World AIDS Day, 2001, THAILAND
There are at least 700,000
Thai People with HIV/AIDS.
Only 5,000 get ARV Treatment presently.
100,000 to 250,000 would benefit from ARV Treatment NOW.
Currently, only 5% of Public Health Spending is for HIV/AIDS.
ACTION ALERT : THAILAND
PEOPLE WITH HIV/AIDS DEMAND EQUAL TREATMENT AND ANTIRETROVIRAL MEDICATION COVERAGE UNDER UNIVERSAL HEALTH CARE PLAN
On November 30, the day before World AIDS Day, about one thousand Thai people living with HIV/AIDS and their allies will descend on the Parliament House in Bangkok to demand equal treatment under the new universal health care plan, which currently provides coverage for treatment of every disease --except chronic renal failure and HIV/AIDS.
The Ministry of Public Health (MOPH) promised to include AIDS drugs if the monthly cost of production were below 2,500 Thai Baht (THB) per regimen. (US$55). Even though the Government Pharmaceutical Organization (GPO) announced last month it could produce regimens for 2,310 Baht/month, the MOPH has resisted inclusion of anti-retroviral drugs in the universal health coverage plan. Activists intend to stay at the Parliament until an outcome that respects their dignity, right to life and health, and equality is achieved.
The International Gay and Lesbian Human Rights Commission (IGLHRC), together with the Thai Network of People Living with HIV/AIDS (TNP+) and the Thai NGO Coalition On AIDS (TNCA), asks for urgent letters to the Prime Minister and Minister of Public Health. We demand that the Thai government fulfill its promise to include AIDS drugs under the universalized health care plan and immediately increase the AIDS treatment budget and step up provision of domestically produced generic anti-retrovirals.
Please write to:
Prime Minister Thaksin Shinawatra
Ms. Sudarat Keyuraphan
Please send a copy of your letters to:
|Mr. Promboon, Thai
NGO Coalition on HIV/AIDS
801/21 Ngamwon Rd.
Phone: +66-2-953-5355, 5356
Medecins Sans Frontieres - Belgium
311 Ratchapongsa, Ladphrao 101
Wangtonglang, Bangkok 10240 THAILAND
Phone: +66-2-375-6491, +66-1-838-4233 (mobile)
Dear Honorable (Prime) Minister,
We congratulate you on your commitment to expand access to essential health care to all people living in Thailand through the new 30-Baht Health Care Plan. We are outraged, however, that people living with HIV/AIDS are being singled out as a group that cannot benefit from this plan, although AIDS is the leading cause of death in Thailand. We request that you demonstrate your commitment to protecting and promoting the health and lives of people living with HIV/AIDS by immediately taking steps to increase the AIDS budget and include anti-retroviral therapy under the 30-Baht Health Care Plan.
Access to essential drugs is a part of the human right to health. Article 25 of the Universal Declaration of Human Rights (UDHR) affirms that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family," and stipulates the right to medical care as an aspect of this right. In 1999, Thailand ratified the International Covenant on Economic, Social, and Cultural Rights (ICESCR), and in doing so acknowledged its obligation to uphold the principles enshrined in it. Article 12 of the ICESCR recognizes "the right of everyone to the enjoyment of the highest available standard of mental and physical health." It mandates States, among other steps, to take necessary measures for the "prevention, treatment, and control of epidemic, endemic, occupational and other diseases," as well as to create "conditions which would assure to all medical service and medical attention in the event of sickness."
Science and practice show that anti-retroviral medications greatly reduce the incidence of opportunistic infections and subsequent hospital admissions, and death. HIV/AIDS therapy can reinvigorate prevention efforts, lessen stigma, and improve the demand for HIV testing. In Brazil, Europe, and the United States anti-retrovirals have turned HIV/AIDS into a manageable chronic infection, providing confirmation of their cost-effectiveness. Treatment keeps people alive and productive longer, including prolonging parents' lives so that they can raise their own children. Most of all, as South African AIDS activists have noted, a lack of HIV/AIDS treatment undermines one's aspirations to freedom, equality and dignity.
