of treatment.

Many of these drugs are patented and sold by large pharmaceutical firms. This means Thailand will have to decide whether to pay their prices, negotiate more favorable terms or exercise its rights under World Trade Organization rules to issue compulsory licenses, which allow other makers to produce a patented drug without permission from a foreign patent owner.

The bank says by exercising compulsory licensing, Thailand could save about $3.2 billion in health costs through 2015.

But by doing so, the government would run afoul of U.S. policy, which is a serious concern, Over said, noting that $3.2 billion represents just a fraction of the value of Thai exports to the United States in the past year

LOP BURI, Pu, a 29-year-old Thai woman with AIDS, is all skin and bone. She is so weak that she cannot even brush away flies off her face.

When Pu learned she had contracted the disease through her job as a sex worker, she was abandoned by everyone around her.

But a month ago Pu, who uses only her nickname, found one glimmer of hope -- a Buddhist temple for people with AIDS.

"She once said to me: 'Everybody has abandoned me. Would you be my father now?'" says Michael Bassano, a 57-year-old American Catholic priest who has been volunteering at the temple since 2004.

The temple, which is built at the foot of a small mountain in Lop Buri, 150 kilometers (90 miles) north of Bangkok, is home to 550 AIDS patients, including 140 children.

Its founder is Alongkot Dikkapanyo, a 53-year-old Buddhist monk, who left a promising career in engineering at the ministry of agriculture at the age of 26 to become a monk.

The idea of turning a temple into an AIDS hospice started in 1990 when two young HIV-positive men came to Wat Phra Baht Nam Phu, which means "the temple of Buddha's footprints" in Thai, and asked Alongkot if they could stay.

Two years later, he took in eight more HIV-positive Thais -- seven men and a woman in their 20s and 30s -- who had been rejected by their families, and turned his temple into an eight-bed AIDS hospice.

"I cannot control the world, but I can help and protect AIDS patients. That's my work," the round-faced monk says.

But after opening the hospice, people refused to offer him alms and stopped visiting the temple.

"In the first three years, nobody came to my temple. I received threats. I understood that people were afraid of infection. Even other monks said a temple should be a place for monks, not for AIDS patients," he says.

"Some families dropped off patients at the temple and never saw them again. But many patients came here by themselves, even with their children, saying they had no other places to go. No place, no money, no work, no food," he says.

Some 20 nurses help care for patients at the temple, which has a full stock of anti-retroviral AIDS drugs that are widely available in Thailand at minimum costs under its health program.

But the temple still has no doctor and receives "very little" money from the Thai government, depending almost entirely on funds from the Thai royal family and private donations, Alongkot says.

Since Thailand reported its first case of AIDS in 1984, about half a million Thais have died of the disease, although the United Nations has praised the kingdom as one of the world's most successful nations in preventing HIV.

But patients keep coming to Alongkot's hospice, proving that the stigma and discrimination against people with AIDS still remain strong in Thailand.

"If you have HIV/AIDS, you disgrace your family by contracting HIV/AIDS," says Bassano, who speaks fluent Thai.

"So because of that, you make all of us lose face as a family, our reputation and our life. So we don't want you anymore. That's what it comes down to," he says.

Surirat is divorced from a British husband but stills calls herself Mrs. Brown. She remarried a Thai who gave her AIDS.

"I wanna die. I wanna die," Surirat says in English in a very thin voice to the gray-haired priest, who gently wipes her tears away.

Alongkot, a Buddhist monk, is forbidden from touching women. But he massages the emaciated bodies of male patients during his daily chats with them.

One gaunt man kneels on the floor and quietly sobs as Alongkot touches his bony arm.

At the hospice, men and women are in equal number, the monk says. Most men got HIV from prostitutes, while many women were infected from their boyfriends and husbands.

Jamong Somana, a 38-year-old who used to drive a Coca-Cola delivery truck, came to the temple four months ago after his parents told him they could no longer care for him. Jamong has not heard from them since.

"If you have sex, please protect yourself from AIDS. If you don't, you will live your life in sadness," says Jamong, who got HIV from a prostitute.

Next to Jamong, Sam Nian, a 49-year-old housewife, says her daughter brought her here three weeks ago. Sam, blind due to the disease, says her daughter and other family members have never visited her at the hospice.

"I got AIDS from my husband, but I am not angry at him," she says with a smile. Her husband died of AIDS three years ago.

Alongkot says around 10 to 15 patients die each month, and the temple, which has its own incinerator, has cremated more than 10,000 bodies since 1992.

"But even after death, most families don't come here to pick up bones," he says. Alongkot has put thousands of white cotton bags containing bones and ashes of AIDS patients around a brown Buddha statue at the temple.

"I tell my patients not to worry about anything and not to feel sad because I don't want them to die in loneliness. I want them to die peacefully," Alongkot says.

Thai AIDS patients protest GlaxoSmithKline over drug patent - Aug 7, 2006

Hundreds of Thais with HIV protested outside the Bangkok office of drugmaker GlaxoSmithKlein, to demand that the British pharmaceutical firm drop its effort to patent a key AIDS drug in Thailand.

The company introduced the drug Combid to Thailand four years ago, but the Government Pharmaceutical Organization (GPO) produces its own generic version at one-fifth the price, or about 40 dollars for one course of treatment.

The drug combines existing medications into a single pill, which makes it easier for patients to comply with their treatment programs.

The activists from the AIDS Access Foundation argue that the medication does not merit a patent because combining existing drugs does not constitute a new invention.

The activists fear that if the patent is granted, Thailand will no longer be able to produce the generic version, which would threaten treatment for tens of thousands of people.

"This will have disastrous consequences for the government's ambitious treatment program." said Achara Eksaengsri, deputy director for research and development of the GPO.

Of the 600,000 Thais with HIV, about 80,000 are receiving treatment. Some 18,000 new cases were reported last year.

Thailand's treatment program has been widely credited with slashing the number of deaths from AIDS by about 75 percent last year.

Young People World Population Day - Millions of youths face bleak future - July 13, 2006

Young people, who make up nearly half of the world's population, were the focus of attention on this year's World Population Day yesterday. Millions of young people have bleak prospects due to forces beyond their control, the United Nations said.

Thoraya Obaid, executive director of the United Nations Population Fund, said youngsters are threatened by poverty, illiteracy, the risk of pregnancy and childbirth, and HIV/Aids.

"More than 500 million people aged 15 to 24 live on less than $2 [76 baht] per day; 96 million young women in developing countries do not know how to read or write; and 14 million adolescent girls aged 15 to 19 become mothers every year. Every day, 6,000 young people are newly infected with HIV," she said during a press conference to mark World Population Day.

In Thailand, a youth forum entitled "Being Young is Tough" was held yesterday by Chulalongkorn University's College of Public Health to mark the event.

Youth representatives from many parts of the country were invited to share their views on the unique challenges they are facing.

Athikhom Dukhum from Chiang Rai talked about the importance of sex education for young people.

He said sex is a taboo subject in northern culture and young people can't raise the issue with their parents when they encounter sex-related problems. Instead, they have to turn to their friends.

"The lack of knowledge and life skills could make things worse. Some people have contracted HIV/Aids, while some had unwanted pregnancies and ended up having an illegal abortion," said Mr Athikhom.

Kakang Phanaamonchai, a Hmong girl from Chiang Mai, said she wanted better education for ethnic minority women to ensure gender equality in their communities.

Rossanee Gareeuma from Yala spoke about the conflicts and differences that are threatening her community's livelihood.

