In the late 1990s, the Thai Government started offering free antiretroviral medicines to several thousand people. Apiwat Kwangkaew, currently Vice-Chair of the Thai Network for People Living with HIV, was one of the lucky ones.
“Twenty years ago I got really sick because of AIDS. I didn’t think I was going to make it,” said Mr Apiwat. Within a few months of starting treatment, he was healthy again.
“What was really tragic was that antiretroviral medicines existed, but my friends and other people living with HIV were not accessing them,” he said.
Because of that experience, ensuring access to HIV treatment has been his life’s passion. He is now one of Thailand’s better known advocates for people living with HIV.
Since the 1990s, the situation has vastly improved. In 2002, Thailand became one of the first members of the Association of Southeast Asian Nations (ASEAN) to integrate HIV services into its universal health coverage scheme. Between 2010 and 2014, coverage of people living with HIV receiving antiretroviral medicines increased from 42% to 61%.
Suchada Chaivooth, Director of the HIV and Tuberculosis programme at the National Health Security Office, said that Thailand had found many benefits from this integration. “The government can negotiate a good price for antiretroviral medicines because it’s supplying a large number of people living with HIV,” she said.
Panya Shoosiri, a gardener from Amphur Thamai village in Chantaburi Province, central Thailand, is one of the many people accessing free antiretroviral medicines. He has been living with HIV for more than 15 years. His monthly income is about US$ 100. “All HIV services are covered by the national plan. It’s a big relief for me,” said Mr Panya.
In 2014, Thailand reached a new milestone, becoming the first country in ASEAN to offer free HIV treatment to people living with HIV regardless of their CD4 count, the measurement used to indicate how significantly the immune system has been affected by HIV. Previously, people who tested positive could only access antiretroviral medicines after their CD4 count had decreased to 350 cells/mm3.
“I campaigned hard for this development because I am sure it will save many lives,” said Mr Apiwat. “People living with HIV often only came back to the hospital when they were really sick and by then the antiretroviral medicines didn’t work so well and they were more likely to die,” he added.
Since the new guidelines went into effect, Thailand has seen enrolment on its HIV treatment programme increase by more than 30%.
During a visit to Bangkok, UNAIDS Executive Director Michel Sidibé said, “The AIDS response in Thailand and around the globe has a lot to offer the universal health-care movement.”
Mr Sidibé pointed out that the AIDS response has achieved one of the most remarkable expansions in modern history. In 2000, fewer than 1% of people living with HIV in low- and middle-income countries had access to treatment. The annual cost per person was sky high. As of June 2015, the global number reached 15.8 million people or 40% of the total number of people living with HIV around the world.
He emphasized so much has been achieved in such little time because the AIDS movement has prioritized people. From the early days of the epidemic civil society has played a key role in expanding access to HIV services.
In Thailand, the government earmarks funds for health-care facilities to team up with community groups. “Our HIV programme is one where hospitals work in partnership with community groups to provide prevention services, reaching key populations at higher risk of HIV and providing them with HIV testing and care,” said Ms Suchada.