Denying access to life-saving AIDS medications to the hundreds of thousands of people who need them now is an abrogation of both domestic and international law. International human rights law guarantees freedom from discrimination on any ground, including health status. According to the Thai Constitution, there shall be no unjust discrimination against a person on the grounds of the difference in health condition. The Constitution also provides that "a person shall enjoy an equal right" to receive health services. Thailand's National Plan for Prevention and Alleviation of HIV/AIDS also prohibits all forms of discrimination against HIV infected people. Thailand's Eighth National Economic and Social Development Plan calls on the government to "promote more comprehensive delivery of health care and health services for people living with HIV/AIDS."
The UN International Guidelines on HIV/AIDS and Human Rights call on governments and communities to confront difficult issues with a sense of urgency, underlining the universality and indivisibility of human rights. On treatment, they say "the human rights obligations of States to prevent discrimination and to assure medical service and medical attention for everyone in the event of sickness require States to ensure that no one is discriminated against in the health-care setting on the basis of their HIV status."
The Thai government, as signatory to the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) Declaration of Commitment (2001), recognizes that "access to medication in the context of pandemics such as HIV/AIDS is one of the fundamental elements to achieve progressively the full realization of the right of everyone to enjoyment of the highest attainable standard of physical and mental health."
Governments play a vital role in achieving universal access to essential drugs. The Thai government has shown in the past that political will is a key to successfully addressing the epidemic. We therefore encourage you to work with the key stakeholders in this treatment access movement, Thai people living with HIV/AIDS themselves. Thai AIDS activists have taken initiative to express their commitment to working with the government to improve its capacity to treat. We stand in solidarity with Paisan Tan-Ud, chairman of the Thai Network of People Living with HIV/AIDS (TNP+), when he says that all people should be treated equally, regardless of the type of illness they suffer, and that there should be no exemption for any disease under the universal health plan nor should cost be the deciding factor.
You have the power and authority to immediately expand your public health and AIDS budget and the availability of quality life-saving generic AIDS drugs. We hope that your government will choose to fulfill its human rights obligations by creating the conditions in which people with HIV/AIDS in Thailand can exercise all their rights, freely, fully, and equally.
In Thailand, 1 in 60 people, or approximately 1 million people are infected with HIV. It has the 15th largest number of HIV-infected people in the world, and there are approximately 30,000 new infections every year; 4,200 are children.
In October 2001, the Thai Government Pharmaceutical Organization (GPO), which produces generic versions of essential anti-retrovirals including AZT, ddI, d4T, 3TC and Nevirapine, announced it would reduce the monthly cost of its anti-retroviral medications from 5,000 Baht (US$112) to 2,500 Baht (US$ 55) by December 2001. Earlier this year, the Minister of Public Health had announced that, according to government policy, once the cost of producing anti-retroviral medication prices dropped below 2,500 Baht the new universalized health care scheme would provide coverage for these drugs. Activists, however, are dissatisfied with the reticence of the government to enact this policy since the price reduction was announced.
The Thai government currently provides AIDS medications to approximately 3,000 people. Recently, Thongchai Tavichachart, director of the GPO, said he expected to have the capacity to serve the needs of 50,000 patients by the end of 2001 and next year could supply at least 100,000. Yet the government has until now made no definite move to expand access.
The Thai national budget for 2002 is 100,000 million Baht, with 1,000 million devoted to HIV/AIDS-related programs. In 2001, HIV/AIDS-related programs received 1,500 million Baht; this year's reduction is attributed to the fact that the new universal health coverage policy includes prophylaxis and treatment for opportunistic infections. In 2002, 250 million Baht will be spent on anti-retroviral treatment; this past year, the budget was 240 million Baht.
The Thai Network of People Living with HIV/AIDS (TNP+) is one of the strongest HIV/AIDS support and advocacy bodies in the Asia/Pacific Islands region, with membership comprising over 460 groups across the country. Working in coalition with non-government AIDS organizations and other allies, TNP+ has been advocating for universal treatment access for people living with HIV/AIDS since the current administration, led by the Thai Rak Thai party, came into power in 1997.