"The sound of bombs and guns has been common in my life. I don't know why this has happened. Buddhists and Muslims used to be friends. We spoke the same language and could even read each other's religious books," she said.

She said she hoped the southern violence ends before the young generation are all gone, as it seems a large number of people in this group have been arrested.

Sufanwee Samaae, from Narathiwat, said the declining economy resulting from the southern strife had forced many of his friends to quit school, as their families could not afford the expenses.

Maratee Mustafakul from Bangkok's Klong Toey community, which is notorious for drug abuse, said drugs remain widespread in her community despite the government crackdown a few years ago.

"Several kinds of drugs are found in my community - methamphetamines, solvents and heroin. When walking around, I often find syringes on the ground," she said.

Ms Maratee said some youths from the area were discriminated against when they applied for jobs.

"Some companies turned down our job applications upon seeing that we're from Klong Toey. I want to ask them to stop being judgmental. There are good and bad people everywhere," she said

The Government Pharmaceutical Organisation (GPO) has to speed up the bidding process for a new anti-Aids drugs factory or its board will face the sack, says Deputy Public Health Minister Anuthin Charnveerakul. Plans for a factory which can make the GPO/VIR drug to World Health Organisation standards had been delayed more than three years. Progress is needed in the next three months, he said.

Bidding for the 940-million-baht plant in Pathum Thani has come to a halt following allegations the process lacks transparency.

Mr Anuthin said the delay is hampering the government's plan to introduce GPO/VIR to the world market.

The plant will seek certification of good manufacturing practice from WHO once it is up and running.

Currently, the state-owned GPO produces 300,000 tablets a day of the drug for people living with HIV/Aids. The new plant, with WHO approval, will increase capacity to 500,000 tablets a day, enabling the agency to place the drugs on the foreign market.

The sale of GPO/VIR drugs to state-run hospitals brings in more than one billion baht a year for the agency.

"I would like the GPO to speed up the project because the construction cost has grown more than 30%," he said, adding the GPO board should prepare to leave unless progress is made.

Wanchai Subhachaturas, GPO deputy director, said the agency is trying as hard as it can.

Commission drafting new human rights bill to protect Aids victims - July 1, 2006

The drafting of a bill aimed at protecting the human rights of people living with HIV/Aids will be completed and submitted for cabinet approval by the end of the year, said National Human Rights Commissioner Pradit Charoenthaitawee. If approved, it would be the first bill that ensures fairer treatment and better understanding of people with HIV/Aids, said Dr Pradit, chairman of the drafting committee. Thailand currently has more than 500,000 people living with HIV/Aids.

Dr Pradit said the National Human Rights Commission (NHRC) decided to draft the bill after receiving a number of complaints from HIV/Aids patients who faced various forms of discrimination. People living with HIV/Aids had been prevented from getting jobs and were unable to get access to basic education and health care services. They were sometimes also detested by people living around them, he said.

"The existing laws on HIV/Aids are obsolete, so there should be a new specific law that could protect the rights of HIV/Aids patients," Dr Pradit said.

Under the proposed bill, compulsory HIV/Aids blood tests for job applicants would be prohibited, while employers who fired infected employees would be prosecuted.

Schools and universities would also be banned from conducting blood tests on students, as there have been reports that some academic institutes have kicked HIV/Aids-infected students out of schools, said the commissioner. State and private-run hospitals would be obliged to provide basic medical treatment for people suffering from HIV/Aids, especially pregnant women infected with the disease.

Many pregnant women did not receive proper pre-natal care and anti-viral drugs to prevent mother-to-child transmission, said Dr Pradit.

Kamol Uppakaew of the Thai Aids Treatment Action Group, who has suffered from HIV/Aids for 10 years, said that apart from drafting the law, the NHRC should also focus its work on educating the public and government officials about the disease. It should encourage them to be more open-minded towards HIV/Aids patients, many of whom had isolated themselves from society because they faced fierce discrimination.

News reports about a Thai woman contracting a new strain of HIV virus is no cause for panic as it is a common occurrence, said medical experts yesterday. "Please don't panic about the new form of viral combination. HIV/Aids can't harm you, if you know how to prevent it. However, we have to closely monitor the viral combination to prevent its spread," said Dr Prasert Tongcharoen, the winner of this year's Mahidol University-B Braun award for outstanding public health service.

Dr Prasert made the comment following local media reports that a Thai woman, who was forced to offer sex services in Africa, was infected with the new combined strain of the A/E and C viruses. The finding, the country's first, has prompted the Department of Disease Control to closely monitor the situation.

Dr Prasert added that the new combined strain was no more dangerous than other strains. However, the country might be burdened with extra expenditure for the development or purchase of effective anti-viral drugs to fight the new strain.

Disease Control chief Dr Thawat Sundrachan also expressed concern about the impact of the new strain on vaccine development. The discovery of a new HIV strain in a Thai citizen was a warning sign to health authorities that they not let their guard down against the disease, he said.

"However, the viral combination might have an impact on our vaccine production plan. Our current stock of vaccine was designed to be active against only the HIV/Aids strains A/E and B. If we have new viral strains, it might take longer to produce a vaccine for them," he said.

The A/E strain is the most widespread in Thailand affecting 98% of the HIV/Aids patients, followed by the B strain. The C strain is mostly found in Africa, China and India.

Emeritus Professor Dr Prasert Tongcharoen of Siriraj Hospital has won this year's Mahidol University-B. Braun Prize for his longstanding fight against infectious diseases in Thailand including dengue fever, rabies, polio, HIV/Aids and bird flu. The 72-year-old virologist was behind the country's success in the fight against polio, having promoted oral vaccination of children since the first outbreak of the disease in Thailand 54 years ago which affected 394 people, 23 of them fatally.

As a result of Dr Prasert's tireless campaign against polio, the government eventually included the polio vaccine in the vaccination programme for children in 1977.

Dr Prasert's work has led to a gradual decrease in the number of polio victims in Thailand, with the "zero case" target having been achieved in 2002.

In 1984, when the first HIV/Aids case was reported in Thailand, Dr Prasert began to study this sexually transmitted disease. He developed a laboratory procedure to identify the virus and initiated a HIV/Aids vaccine trial project in Rayong and Chon Buri provinces.

Dr Prasert is also keenly interested in the fight against new diseases, such as avian influenza.

He played a key role in monitoring government handling of bird flu since its first outbreak in the country in 2004. Since then, he has devoted himself to studying measures to combat the deadly H5N1 strain of the virus.

He is currently conducting a study to find the most effective method to vaccinate people against regular influenza in response to the country's limited supply of vaccine.

"I am very proud of this prestigious reward," Dr Prasert said. "This shows that my work has benefitted the people."

Dr Prasert has over the years been appointed to a number of positions of honour. He has been a member of the World Health Organisation's Expert Committee Advisory Panel on Virus Diseases since 1975. He was also made director of the WHO's Collaborating Centre on Aids from 1986-1994.

The Mahidol University-B. Braun Prize has been awarded to outstanding medical professionals yearly since 1993.

Her Royal Highness Princess Maha Chakri Sirindhorn will present the 700,000-baht prize to Dr Prasert in a ceremony at Amporn Gardens on July 6.

To commemorate World Aids Orphans' Day, the FXB Foundation (Thailand) is holding a "Living Together in Harmony" event today to tell the public about children affected by the disease and what can be done to help them.

