Fighting AIDS in Asia/ In Thailand, the armed forces help beat back an epidemic

October 13, 2002|By Richard Halloran

THAILAND, once a festering sore of people infected with HIV/AIDS because of illicit drugs and a notorious sex trade, has made remarkable headway in beating back that deadly scourge.

And it has been the Royal Thai Army that has led the charge as the Thais forged a consensus that HIV/AIDS was not just a medical issue but one of national security.

"This perception of HIV/AIDS as a national threat was the turning point in our fight," Maj. Gen. Suebpong Sangkharomya, a senior medical officer, told a recent conference here. "It was as if everybody suddenly woke up to the fact that our house was on fire and it was everybody's business to pitch in and help put out the fire."

General Suebpong said that critical to the campaign had been educating drug users about the danger from dirty needles and persuading prostitutes to insist that their customers use condoms.

"From the outset," he said, "we had to accept the fact that we can't stamp out the sex trade. So we encouraged the 100 percent use of condoms to prevent the spread of the virus. Now, anyone who refuses to use a condom is refused service."

The general asserted that without intervention, Thailand would have suffered 8 million cases of HIV/AIDS since 1984 instead of 1 million cases. He said the Thai army had seen a drop in the number of men entering the army who had symptoms of HIV/AIDS, from 3.7 percent in 1993 to 0.7 percent last year.

Throughout the world, an estimated 40 million people suffer from HIV/AIDS today, about the same number as all the people of every nation who died in World War II. Another 25 million have already died. About 28 million of the living victims are in sub-Saharan Africa and 7 million are in Asia. With the exception of Thailand, the spread of HIV/AIDS is accelerating in Asia.

Jack Chow, the State Department's senior official dealing with HIV/AIDS, told a recent gathering at the University of Hawaii that the world faces "a disaster of unimaginable proportions" as HIV/AIDS moves and mutates at a frightening pace. He said that up to 75 million people could be infected by the end of the decade.

After the first cases of HIV/AIDS were found in Thailand in 1984, General Suebpong said, "the official policy was generally to hush up the problem for fear of losing tourists and causing public panic." Five years later, however, "enough alarms had been raised to make people sit up and take notice of the disaster in the making."

The first action, as might be expected of military leaders, was to gather intelligence to determine the prevalence of HIV/AIDS. Once having found the incidence among soldiers, the Thais gathered information on other groups at risk, such as students, factory workers living away from families and seafarers.

"From these findings sprang the perception of HIV/AIDS as a threat to the national security of Thailand," the general said. The spreading illness endangered economic development, threatened to overwhelm health care facilities, burdened the educational system and hampered industrial production through time lost by skilled labor. It further undermined military readiness with the strain on money and facilities.

Thailand set about preventing new infections, treating those already infected, seeking help from abroad and initiating new research. Classes on AIDS were included in all military training, and warnings were directed at other groups. Testing was expanded. Leaders sought to foster a supportive attitude among the public to avert discrimination against those with HIV/AIDS.

The Thai army doctor pointed to four lessons his compatriots had learned.

"Prompt assessment and response is essential," he said.

Seeing HIV/AIDS as a national security threat was a key to success.

All agencies in a nation must coordinate their anti-HIV/AIDS actions.

"And the resources of the armed forces can be used effectively to help a country respond," he said pointedly, clearly suggesting that the militaries of other nations could be catalytic in forging a national consensus to battle HIV/AIDS.

Richard Halloran is a journalist and free-lance writer who specializes in U.S. military and Asian affairs. He lives in Honolulu.

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