Movement toward ARV in the Universal Health Coverage in Thailand
It is again coming to the World AIDS Day. Usually, when it comes to the 1st of December, we will hear lots of messages saying how many people infected with HIV globally and nationally. Besides, it is kind of shock to know an enormous number of infected people die of AIDS each day and each year. It has been about 20 years since the start of HIV epidemic in Thailand and we have lost not less than 300,000 people who have died and were actually forces for the nation. Without committing to do something, we will have at least 7 people DEAD each hour even though there are effective antiretroviral treatments available.
Therefore, we, the Thai Network for People living with HIV/AIDS and AIDS NGOs about 1,000 lives are here to show our solidarity and to listen to the commitment from the new government of era "Rethink Redo".
This government has announced what so called "30 Baht Health Scheme" in which the scheme supposes to cover treatment of all diseases, but apparently it excludes antiretroviral treatment for AIDS. The minister of health once has said that ARV would be considered in the universal coverage if prices come down to 2,500 baht. To support this idea, the Government Pharmaceutical Organisation (GPO) will reduce price of triple regimen to 2,310 baht in mid December this year. That's why we're here to remind the minister keeping her promise.
Detail of movement.
- 8.00 am. Perform religious ceremony "showing respect to the King
- 9-10 am. Walk to the government house.
- from 10 am. Wait for the answer from the government and there are
activities throughout the day
The whole day, we will have activities called "barefoot doctors" to show the capacity of PHA who can help to screen their friends and be involved in treatment which is always seen as doctors' responsibilities and not the patients'.
We need media attention who could help us
pass on this message to the man of power and general public. Please
Jeeranuch (01-8118333), ACCESS
Nimit (01-9104884), ACCESS
Paisan (01-8245434), Chairman of Thai Network for people living with HIV/AIDS
Onanong (01-8384233), Medecins Sans Frontieres-Belgium, Thailand
Medecins Sans Frontieres - Belgium
311 Ratchapongsa, Ladphrao 101,
Wangtonglang, Bangkok 10240 Thailand
Tel: +66 2 375-6491 (Office)
+66 1 838-4233 (Mobile)
Fax:+ 66 2 374-9835
Thai government to make
own, cheaper AIDS drugs by end of year
by BUSABA SIVASOMBOON, Associated Press Writer, 10/19/2001
BANGKOK, Thailand (AP) - Thailand's state pharmaceutical enterprise plans by year's end to be manufacturing most of the expensive drugs commonly used to treat people with HIV, the virus that causes AIDS.
The move will cut the cost of treatment in half, Thongchai Tavichachart, director of the Government Pharmaceutical Organization, said Friday. He said the price of an average month's supply of the drugs would drop to 2,300 baht (dlrs 51) per person from 5,000 baht (dlrs 92.50) at present.
In January, in a move to make medicines more affordable, Thailand changed drug registration regulations in a way that give high-priced foreign products competition from locally-produced generic versions. The high cost of medicines on which multinational pharmaceutical companies hold the patents has in recent years become a major complaint in many developing nations. The issue frequently arises with drugs used to treat symptoms and side-effects of AIDS.
Thongchai said he expected that the Government Pharmaceutical Organization would in the next three to four months have the capacity to produce enough of the drugs used in so-called "AIDS cocktails," comprising drugs such as AZT and Nevirapine, to serve the needs of 50,000 patients. Within a year, it should be able to supply at least 100,000 patients.
The official number of HIV-infected persons in Thailand is 500,000, although other estimates are twice as high. About 200,000 patients are undergoing drug therapy, said Thongchai. He said the Government Pharmaceutical Organization has invested 20 million baht (dlrs 445,000) in improving its AIDS drug manufacturing capacity. The enterprise currently manufactures small amount of the drugs on a trial basis.
There have been several major moves this year to tackle the problem of expensive patented AIDS drugs. In February, an Indian drug company announced it would offer AIDS treatments to poor countries at a massively reduced price. Cipla Ltd. said it would sell its triple-combination therapy drugs to the aid agency Doctors Without Borders - known by its French initials MSF - for dlrs 350 and to governments for dlrs 600 per patient per year. The drugs currently cost more than dlrs 1,000 in developing countries, while in rich countries they can cost as much as dlrs 15,000 annually.