The event, to be held at Bodin Decha School, Lat Phrao Soi 86, is open to all. Participants will have a chance to enjoy a host of activities and performances such as a "khon" masked dance by a disabled eight-year-old from Ratchabophit school, a debate, an exhibition of paintings and more.

The FXB Foundation is a unit of Francois-Xavier Bagnoud International, a non-profit organisation founded in Switzerland in 1989 by Countess Albina du Boisrouvray in memory of her son, Francois-Xavier Bagnoud, a 24-year-old rescue-helicopter pilot who lost his life during a mission in Africa.

The FXB Foundation (Thailand) was officially founded in 2002 to give attention to HIV-positive people, orphans and families affected by the disease.

Supattra Kattiya-aree, the foundation's country director, said: "The Living Together in Harmony event is part of the campaign initiated by FXB Thailand to call public attention to the plight of Aids orphans and HIV/Aids-infected children in order to improve these children's psychological condition."

Serious thought should be given to a plea issued on Wednesday by scientists around the world calling on the G8 leaders not to get so caught up in the potential threat of bird flu that they divert their attention from the real global killers: TB, HIV/Aids and malaria. They issued the appeal ahead of the G8 summit in St Petersburg next month, which will have a bearing on the allocation of funds.

The World Health Organisation estimates that between them the three kill around six million people every year. By comparison, 129 people are known to have died of avian influenza since 2003 out of the 226 recorded cases. In Thailand, 14 out of the 22 who contracted bird flu have died. All caught it from handling or being in extreme proximity to infected fowl. There have been no proven cases of human-to-human transmission or a mutated H5N1 strain, and yet the hysteria surrounding the menace of bird flu has been so great that several panic-stricken families in the West have turned their homes into sterile bunkers and sealed themselves off from the outside world, while alarmists speak as though an imminent global pandemic were all but certain.

Noteworthy is that the call to keep a sense of proportion and not fall victim to scare tactics was issued by the national science academies of every G8 country with no dissenting voices, including the respected Royal Society in the UK and the National Academy for the Advancement of Sciences in the US.

While recognising the potential danger if bird flu makes the long-feared evolutionary jump to human-to-human transmission, Royal Society president Martin Rees said: "It is also crucially important for the global community not to forget that, at present, avian influenza is not the most significant disease concern for people globally. It is other emerging diseases and existing infectious diseases such as tuberculosis, HIV/Aids and malaria which are causing widespread illness and severe economic harm to developing countries." He could also have added the increasing and very real threat of dengue fever to Thailand and this region.

The scientists' statement calls for better funding of such efforts. Rather than competing for cash, the threat from bird flu should serve as a catalyst to combat existing epidemics, they say. For example, the WHO-backed plan to eradicate TB, which kills between two and three million annually, is $31 billion short of the $56 billion it needs, but world leaders have not put this on their agenda. No one has. It is not fashionable.

In the last three years, we have been through the Severe Acute Respiratory Syndrome (Sars) health crisis and are continually on alert for bird flu. With so much experience, we should be confident of our ability to handle medical emergencies and have quarantine and control honed to a fine art, and we are ready to combat any mutated form of H5N1.

Yes, we should do everything in our power to control this potential threat and people are right to be wary of it. We must, and are, taking it seriously. But let us not forget that we will only be in serious danger if it crosses over, mutates and becomes a human-to-human strain. Then, and only then, are we at risk of an epidemic which could spiral into a pandemic if a vaccine could not be synthesised and distributed in time. Even so, it could get watered down in making the jump to humans and turn out to be nothing more than a really nasty flu. And such a jump, if it ever happened, could take years.

Medical technology, in the meantime, is moving fast to combat such threats. After all, this is not 1918 when 50 million died in a global flu outbreak.

We are already one of the best-prepared and equipped countries in the region in terms of being able to tackle a large-scale and fast-developing public health emergency. Disease containment is nothing new. The biggest danger lies in diverting money away from the real health plagues and scourges to subsidise non-essential research into something that most probably will never happen. Let us listen to the world's most eminent and respected scientists on this and not the purveyors of doom, regardless of the political clout they might wield.

A three-day meeting at the United Nations attended by more than 150 countries has failed miserably in its attempt to address the world's Aids crisis. It was hoped that finally, after 25 years of having to deal with this virus, a much more definitive statement would emerge so that the world would be better prepared and informed. Instead, yet again the politicians and technocrats have held the world to ransom, using inappropriate language to gloss over arguably the most important details which affect the lives of every person on this planet.

Thailand's UN Ambassador, Laxana Laohaphan, who participated in the talks, said the meeting was not intended to come up with a concrete plan but to get nations to come up with their own plans to get universal access to Aids treatment by 2010. "It is only a political declaration," she said.

But US first lady Laura Bush took the initiative when she told the General Assembly that people must understand how the deadly virus is transmitted. She called on countries to improve literacy so their citizens can make better choices. That is fine, but the fact is that the information being given also has to be more accurate and definitive than it has been in the past, and that is where this meeting failed.

Unfortunately, employees of the United Nations in departments like the World Health Organisation, have their own agenda. By keeping the Aids issue high up in the world's governments' corridors, and therefore their funding budgets, they secure their future employment. Add to this various governments' political and religious concerns and it soon becomes difficult for the average person to decipher if they are at risk of Aids or not. A UN report released to coincide with the meeting said that 40 million people worldwide are living with HIV/Aids, and 8,000 die every day from it. Shocking figures indeed. But what every person in the world wants to know is: are they at risk of getting Aids?

Even Britain's development secretary, Hilary Benn, said he wished the document could have been more truthful. And Britain ranks second behind the United States in the amount of funding it gives to Aids. Mr Benn was right in criticising the declaration for not spelling out the ways the virus is transmitted and for allowing certain myths to perpetuate.

The final document states that Aids mainly affects "vulnerable groups" but fails to mention that these groups are homosexual men, drug users and prostitutes. The United States rejected a paragraph because it called for "harm reduction", a euphemism for needle exchanges successfully established in some countries for drug users, which Washington opposes.

The Centre for Health and Gender Equity, which says it represents nearly 70 international advocacy groups, denounced the document for failing to show greater political leadership while ActionAid International said "it is incomprehensible how negotiators could come up with such a weak declaration".

It is time for our world leaders to hide their embarrassment and political agendas and be frank. Besides injecting drug users and poor medical practices in poverty-stricken countries, our leaders need to state that transmission of Aids, both male to male and male to female, is almost always via anal sex. Research by the US Centers for Disease Control (CDC) and by the University of Tuebingen in Germany shows that anal sex, both heterosexual and homosexual, is the second-biggest cause of HIV transmission. Other studies suggest the transmission from an infected male to female via vaginal sex is only about 10 in 10,000 while transmission from infected females to males could be just five in 10,000. Studies also suggest that these few vaginal sex transmissions could be due to the fact that one partner has a sexually transmitted disease at the time, allowing transmission through an open sore.

But condom companies which benefit financially, and technocrats who get to keep their jobs, are certainly unwilling to publicly divulge this type of information and instead use less descriptive language which is being too easily misconstrued by the world.

Doctors, activists and patients have signed a letter to petition Abbot Laboratories of the US to sell a new version of its anti-Aids drug here, since its old drug cocktail on the market now is too costly.

The letter has been signed by prominent figures, including the director of the Thai Red Cross Aids Research center, Khon Kaen University's Faculty of Medicine lecturers, Mahidol University's paediatricians, former senator Jon Ungphakorn and Kamol Uppakaew, president of the People Living with HIV/Aids Network. It was sent at the end of April to the US firm.

