Chinks in Thailand's Aids armour

Prevention efforts focused on the sex industry

Many governments battling the spread of the Aids epidemic around the world have been urged to look for inspiration to Thailand.

Its strikingly successful efforts to stem the tide of infection of HIV, the virus that causes Aids, are often held up as a model.

Thailand's triumphs over Aids in 1990s

Over 90% drop in sexually transmitted diseases

Condom use up to 95% (from 14%) in commercial sex

Over 50% drop in HIV infection among army conscripts

A progressive and highly effective media campaign in the early 1990s alerted Thais to the disease, aiming primarily at promoting condom use in the sex industry.

In 1995, at the peak of the anti-Aids campaign, hourly television and radio public information spots were a mandatory requirement for broadcasting stations.

The result was a tremendous drop in the number of new infections.

Condoms were heavily promoted

"[It's] a huge success... difficult to see in any other developing country," said Martha Ainsworth, co-author of a World Bank study on AIDS in Thailand.

Yet 10 years on, the government's achievement in curbing the extent of the country's epidemic may be in jeopardy.

Experts are warning that early success has bred complacency, with the result that the epidemic could threaten to spiral out of control again.

Drug users

Also, Aids prevention efforts were directed towards what was seen as the root of the problem - sex workers and their clients.

The disease has spread to every level of society, including babies

They have not really focused on some groups at high risk of infection - drug users and illegal immigrants.

The proportion of new infections among drug users has since grown steadily.

"This will keep the epidemic going," said Aids researcher Dr Chris Beyrer of Johns Hopkins University. "The great gains made could be lost."

Sold into sex work

Illegal migrants - who are quite common in the country's sex trade - also constitute a particular problem.

Srinuan Taisamoot, who has Aids, lives in a wooden shack in a forest outside of Chiang Mai. Her story is as appalling as it is typical.

She was smuggled into Thailand from Burma after her brother sold her to a brothel owner. Until her escape two years later, she gave herself to as many as 20 men a day.

Aids prevention messages were found everywhere in Thailand

The girls in the brothel knew about syphilis, she said, but no-one ever told us about Aids.

Such cases are sadly familiar to community worker Lamai Dechaborn.

In 1989, nearly half of Chiang Mai's female prostitutes were infected with HIV. Today, many of them are battling Aids.

Bringing Aids awareness to relatively inaccessible groups like illegal migrants has always been difficult.

Now, with budget cuts, programmes to help them will be in trouble without sufficient government funding, Aids organisations say.

Budget cuts

The government has cut funding for Aids significantly. In 1996, the Aids budget reached $86m; three years later, following an economic crisis, it dropped by 43%.

Schoolchildren were also taught about Aids

Mechai Viravaidya, the former cabinet minister who spearheaded the drive to control the disease, said this was a national tragedy.

He said government funding for condoms was cut by two-thirds, while a reduced budget for prevention and education had resulted in the posters, television and radio messages warning people about Aids disappearing.

"So the people naturally thought that without condoms, without messages, Aids must be gone," said Mr Mechai, whose relentless advocacy of safe sex earned him the inevitable sobriquet - Mr Condom.

Dr Somsong Rugpoa, who heads the Department of Communicative Disease Control at the Ministry of Health, said until the economy improves and allows a bigger budget, efforts must be made to find funding elsewhere.

He added talk of success in prevention campaigns was overshadowed by growing numbers of those infected.

"Each year we have a cumulative figure - that means the problem is bigger all the time," he said.