In August, Brazil threatened to make a generic version of the AIDS drug Nelfinavir, made by Swiss pharmaceutical giant Roche, based on a law that allows the government to produce a generic version of a patented drug in the case of "economic abuse" or a health "emergency." The threat was withdrawn when Roche promised to slash its price by 40 percent. Multinational drug makers have also extended generous terms to some countries in Africa, hardest hit by the AIDS epidemic.
Thai activists report over 1000 PLWHAs showed up for this historic and victorious demonstration!
Thailand to include AIDS treatment in
subsidized state health care plan
By UAMDAO NOIKORN Associated Press Writer
BANGKOK, Thailand (AP) - Thailand's government on Friday bowed to AIDS patients' demands to provide them treatment under a government program that offers medicare for 30 baht (70 U.S. cents) per hospital visit.
Addressing about 300 HIV patients protesting in front of the government headquarters, Public Health Minister Sudarat Keyurapan said the government has decided in principle to put AIDS treatment in the medicare program next year. The announcement is a triumph for 1 million Thais suffering from HIV or AIDS, who have campaigned for government medical help since the 30-baht program was launched April 1st. The program will initially cover those showing symptoms of the disease.
The plan, one of Prime Minister Thaksin Shinawatra's nine populist promises that won him a landslide victory in January elections, began April 1 as a pilot project in six provinces and went nationwide in October. It aims to cover 46.6 million of Thailand's 62 million people who have no private health insurance. The program's beneficiaries pay 3020 baht (70 cents) every time they visit a hospital to be eligible for consultation, treatment and medicines for almost every disease except AIDS and kidney dialysis.
"We're very happy that the government finally looked at our plight," said Paisan Tan-Utra, president of Thai Network for People Living with HIV and AIDS. A working committee comprising all parties concerned would be set up to oversee the progress. The first talks are expected to start next month or in January, Paisal said. His group is staging an all-day rally with activities in front of Government House to mark World AIDS Day on Saturday. Paisan said the government bowed to the demand after talks between the representatives of the protesters and minister Sudarat, who was accompanied by the heads of the Communicable Disease Control Department and the Government Pharmaceutical Organization.
Sudarat said the ministry would double the anti-AIDS budget to 50020 million baht (dlrs 11 million) next year. Under the deal, each patient would receive the locally made AIDS cocktail drug worth 2,310 baht (dlrs 52) every month. "The budget could cover about 6,000 to 7,000 AIDS patients and the rest would join soon," said Sudarat.
At present, most HIV-positive people are left untreated as they cannot afford the drugs despite the government's effort to cut costs by producing some of the cheapest ones locally.
Thailand is credited with bringing down the rate of HIV/AIDS infection by 80 percent after a massive awareness and condom distribution campaign in the early 1990s.
11/30/2001 Associated Press Newswires
--------------- -------------------------------------------------------------------------------------------------disappointing UPDATE below
Thailand to include AIDS treatment
in subsidized state health care plan
By UAMDAO NOIKORN, Associated Press Writer
Associated Press Newswires
BANGKOK, Thailand (AP) - Thailand's government on Friday bowed to AIDS patients' demands to provide them treatment under a government program that offers medicare for 30 baht (70 U.S. cents) per hospital visit. Addressing about 300 HIV patients protesting in front of the government headquarters, Public Health Minister Sudarat Keyurapan said the government has decided in principle to put AIDS treatment in the medicare program next year.
The announcement is a triumph for 1 million Thais suffering from HIV or AIDS, who have campaigned for government medical help since the 30-baht program was launched April 1. The program will initially cover those showing symptoms of the disease. The plan, one of Prime Minister Thaksin Shinawatra's nine populist promises that won him a landslide victory in January elections, began April 1 as a pilot project in six provinces and went nationwide in October. It aims to cover 46.6 million of Thailand's 62 million people who have no private health insurance. The program's beneficiaries pay 30 baht (70 cents) every time they visit a hospital to be eligible for consultation, treatment and medicines for almost every disease except AIDS and kidney dialysis.