But it received a lukewarm response from the US manufacturer who said Abbot Laboratories would sell the new version of the second-line fixed dose combination lopinavir/ritonavir (LPV/r), marketed as Kaletra, in only the least developed countries such as those in Africa.

The company did not say how soon the drug could be registered in Thailand to replace its old version, which costs the Public Health Ministry (US$2,700) 108,000 baht per Aids patient a year.

The price Thailand has paid in recent years is even higher than Brazil has forked out to the American firm at (US$1,380) 55,200 baht per patient a year.

The new version of Kaletra will be sold in poor countries at only 20,000 baht, according to Medicins Sans Frontieres.

The US Food and Drug Administration approved in October last year a new version of LPV/r that has critically important advantages for patients in developing countries - a lower pill count, down from six to four per day, storage without refrigeration and no dietary restrictions.

Abbot has gradually recalled its old version from the American and European markets, supplying the new version instead, but the firm seems to be using Thailand as a dumping ground for the old drug version, MSF said.

There are currently 82,000 Aids patients with access to anti-retroviral drugs under the Public Health Ministry's programme and an estimated 8,000 patients who need to change from the basic cocktail to the LPV/r cocktail due to drug resistance.

Meanwhile, the National Health Security Office urged new HIV/Aids patients with 30-baht gold cards to register at services centres near their homes to continuously receive counsel and drugs under the 30-baht universal health care scheme.

The project, funded by the Cariparma foundation, is designed for poorer countries. Any multinational wanting to buy the patent will have to sign an agreement on pricing and distribution.

PARMA – Every year, five million people are infected by HIV, joining millions of others who are kept alive by drugs. However cost and complicated drug cocktails mean that only 5% of AIDS sufferers can obtain adequate treatment. In addition, dangerous resistance to anti-HIV drugs can be built up by low dosages, patients may be non-compliant and tablets may be shared by lovers or relatives, as happens in Africa. Only a few years ago, patients had to take as many as eighteen or twenty pills every day and overall costs were high for both individuals and governments.

The problem has prompted first South Africa and then India to threaten recourse to copycat domestic drugs so that they can treat their population, free of charge without running up government debt, and so stop the pandemic. The battle is still going on. Efforts focus on new, single-dose, low-cost medicines and one such product is made in Italy, thanks to the RIGHT-Fondazione Cariparma project, a non-profit initiative whose main goal is to deliver the drug to poor patients. Any multinational that wishes to purchase the new drug, after the clinical tests announced yesterday at a conference in Parma, will have to sign an agreement on pricing and distribution. The AIDS battle has to be won in developing countries, which are constantly growing reservoirs of infection. “It’s a poverty-driven pandemic”, agrees Argentine infective disease specialist Pedro Cahn, the newly elected president of the International AIDS Society, which unites 10,000 researchers in 132 countries. The aim is cheaper, easier-to-use drugs. But research has a price and that is where Cariparma comes in. The foundation has donated two million euros to the three-year (2005-2007) RIGHT project for the new treatment: two molecules in a single tablet, to be taken just once a day. Franco Lori, the scientific director of RIGHT (Research Institute for Genetic and Human Therapy) says, “Low toxicity, low induction of resistance, ease of application and low costs are the distinguishing characteristics of the new combination of an antiviral drug and an immunomodulator already tested on about 300 patients in South Africa and Italy.

Now phase three – clinical trials – will start in Uganda, South Africa, Pavia, Parma and Thailand”. The hubs of the study will be Pavia’s Policlinico San Matteo, Parma hospital and Georgetown University in Washington. Carlo Gabbi, president of the Cariparma foundation, says, “Scientific research is an area of primary importance whose positive fallout reflects the level of social and economic progress of the entire community”. Giorgio Delsante, the foundation’s general secretary, notes, “Our intervention is at the most crucial stage of fine-tuning and trialling of a drug that we believe will be fundamental to the fight against AIDS in poor countries”. It is poverty that creates the pandemic, insists Cahn. Here are some figures. Around the world about 40 million people are infected by the virus and each year there are about five million new infections. In Africa, AIDS trims 1-2% off economic growth and means that 60% of today’s adolescents are likely to die before they reach the age of 60. In Cambodia, 20% of children are forced into work because there are AIDS sufferers in their families. By 2020, the disease will be responsible for the loss of 5-35% of the work force in thirty-eight countries. Cahn goes on to note that “1.3 billion people live on less than one dollar a day”. How do they get treatment? The Argentine-born researcher says, “They don’t. HIV is pandemic today because of poverty, malnutrition and socio-economic imbalance

Nearly 50 members of the Thai Network of People Living with HIV Aids yesterday lobbied the Commerce Ministry and the Intellectual Property Department to reject US-based GlaxoSmithKline's (GSK) request for patent registration of an HIV medicine known as COMBID. Network chairman Kamol Upakaew pointed out COMBID is not a brand-new anti-HIV medication but a combination of two drugs, AZT and 3TC, produced by the Government Pharmaceutical Organisation. As such, it does not qualify for patent registration under Thai law.

The patent, it said, would monopolise anti-HIV drug production, meaning the 4,000 patients who take AZT and 3TC at a cost of 1,500 baht per month each will have to pay up to 8,000 baht a month if the patent application goes through.

Mr Kamol also called for more pharmacists to sit on the pharmaceutical patent-vetting sub-committee. The only pharmacist present is a wife of a GSK executive, which he said raises questions over conflicts of interest.

Commerce Permanent Secretary Karun Kittisataporn, promised the top priority would be the welfare of HIV/Aids patients.

He would invite the network to supply the sub-committee with more information on the alleged conflicts of interest.

Thailand Aims to Halve HIV Infections Within Three Years - February 15, 2006

On Tuesday at an HIV/AIDS conference in Pattaya, a senior Thai health official announced a campaign designed to halve new HIV infections within three years. Health officials from 22 countries are attending the three-day conference, which aims to find regional strategies for providing universal HIV/AIDS treatment.

"Thailand will move ahead with a strategic aim to strengthen our prevention programs and to reduce new infections by half within three years," said professor Arun Pausawasdi, Thai vice minister for public health. "We do anticipate that the number of new HIV infections in 2008 will be 7,500 cases [against 15,000 new cases reported in 2005] and this, in 2010, there will be no more than 6,000 cases."

More than one million Thais have contracted HIV since the first case was reported 22 years ago, according to a Thai government statement in July. Roughly 500,000 have died and approximately 500,000 are living with the disease. A UN report in November said Thailand's adult HIV prevalence rate fell to a record low of 1.5 percent in 2003, but it noted that only 51 percent of Thai sex workers reported using condoms.

Arun told the conference that the Thai government has declared universal antiretroviral coverage for HIV/AIDS patients who meet the necessary criteria.

Michel Sidibe, director of country and regional support for UNAIDS, said getting information to young people and dealing with discrimination were barriers to the UN's goal of universal access to treatment by 2010. Other challenges, Sidibe said, were reaching men who have sex with men, sex workers, and dealing with issues of immigration and migration.

Govt urged to spend liquor taxes on tackling Aids plague - February 9, 2006

An academic yesterday urged the government to raise taxes on liquor and to use the money generated in the fight against HIV/Aids. Asst Prof Kitti Gunpai, deputy dean of the faculty of communication arts, Chulalongkorn University, said the national budget for HIV/Aids problems is too small, and the government should collect at least 2% more in liquor taxes to boost spending.

