Thailand Shows the Way Towards an HIV-Free World

By Dr Poonam Khetrapal Singh Reprint | | Print |

Dr Poonam Khetrapal Singh is the Regional Director of the South East Asia Region of WHO.

NEW YORK, Jun 7 2016 (IPS) - Thailand has provided the world with an important milestone towards the global goal of ending pediatric AIDS. This week, the World Health Organization is formally declaring that Thailand has officially eliminated new HIV infections among children.

Whereas in 2000 an estimated 1000 children in Thailand were newly infected with HIV, in 2015 just – 85 children were infected with the disease. This very low level of new infection among children is comparable to the results achieved in North America and Western Europe, where mother-to-child HIV transmission is extremely rare.

Last year, Cuba became the first country to be officially acknowledged as having eliminated mother-to-child transmission of HIV and syphilis. This week’s landmark represents the first time that a country with a large HIV epidemic has reached this milestone for children. In Thailand today, 98% of all pregnant women living with HIV receive antiretroviral therapy, and the rate of mother-to-child HIV transmission is less than 2%. This is a remarkable achievement in a country where an estimated 450 000 people were living with HIV in 2014.

Several factors have contributed to Thailand’s extraordinary achievement. First, sustained success in preventing new HIV infections generally has reduced the burden of HIV among women of childbearing age. From 2000 to 2014, the annual number of women newly infected in Thailand fell from 15 000 to 1900 – an 87% reduction. That is a degree of prevention success that exceeds what has been recorded in most high-income countries.

Second, Thailand has established a solid framework for Universal Health Coverage. This means that essential health services are available to both rich and poor, making Thailand a pathfinder for Universal Health Coverage not only in the region but for the entire world.

Finally, Thailand has demonstrated a visionary commitment to equitable access. Like Thai citizens, immigrants are also covered for HIV treatment. In our increasingly connected and mobile world, withholding lifesaving health services solely based on one’s country of origin is both inhumane and contrary to basic principles of public health. Thailand’s commitment to equity reflects a response grounded in human rights that will leave no one behind.

Thailand’s success reflects much more than the story of one country. It also exhibits how the AIDS response has changed our world. For far too long, it was assumed that only the wealthiest countries would obtain immediate access to biomedical breakthroughs but that everyone else would wait years or even decades before benefiting from lifesaving technologies. Beginning with AIDS, though, low- and middle-income countries are attempting to guarantee the same standard of health as is available in the wealthiest countries. This is a tectonic shift in the history of global health, and this universal approach is fundamental to achieving the Sustainable Development Goals.

Thailand’s achievement offers inspiration as we work towards the global goal of ending the AIDS epidemic as a public health threat by 2030. National leadership, looking to science as the guidepost for action and involving affected communities have been central to what Thailand and other countries around the world have achieved thus far in our response to AIDS.

But the many gains that have been made in the AIDS response have also been possible because of transformative international partnerships – not only between the North and South but also South-South partnerships. Thailand has not only benefited from this partnership but has also served as a critical source of knowledge, learning and best practices on AIDS. Thailand has been the home of some of the most important HIV clinical trials and implementation studies, including with respect to prevention of mother-to-child transmission. Thailand’s early pioneering of condom promotion among sex workers has inspired effective HIV prevention measures all across the world – in both financially rich and not-so-rich countries. And as Thailand’s investments in health have placed it on track to achieve HIV treatment for all within the next several years, Thailand is showing the entire world what it takes to fully leverage antiretroviral therapy to reduce new HIV infections and AIDS-related deaths.

As the entire global community gathers this week in New York to agree on concrete commitments towards ending the AIDS epidemic once and for all, Thailand’s story also teaches us another important lesson. At the same time that we work towards achieving HIV treatment for all, we also need to keep the focus on prevention efforts that reduce the risk of HIV acquisition.

So while we congratulate and celebrate Thailand today, let us also pledge to use the lessons from Thailand’s experience to generate the same kind of achievements all across Asia and the entire world.