"We're very happy that the government finally looked at our plight," said Paisal Tan-Utra, president of Thai Network for People Living with HIV and AIDS. A working committee comprising all parties concerned would be set up to oversee the progress. The first talks are expected to start next month or in January, Paisal said. His group is staging an all-day rally with activities in front of Government House to mark World AIDS Day on Saturday. Paisal said the government bowed to the demand after talks between the representatives of the protesters and minister Sudarat, who was accompanied by the heads of the Communicable Disease Control Department and the Government Pharmaceutical Organization. Sudarat said the ministry would double the anti-AIDS budget to 500 million baht (dlrs 11 million) next year. Under the deal, each patient would receive the locally made AIDS cocktail drug worth 2,310 baht (dlrs 52) every month. "The budget could cover about 6,000 to 7,000 AIDS patients and the rest would join soon," said Sudarat. At present, most HIV-positive people are left untreated as they cannot afford the drugs despite the government's effort to cut costs by producing some of the cheapest ones locally. Thailand is credited with bringing down the rate of HIV/AIDS infection by 80 percent after a massive awareness and condom distribution campaign in the early 1990s. un/vj/kgo
Thais rally for cheap access to AIDS drugs.
11/30/2001 Reuters English News Service
BANGKOK, Nov 30 (Reuters) - Over 1,000 HIV-positive Thais rallied outside parliament on Friday, demanding cheaper access to anti-AIDS drugs and protesting against their exclusion from government-subsidised medical care.
Dressed in yellow and waving banners reading "we are being discriminated against", the protesters asked to be included in the Thai government's new low-cost health scheme. Some protesters, dressed in white, created a "human monument" meant to symbolise hope.
Prime Minister Thaksin Shinawatra swept to a landslide election victory in January this year on a raft of populist policies including a subsidised health scheme that slashed hospital consultation fees to 30 baht ($0.68) per visit. But critics were angered the government did not include treatment for HIV/AIDS in the scheme.
"The government pharmaceutical organisation can manufacture many of these drugs, including triple therapy regimen, at less than $50 per month per person," said Jon Ungphakorn, a member of Thailand's upper house and an HIV/AIDS campaigner. "Tomorrow (December 1) is World AIDS Day and we want a significant gesture from the government so that people living with AIDS can lead a longer life, lead a healthier and good quality life and be with their families for a long time," he said.
According to the Thai Network for People Living with HIV/AIDS, the country has around 700,000 people who are either HIV positive or suffering from AIDS. Around 100,000 - those with particularly vulnerable immune systems - need anti-viral treatment.
Public Health Minister Sudarat Keyuraphun told protesters she agreed in principle that HIV/AIDS treatment should be included in the government's health scheme and said her ministry would propose funds to provide drugs to between 6,000 and 7,000 people.
Activists said they were encouraged by Sudarat's response, but wanted the government to supply cheap anti-AIDS drugs to all that needed them within three years. "We tried pushing on anti-viral drugs, but the people at the ministry (of health) said it's not effective, expensive and the infrastructure is not ready," said Paisan Tan-Ud, chairman of the Thai Network for People living with HIV/AIDS. "But today it seems like they've changed a little bit - much better than before," he said. ($1=44.05 baht).
March 22, 2002
Agence France-Presse -------------------------------------------------------------------------------------disappointing UPDATE below
Thailand to launch dollar-a-day anti-AIDS cocktail
BANGKOK, March 22 (AFP) - Thai health authorities said Friday they will begin selling the world's cheapest anti-AIDS drug early next month for less than a dollar a day, in a move applauded by activists.
The Government Pharmaceutical Organisation (GPO) is behind the first locally produced anti-retroviral (ARV) "cocktail" which could end up helping hundreds of thousands of HIV sufferers battle the virus which causes AIDS.
The drug, called GPO-VIR, is a single pill combining Stavudine, Lamivudine and Nevirapine, which are known to inhibit the production of HIV in the body.
GPO director Thongchai Thavichachart told AFP his organisation produced a successful initial batch of 120,000 tablets of the drug on March 18 and will first market it at six GPO outlets in early April.
"We will sell it for 20 baht (46 US cents) per tablet, which is very cheap," he said.