"HIV/Aids is a serious threat to our society. The 1.7-1.8 billion baht we spend each year to combat the disease is too small compared to the scale of the problem we're facing," said Mr Kitti at a seminar on 'TeenAIDS' yesterday.

He linked liquor, sex and Aids together in proposing the idea, saying drunkenness could possibly end up in unsafe sex and also HIV/Aids.

He said large sums of money were collected each year from cigarettes and liquor taxes for the health promotion fund. Unfortunately, that money is primarily allocated to campaigns against drinking and smoking, while little is given to HIV/Aids prevention, he said.

Besides liquor, Mr Kitti added the government might collect taxes from products or advertisements that arouse people's sexual desire so producers would take responsibility for their content.

Political commitment is another key factor in the fight against HIV/Aids, he said. Any good policy would not be fully implemented if the government leader did not show his commitment to tackling the problems.

"We have the National Aids Committee which is chaired by the prime minister. During the term of former prime minister Chuan Leekpai, he usually chaired the meeting himself, but that has not happened under the current prime minister. When the head doesn't move, the tail won't wag,"said Mr Kitti.

Senator Rabiabrat Pongpanich said the government should be more active in its battle against HIV/Aids. The campaigns or any programmes to tackle the disease should be ongoing, not sporadic.

A survey places teenagers as the new high-risk group with a steady increase in a number of infections. The rate of new cases has increased by 11.2% in 2001, 11.7% in 2002 and by 15.1% in 2003.

Itthirak Samitsuwan, president of the Life and Hope Association, for people living with HIV/Aids, said many temptations put teenagers at risk, including the internet, pornography, and the craze for luxury and expensive items.

HIV/Aids patients yesterday urged the Public Health Ministry to intervene in the Intellectual Property Department's plan to grant a patent on a giant American pharmaceutical company's widely-used anti-Aids drug.

The patent would end patients' right to access a cheap anti-retroviral drug, said Nimit Tienudom, director of Aids Access Foundation, who submitted a petition to Public Health Minister Phinij Jarusombat.

"If the drug is patented, the ministry will have to pay around 400 million baht more to procure the same drug for 4,000 people living with HIV/Aids," he said.

The US-based GlaxoSmithKline submitted a request to patent Combid, a combination of 3TC and AZT anti-Aids drugs, in October 1997.

But the patent has still not been granted partly because of strong opposition from Aids advocates who fear a patent would gravely affect Aids sufferers in the country.

Patent opponents also argue that Combid is not qualified to be patented because it is not an "innovation".

They say the company only added a new substance in an existing formula. The British government refused to patent the drug on the same grounds.

However, the Intellectual Property Department recently agreed to continue the patent process despite strong opposition from Aids patients and activists.

"It is likely the department will grant the patent next week. If we can't stop it, we will file a complaint in court as a last resort to defend the public interest," said Mr Nimit.

He said if GlaxoSmithKline successfully patented Combid, the Government Pharmaceutical Organisation (GPO) would no longer be allowed to manufacture its cheaper version of the drug, GPO-VIR, which uses the same formula as the Combid.

The GPO-made anti-Aids drug costs 1,500 baht per course, while Combid costs upto 8,340 baht per course.

Mr Phinij said he was concerned about the issue because a patent could cause a huge adverse impact on Aids patients.

The minister allayed some fears, however, saying that the Commerce Ministry's Intellectual Property Department had told him that a Combid patent decision would not be made soon.

"This gives the two ministries more time to look into the pros and cons of the patent," said Mr Phinij.

As well, he said, the ministry also plans a new campaign focusing on HIV/Aids prevention and control, including a safe sex campaign for teenagers on Valentine's Day.

Mr Phinij said the rate of teenagers using condoms was quite low due to their belief that having sex with a friend was safe sex.

Such misinformation was likely behind the jump in teenagers infected with HIV/Aids from 10,000 in 2003 to about 13,000 last year, he said.

Despite previous failed attempts by non-governmental organisations, government authorities now seem to be in favour of having condom vending machines installed in public schools and universities. At a recent seminar of Public Health Ministry officials and those attached to the Office of Higher Education Commission, Health Minister Pinit Jarusombat said condom machines could be an effective way of preventing the spread of HIV/Aids and unwanted teenage pregnancies.

His statement was promptly welcomed by Education Minister Chaturon Chaisaeng, who said he did not oppose proper sex education and installation of condom machines in educational institutes.

In the past, Thai officials were criticised when they distributed condoms at public places and social functions. Now, the idea has been recognised for helping prevent the spread of HIV/Aids.

Many people oppose the idea on the grounds that it will encourage them to have sex before marriage. This is against Thai social ethics. Of course, there are those who think it is better for students to have safe sex, rather than pretend that they do not indulge in sex at all.

This is a sensitive matter and all parties concerned must have a say. We think it is a bit premature for Mr Chaturon to come out in support of the condom idea before taking divergent views into consideration.

The Education Ministry has no objection to the Public Health Ministry's plan to install condom-dispensing machines in schools, said Education Minister Chaturon Chaisaeng yesterday. The scheme had been proposed once before but a fierce outcry from conservatives forced the Public Health Ministry to back down.

The plan is being dusted off by health authorities who said it would help contain the spread of HIV/Aids and other sexually-transmitted diseases among youngsters.

Mr Chaturon yesterday said he has no objection to the plan, but suggested that, in light of public sensitivity, schools and universities should have the freedom to decide whether or not to allow condom-dispensing machines on their premises.

The institutions which agree to join the project must also work with the Public Health Ministry to organise sex education and HIV/Aids prevention programmes on their premises, he added.

Mr Chaturon said it is imperative that the two ministries work together to systematically promote the right value and perception about sex among the young.

"Young people must be made aware of the choice they have and of the proper path they should be taking," he stressed.

The education minister said the decision by academic institutions to join the scheme must not be profit-oriented. "If that was the case, then the move would be no different from putting up condom dispensers in a hotel," Mr Chaturon said.

People who oppose the plan must try to see the gravity of the HIV/Aids situation in the country. Some of the measures launched to contain the HIV/Aids spread may be perceived as being unconventional and indiscreet on the surface, he said, "but the question begging an answer is whether it is more acceptable to watch more and more young people get infected with Aids".He said the issue was considered "taboo" in Thai society and thus always triggered a controversy whenever it was raised for public discussion.

Chiang Mai - Schoolteachers in this northern province, where the HIV/Aids infection rate is one of the country's highest, have voiced concern over a major cutback in the Public Health Ministry's budget for Aids prevention, saying it will increase infection rates among youngsters. According to the Department of Disease Control, this year's Aids prevention budget has been slashed from last year's allocation of about 300-400 million baht to just 180 million baht.

Sirapong Charoenkusal, deputy principal of Lanna Polytechnical College, a private school, said more than 5,000 condoms had been received by the school for free distribution to students in the years before 2005, when none was given at all by the ministry due to budget constraints.

"Currently, we have to rely on ourself to protect our students from the deadly disease," Mr Sirapong said.

The school was the first in Chiang Mai to have provided safe-sex counselling and free condoms to its students in 1995. It has about 4,000 students, mostly male.

The school's health consultant said the condom shortage and lack of budget would set back HIV/Aids prevention activities and put young people at greater risk of contracting HIV/Aids.

Teenagers felt more at ease obtaining condoms provided at school than buying them from convenience stores, he added.

A 15-year-old female student expressed concern over the Aids prevention budget shortage.

"The condom shortage at our school has made it difficult for us to protect ourselves from sexual diseases and unwanted pregnancies," she said.