The dosage is set at two tablets per day, making the 1,200 baht (27 dollars) monthly cost the cheapest in the world, Thailand's public health ministry said.
It would also slash Thailand's current lowest monthly cost of 2,500 baht for ARVs by more than half.
The GPO aims to increase production to three million tablets per month over the next six months to meet demand, Thongchai said.
He noted the GPO has successfully prescribed cocktails of the three separate drugs for three years to more than 2,000 AIDS patients.
GPO, Bangkok's Mahidol University and the Department of Medical Science in the health ministry are to submit a proposal for GPO-VIR testing on up to 16,000 HIV-AIDS patients, he said.
International group Medecins Sans Frontieres (Doctors Without Borders - MSF) welcomed GPO-VIR's launch and said it was considering buying the drugs for use internationally.
"We have used GPO drugs on hundreds of patients in Thailand and we have no reason to believe there is any problem with the quality of GPO-VIR," said the Thailand director of MSF-France Yorgos Kapranis.
"Thailand is the only country in Southeast Asia that is producing affordable generic drugs for AIDS patients," he added.
Thai AIDS activists also voiced their approval.
"This launching of the cocktail pill is a benefit on personal and national levels," said Nimit Tien-udom, director of the AIDS Access Foundation.
A previous Thai concoction touted as a "miracle cure" for AIDS, V-1 Immunitor, was distributed last year to thousands of HIV patients in Thailand before it was declared ineffective by the ministry of health.
Distribution of V-1 Immunitor touched off a storm of controversy among AIDS activists and health officials.
Public Health Minister Sudarat Keyuraphan said in a statement the success of GPO-VIR could reduce expenses for some 695,000 Thai HIV-AIDS patients, some of whom have been paying up to 20,000 baht (460 dollars) monthly for drugs.
An estimated one million of Thailand's 60 million people have been infected with HIV, and one third of those have already died.
More than 180,000 Thais contracted HIV last year and some 68,000 developed full-blown AIDS, according to the health ministry's AIDS division.
Thailand's vocal AIDS activists have long pressed the government for anti-retroviral drugs and HIV treatment to be included in a public health care scheme which allows patients to pay just 30 baht per hospital visit.
Cross-posted from AEGIS
Thursday, August 15, 2002
HIV-Positive Men NOT Eligible for Thailand's Proposed National Health Care
HIV-positive men will not be covered under the new national health care plan proposed by Thai Prime Minister Thaksin Shinawatra, the Christian Science Monitor reports. Under the plan, "underinsured" people can access any medical treatment for a 75-cent copay, and although HIV-positive women and children are eligible for the subsidized health care coverage, men with HIV are not. HIV/AIDS activists are insisting that the government provide health care for all HIV-positive people. Sen. Jon Ungpakorn, "a long-time campaigner for health care reform," has suggested that the national health insurance copayment be increased to approximately $48 per patient per year and include all people with HIV/AIDS. Ungpakorn added that the coverage must be "comprehensive" to draw in middle-class patients and keep the program from becoming "a third-class form of health care for the poor." Although the proposed health plan has not yet passed the parliament, officials have already distributed 45 million cards to potential beneficiaries. Approximately one million Thai residents are HIV-positive and 200,000 more have AIDS.
(Montlake, Christian Science Monitor, 8/14)
Brief speech by ACT UP/New York
at the Community March, Chiang Mai, Thailand, December 18, 2001 (presented in Thai and English) :
"As members of ACT UP/New York, we are honored to be with you.
"Nothing has ever been given to our communities; it has always been TAKEN by the courageous and the radical.
"The United States Government has a very poor record on AIDS and healthcare, both worldwide and in our own country:
- The United States Government makes HIV prevention ILLEGAL for people with greatest risks.
- The United States Government prohibits people with HIV from Immigration.
- The United States Government PIMPS for corporate drug-company monopolies on AIDS treatments.
- The United States is the only industrialized country in the world without NATIONAL HEALTHCARE,
leaving more than 40 million of it's population without access to Healthcare.
"The United States Government has no right to speak to other countries on AIDS Care.
"Universal ACCESS to Treatment and Care is a HUMAN RIGHT. We stand in solidarity with you."
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