"I feel more relaxed getting condoms at school. I don't want to walk into a shop to buy them."

"At least we would learn how to protect ourselves from the [Aids] disease," she said, adding that the provision of condoms with safe-sex advice was better than setting up condom-vending machines in school.

Giving youngsters easy access to condoms, however, has become a controversial issue in the country. Opponents say the practice is tantamount to encouraging young people to be promiscuous.

Disease Control Department chief Thawat Suntrajarn said this year's budget cut was the biggest ever experienced by the department since its launch of the HIV/Aids prevention programme.

With such a small budget, he said, it was virtually impossible for the department to reach its HIV/Aids control target.

The department aims to reduce the number of new infections to 7,500 in 2008 and 6,000 in 2010.

The Healing Power Of Painting: Talented 13-year-old artist with HIV is currently exhibiting her works - January 21, 2006

When 13-year-old Bua first attended a painting workshop for HIV-positive children at the Laemkom Art School in January 2004, nobody realised that a star was about to be born. It was not until Bua had finished her first work, a vertical painting which featured a big tree in the middle of the frame, that the teacher began to realise she was special.

"The other 15 students' paintings were horizontal, and kids would normally draw a tree on either the right or the left side of their works. But Bua's work was different,"said art teacher Sajja Jantim, who is affectionately known to his students as "Khru Laem".

"In her work, Bua painted herself gently touching the big tree. It showed that she was thinking of something that is very important to her," said Mr Sajja.

Besides this, she took more time than the other students to finish a painting. She was quiet but concentrated very hard in order to perfect her works.

The teacher described Bua as a quiet and sensitive person whose paintings say a lot of things. "But we could feel a strong power inside her," he said.

The workshop was initiated by 'We Understand' group, an NGO working for HIV-positive children, which is concerned about the declining mental health of these children. The group turned to Laemkom Art School, at the Children's Discovery Museum near Chatuchak Park, in the hope that art could help heal the children under its care.

Yet for Bua, the results have been more than healing. After completing two workshops, Bua's artistic talents have been noticed by all the teachers, who believe she could be a great artist if she is well-supported.

Mr Sajja persuaded Bua, who is from Phetchaburi, to come for a painting course at his school once or twice a month, free of charge. The school has paid for equipment, while the 'We Understand' group has taken care of transport costs for Bua and her father.

Painting has now been an important part of Bua's life for about two years. Her artistic skills have been gradually developed, while her personality and mental strength has improved.

Mr Sajja divided the girl's work into three development phases. The first was when the girl, who was in poor health, started to learn and developed her painting skills through an assigned theme.

The second phase showed the girl's dull feelings in the paintings, and the third phase started when she began her symbolic painting, which took her out of darkness to light.

"Her early paintings reflected the thoughts that occupied her at the time. No matter what themes we assigned to her, her works dwelled upon death, her mother who passed away, and temples," said Mr Sajja.

Yet the girl showed her outstanding talent when she began semi-abstract paintings. She felt free and was more herself, and her works always carried a deep meaning.

There are symbols that usually appear in most of her works, including a candle, which she said represented the light she has been wishing for, a hand that always reaches for the light, and an open eye to see and lead her to the light.

When asked what her favourite piece is, Bua shyly pointed to one with the title Paint Brightness Into the Night, Paint My Life to Fight Weakness. The work is painted in black and light blue, with pictures of little girls which Bua said represented her and her HIV-positive friends. The black is the darkness they have been living in, and the light blue is the brighter world they are wishing for. There is a full moon in the light blue part, representing her father who always gives her support and hopes to live on.

Mr Sajja said Bua's latest works are bigger and more colourful, as if she has become, little by little, more free from the thought of the fatal disease.

"From the sad, quiet girl we first met, Bua has become a little more cheerful. Her eyes are brighter with more power. She has started to laugh and said some funny things to us," he said.

To show her talent to the public, the school has decided to put her works, totalling more than 100, in an exhibition entitled "The Art of Bua". Mr Sajja said it is the first exhibition of art by HIV-positive children in Thailand.

It takes place at the Laemkom Art School, at the Children's Discovery Museum, until March 3.

When asked how she felt seeing her works on display, Bua smiled shyly and said: "I feel proud and really happy."

On Friday, Thailand's Foreign and Health ministries donated 50,000 condoms as part of its "forward engagement" policy with Africa's fight against HIV/AIDS, the UN Development Program announced. UNDP will ship the condoms to Burkina Faso, Gabon, Ghana, Kenya, Mali, Nigeria and Uganda. In Thailand, about 550,000 Thais are infected, and AIDS is the leading cause of death. "This shipment is an expression of Thailand's interest in working with Africa to halt this killer in its tracks," said Joana Merlin-Scholtes, UN resident coordinator and UNDP representative for Thailand.

United States Offers Flexibility on Drug Patents as 6th Round of Free Trade Talks with Thailand Ends - January 17, 2006

After winding up the sixth round of bilateral trade talks on Friday, a US negotiator said the United States would consider changes to its preferred terms for a Free Trade Agreement with Thailand. But critics charge that the FTA's provision extending the duration of patents would hamper Thailand's ability to produce cheaper generic AIDS drugs.

"While we welcome the views of all Thais on this and all FTA issues, the claims by some groups that the FTA will cause drug prices to rise by whole multiples of their current price is based on a lack of understanding of the US proposal, runs counter to the experience of our other FTA partners, and amounts to scaremongering," said Assistant US Trade Representative Barbara Weisel. "We have been providing $12 million US a year to the Thai government to help HIV/AIDS patients; we will not include anything in the FTA that will undercut these efforts," she added.

The talks, which began Jan. 10 in Chiang Mai, have been beset by Thai protesters who fear that the FTA could increase the cost of antiretroviral drugs.

Anutin Charnwirakul, the country's vice health minister, said Thailand will take a closer look at the issue based on the US proposal on intellectual property. The US negotiators will return to Washington in the next two weeks and discuss the next move with US Trade Representative Robert Portman. The two countries hope to finalize an agreement in the next few months.

Unshackling the drug habit: Sight of addicts, mental patients chained to walls of rehab centre accepted by locals - January 12, 2006

The sight of men chained to trees and walls at a ponoh school in Mayo district may shock strangers, but not local people.

These men have been diagnosed as mentally deranged from prolonged drug abuse, or are HIV-Aids positive.

A charity rehabilitation centre set up at the school provides herbal treatments which are accepted by local people even though they have not been approved by the Public Health Ministry.

The centre was founded by Sakariya Jehtae, the babor, or headmaster, who was formerly a religious teacher at Thammathan Foundation School in Yala. He converted his house into a ponoh school-cum-mental asylum and Aids treatment centre, operating under religious principles, 18 years ago.

Nearly 2,000 patients have so far been treated at the centre with herbal medicines twice a day, in the morning and at bedtime.

Most patients are young Muslim men, all are shackled to prevent them escaping. Some had gone berserk and smashed everything around them.

The herbal treatments are said to cure drug addicts, the mentally ill and those in the early stage of HIV-Aids.

When Mr Sakariya died in October last year, the task of running of the facility passed to his wife Mrs Nuriyoh, 42, nephew Muhammad Soreh Kiya, 32, and two followers.

"We use herbs from this area and from Arab countries," Mrs Nuriyoh said. "Despite the lack of approval from the Public Health Ministry we will continue the treatments because they are effective and acceptable to local people and we will continue helping them, she said.

Mr Muhammad said not everyone agreed with their methods, but patients must follow the rules.

"Drug addicts, the mentally ill and hallucinating patients here must follow our rules. Their relatives must allow us to chain patients to prevent them from escaping, damaging things and attacking other people," he said.

"Suffering caused by being chained will make them stay away from drugs. People criticise us for chaining them, but it's our rule to confine them for 3-6 months depending on the severity of their condition."

Malang Masae, 36, from Yaring district said he was admitted suffering from hallucinations as a result of drug abuse. He had now recovered. He wanted to go home and would not take drugs again because being chained up was painful.

Abdulloh Jehso, 25, from Mayo district could speak sensibly again after two months of treatment for marijuana addiction and alcoholism, but admitted loneliness might cause him to use marijuana again after going home.

Neither of the two men had any ideas about the violence in the far South and said they could not care less about it.

Even after four months, Kamanording Useng still thinks of little else than the cartoon characters Super Seya and Pokemon.

Eam-Orn Kittitornkul, 54, a Phuket native, is Chief of the Aids Section of the Phuket Provincial Health Office (PPHO). She started working with the very first Aids patients in Phuket back in 1988. Here she gives the Gazette’s Sangkhae Leelanapaporn insights into the difficulties of overcoming the social factors and changes that result in people living risky lives.

Phuket ranks second in southern Thailand in terms of Aids prevalence and fifth nationwide. There are around 6,000 HIV-positive people in Phuket and about 3,700 people with full-blown Aids.

Eam-Orn Kittitornkul recalls the early days, 17 years ago, when the first cases emerged on the island.

“Right at the beginning we were dealing with only one or two Aids patients at a time,” she said. The numbers climbed in the following 10 years but then, between 1998 and 2000, the rate of new cases reported dropped significantly.

Sadly, the respite did not last. “Today it’s like a second wave is coming in,” K. Eam-Orn said. “The first wave was caused by prostitution but the latest wave is prevalent amongst teenagers.”

It is thought that HIV was brought to Thailand by gay men but then spread to sex workers, then to wives and eventually to children.

“Between Thais the ratio between HIV-positive men and woman used to be 8:1 – that means eight men had the disease for every woman who had it. But now the number of women who suffer from the disease is almost the same as the number of men.

“The reason more women have HIV than ever before is that Thai society has changed over the years. Women have started to have more than one boyfriend. Married women sometimes enjoy a ‘toy boy’ or take a lover.

“Sometimes they don’t care about the danger – they just want to have an extra man. And if that man has a relationship with another woman, the chain of infection is set up. This is how people put themselves more at risk of getting HIV.

“There is still a lot to be said for the old tradition of one-husband-one-wife,” she noted.

At first it was very difficult to campaign for safe sex and condom use, she said.

“We offered free condoms and almost forced them on prostitutes. But sometimes they refused to take them. Some said that they were worried they would not be able to have sex any more because their genitals might react badly to condoms, or other strange reasons. They also said that men could not maintain an erection when wearing one.

“It’s better now because [the sex workers] understand and have greater awareness of HIV and Aids. They insist customers use condoms. Now we have almost run out of condoms!”

The PPHO provides up to 400,000 condoms per year to sex workers in Phuket; distributing more than 30,000 a month.

“We ask the sex workers, ‘What will you do for money if you contract HIV? Who will look after your children or your parents if you don’t take precautions?’ Sometimes it’s not easy to explain these things.”

When sex workers go for a check-up or treatment at the PPHO, they also receive free counseling.

K. Eam explains: “If sex workers come in with STDs [sexually-transmitted diseases] it means that they cannot work, so they suffer a loss of income. You have to understand that some nights they can have four to five customers and it means a significant loss of earnings if they cannot work.

“So condoms can preserve their livelihood as well as protect them from [HIV and] other venereal diseases. The PPHO always gives individuals HIV and Aids awareness talks though sometimes health officers have to go to the beer bar, karaoke, massage business or nightspot where the [infected] sex worker has come from, to deliver the message.

“Most of the women who become prostitutes have done so because they have domestic difficulties such as a violent husband or one who has taken a second wife.

“Sometimes they have been abandoned and left with children and elderly parents to look after.”

Nowadays the PPHO has a new target for its Aids awareness campaign – teenagers. Officers go to college campuses and schools, raising Aids awareness by using lighthearted slogans such as “Are you sure? I’m sure.”

“Teenagers tell me that the reason they don’t want to use condoms is that it doesn’t feel natural and that they’d rather feel trust between each other than rubber.”

But, in K. Eam’s experience, the reason teenagers contract HIV is precisely that misplaced trust.

And the alternatives? “Masturbation, mutual and solitary, is a safe form of sex with no risk of HIV and there’s no need to wear a condom.

“[As to full intercourse] there are three main methods recommended by the WHO, which we pass on to help people avoid the risk of contracting HIV.

“One is abstinence, the second is being faithful to your partner and the third, of course, is wearing a condom.

“If people would only stick to at least one of these methods they would be far less likely to get Aids.”

The average time that untreated HIV takes to develop into full blown Aids is usually between six and eight years, depending on the health of the sufferer. With today’s “drugs cocktails” that slow down the progress of the disease, people stand a far greater chance of living longer.

K. Eam-Orn added, “I would like to suggest to housewives, especially in rural areas, that if their husbands work in another province and like to party at night, or even if they travel a lot, these women should use condoms when having sex.

“One never knows what the man does once he is away from home.

“From the information I’ve gathered from rural housewives, they don’t use condoms because they trust their husbands.”

“Because of medical pro-gress one marriage partner can have HIV and yet feel healthy enough to carry on normally.

“But this doesn’t mean that he or she won’t pass the disease on so, again, it’s best to wear a condom.

“People still need sex, even when they are HIV-positive.

“What makes life especially difficult for us at the PPHO is infected people having sex outside their relationship without telling anyone.

“We try to explain the dangers to them but it’s hard for them to grasp because they consider sex to be their right, and a natural part of life.”

In the case of sex workers, K. Eam-Orn says that most use condoms when dealing with customers but often don’t when making love with husbands or boyfriends.

“In fact, I don’t think men who have sex workers as girlfriends are honest with them – often the man may feel that she is not honest with him,” she added.

So whether it is a case of too much trust, as in the case of teenagers, or too little, the result can be the same – that partners do not take precautions.

HIV and Aids take a terrible toll on lives. The saddest thing is that this need not be the case.

Thailand, China to Launch Herbal Drug for People with HIV - January 11, 2006

China and Thailand plan to release an herbal drug which they said can increase the immune strength of people with HIV, a Thai official said today. The drug, SH Instant, is a combination of three Chinese herbs and two herbs from Thailand, said Pongpan Wongmanee, deputy chief of the Thailand Health Ministry's Medical Science Department. In a study of 60 patients, the 40 who took the herbal drug did better at fighting HIV than those not taking it.

Thailand should think carefully about surrendering its sovereign rights under the WTO - and access to cheap medicine - in exchange for an FTA with the United States Thai and US trade officials are now meeting in Chiang Mai for yet another round of negotiations in an effort to move closer to a bilateral free trade agreement (FTA) between the two countries. On the agenda this time is the complex and controversial issue of trade-related intellectual property rights (Trips) and implications for access to affordable life-saving medicines. Trying to understand the intricacies of these trade negotiations is enough to put most people to sleep. But appearances can deceive. Behind the technical jargon and closed-door negotiations is an eye-opening reality: at stake are the lives of hundreds of thousands of Thai citizens and the future of Thailand's much praised "30 baht" universal health-care scheme.

If the outcomes of other US bilateral trade negotiations are anything to go by, Thailand may well be in for a rough ride. Similar agreements have been signed with Australia, Chile, Morocco, Singapore, Bahrain and Central American countries, and all contain provisions that oblige these countries to tighten their intellectual property rights legislation well beyond internationally agreed standards. To the surprise of many observers, these countries have bargained away reasonable flexibilities and safeguards in the implementation of intellectual property rights provided by the World Trade Organisation. These safeguards ensure access to life-saving medicines at an affordable cost by permitting countries to produce or import less expensive versions of essential drugs.

Last month, a group of world-renowned experts from Argentina, India, France, Malaysia, Philippines, Switzerland, Thailand, the US and Venezuela assembled in Bangkok for a two-day consultation about these complex issues with Thai government officials, trade negotiators, academics and activists. The meeting was organised by the Thai Food and Drug Administration, the Department of Disease Control of the Ministry of Public Health, Chulalongkorn University, UNAids, UNDP and World Health Organisation.

These experts urged the Thai government not to give up its sovereign right to use, to the fullest extent, all available flexibilities contained in the Trips Agreement of the World Trade Organisation and reaffirmed by the Doha Declaration.

They declared that Thailand should not be obliged to accept any so-called "Trips-plus" provisions that have been inserted into other bilateral free trade agreements.

They suggested that Thailand should consider following the example of Malaysia and issue "compulsory licences" (permission to produce drugs locally) for second-generation HIV drugs, as allowed by the World Trade Organisation. This will ensure an affordable supply of HIV treatment for those patients that are inevitably developing resistance to the first generation treatment.

They also recommended that Thailand ensure transparency of the FTA negotiating process. Negotiating texts should be given to all relevant government agencies, civil society, private sector firms, consumers and other stakeholders, and all these groups should be consulted before any final agreements are concluded.

The stakes are indeed high, especially for the 600,000 Thais living with HIV/Aids and whose survival will depend on the availability of affordable anti-retroviral drugs.

As of today, more than 80,000 people have access to these life-prolonging treatments, thanks to the supply of cheap locally produced generic drugs, and the target is 150,000 by 2008. As a result, Aids deaths in Thailand have fallen by an extraordinary 79%.

The recent decision of the Thai government to include HIV treatment in the 30 baht health-care scheme is being praised the world over. It is also a tribute to Thailand's firm commitment to the human right to health care as enshrined in the Thai Constitution.

But this also means there is no turning back. As HIV-positive people inevitably develop resistance to first-generation drugs, the public health services will be morally and legally obliged to find ways to ensure access to second- and third-generation treatments to keep these people alive and healthy, whatever the cost.

This is why so many experts and activists are worried about the US-Thai FTA. Restrictive intellectual property rights will prevent Thailand from using locally produced affordable generic drugs and the price of second- and third-generation HIV drugs will remain exorbitantly expensive.

Depending on the rate at which patients become resistant to first generation HIV treatment and the rate of expansion of the programme, the cost of the government's HIV treatment programme may increase from a current US million (1.5 billion baht) to as much as 0 million (20 billion baht) a year within 10 years.

Add to this other diseases requiring long-term treatment and the accumulated financial strain on the national health budget would be untenable.

Giving up internationally agreed flexibilities in the implementation of intellectual property rights would put at risk the survival of hundreds of thousands of Thai citizens, and would likely bankrupt the 30 baht scheme in the process.

Thousands Begin Protest Against Thai-US Free Trade Pact - January 9, 2006

CHIANG MAI - Thousands of activists, many from AIDS groups fearing unaffordable drugs, began a weeklong protest Monday against a free trade pact between the United States and Thailand.

The sixth round of talks, which began Monday, are regarded as crucial in finalizing the free trade agreement, or FTA, which the American side hopes can be done by this spring.

The pact's aim is to enhance trade between the two nations by lowering trade barriers and other kinds of domestic protection, moves that supporters say will boost economic growth.

Opponents, however, say a U.S.-Thai deal would hamper Thai development of cheap anti-AIDS drugs by tightening licensing and patent regulations. It would also hurt farmers by opening local markets to low-priced competition and allow foreigners to control privatized state enterprises and raise the price of essential services, they say.

More than 10,000 protesters marched to the U.S. Consulate in the northern Thai city of Chiang Mai, carrying anti-free trade banners and shouting, "We don't want FTA... fight, fight." There were no reports of violence or arrests.

"The FTA will increase the price of drugs against AIDS to the levels that HIV carriers in Thailand will not be able to afford,' said Chanwadee Kaewsrinuan, a member of an AIDS network. The protesters vow to continue demonstrations until Friday.

A statement from the U.S. trade delegation said it welcomed "all forms of discussion and debate regarding the FTA. It's a sign of a healthy democracy."

The talks are part of American efforts since 2002 to forge trade accords with six members of the Association of Southeast Asian Nations - Malaysia, Indonesia, the Philippines, Thailand, Singapore and Brunei. The Bush administration recently concluded an FTA with Singapore.

"The FTA will affect all sectors of the Thai economic from utilities, to agriculture to intellectual property, especially drugs patents," said Senator Kraisak Choonhavan, who has accused Prime Minister Thaksin Shinawatra of moving ahead on the deal without consulting Parliament or the public.

Thaksin said Monday that such consultations are not necessary while negotiations are ongoing and promised that drugs would not become expensive. He said the negotiations should be concluded by June.

Barbara Weisel, an assistant U.S. trade representative, said earlier the negotiations would focus on ways Thailand can cut trade barriers in financial, telecommunication and insurance services.

"We see this as a key round," Weisel told The Associated Press in a telephone interview from Chiang Mai.

Weisel said this week's talks are "an opportunity to see how far they're willing to go" in opening up markets. "We'd really like to see some significant progress this round."

Certification urged for Aids drug: New GPO production plant is needed first - January 5, 2006

The Public Health Ministry has told the Government Pharmaceutical Organisation (GPO) to obtain good manufacturing practices (GMP) certification for its HIV treatment drug from the World Health Organisation as soon as possible, to sell the drug on the international market. Deputy Public Health Minister Anuthin Charnveerakul said the GPO should follow guidelines provided by WHO representatives to obtain the WHO/GMP certification for its anti-retroviral drug known as GPO/VIR.

The GPO/VIR drug has already been approved by the Thai Food and Drug Administration (FDA). However, to be sold abroad, it needs the WHO/GMP certification. To date, no domestically-produced drugs have received such certification.

Lt-Gen Monkol Jivasantikarn, GPO managing director, said WHO had sent its staff to inspect the state-owned pharmaceutical factory and its production processes twice. He said it was hard for the GPO to follow WHO guidelines.

"We have two options to get the certification - either we modify the factory to bring it into line with WHO guidelines, or build a new factory. The second option is more likely, as we are building a new plant," Lt-Gen Monkol said.

The certification could be given in the next six months once the requirements are met, he said.

The GPO produces about 300,000 tablets of GPO/VIR for 150,000 people living with HIV/Aids. Its new factory would be able to produce 500,000 tablets a day. Currently, Thailand supplies GPO/VIR drugs to neighbouring countries such as Indonesia and Cambodia.

The agency would build the plant in Pathum Thani province on a budget of 940 million baht. However, construction had been delayed by bidding problems.

The plant would enable the GPO to make annual income of more than four billion baht, with over 900 million baht in profits, from locally-made generic drugs, including GPO/VIR, he said.