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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

    

AIDS IN THAILAND

http://members.xoom.virgilio.it/joythay/pagine%20eng/AIDS%20Thailand.htm

THAILAND: AIDS, THE FIRST CAUSE OF DEAD.

They died AIDS is the first cause of died in Thailand. Today governmental sources have declared, cited from the Bbc online, finding as the virus it is now seriously threatening also social categories till now considered not to risk.

The disease advance everywhere, accomplice the disinformation, than cause a good slice of the Thai population to confuse the AIDS with one cardiovascular disease. " In the small villages one still believes that many die of infarct, but we have culvert accurate searches that demonstrate clearly as in the rural zones it dies itself mostly of AIDS ", the minister of the health Surapong Suebwong-lee has declared, also not supplying some data.

The worry of the government, than auspice to soon receive aids from the bottom for the AIDS of the United Nations, is therefore high, above all to continuation of the crescent number of professionals hit from the disease; since it testifies as huge efforts are necessary in order launch a concrete program of prevention and information.

The Thailand is between the Asian Countries with the most number of persons with the virus of the HIV and with more than million its been involved inhabitants in the prostitution industry. A market dangerously of succeeding, if every year succeeds to attract more than ten million than sex-tourists.

  The World Health Organization (WHO) estimates that by the year 2001 there will be 1,5 million HIV positive persons in Thailand.

WHO also estimates that by the year 2001 there will be 35 people dying of AIDS related illnesses per hour in Thailand. This will leave more than 95,000 children under the age of 15 as orphans. An estimated 46,000 Thais will die of AIDS this year.

The first HIV cases were reported in homosexual men in 1988, and by 1989, it was evident that heterosexual transmission by commercial sex workers would become the predominant mode of transmission. The 1990 Survey of Partner Relations and Risk of HIV Infection identified risk taking behaviors within Thai society, so that the Thai government permitted HIV warning messages in the media. In 1991, the government promoted condom usage in the commercial sex industry by recruiting cooperation among owners and sex workers. 60 million free condoms were supplied each year.

Seventy-five percent of all Thai men visit prostitutes or have "lesser wives" on a regular basis.

Twenty percent of Thailand's prostitution takes place with foreign men visiting Thailand.

Prostitution is illegal in Thailand, yet police turn a blind eye. Police receive payoffs for not raiding brothels.

Eighty-seven percent of all women and children in prostitution in the Chiang Rai and Chiang Mai provinces are HIV positive. The national numbers indicate one out of every two women and children in the prostitution industry in Thailand are HIV positiv.

There are over two million women and children in prostitution, of which 800,000 are children aged 15 or under. Twenty percent of these children are boys.

Many young girls are sold by their parents into prostitution. Parents take "loans" out on the girls, and the girls must "work" it off at a 100 percent interest rate. When the "loans" are almost paid off, the brothels give the parents another loans.

Some children are kidnapped and/or deceived into prostitution.

The Crime Suppression Division is active in raiding brothels to rescue young girls from prostitution, but there have been cases where they have resold the very girls they rescue.

The brothel owners have been known to go up to the villages in search of children who have managed to escape the brothel or who have been returned to the villages by the police. They often threaten the lives of the parents of these children if don't come back to the brothel.

Children who are HIV positive or who have full-blown AIDS have been left out in the forests to die.

HIV positive children returning to Burma have been shot or injected with cyanide in order to keep HIV infection from spreading further there.

Because of the HIV scare, girls are being forced into prostitution at younger and younger ages. Today, it is not uncommon for girls to be sold into the sex trade as young as age nine or ten.

Health experts warned the economic and social impact of the Acquired Immune Deficiency Syndrome (AIDS) epidemic will begin to hit home next year, with a dramatic jump in death rates. Dr Ghazi Farooq of the United Nations Population Fund said the cost of HIV and AIDS had reached staggering proportions. "The direct cost of HIV/AIDS in Thailand is estimated to be between seven to nine billion dollars by the Year 2000," he said, adding the indirect costs such as lost productivity were much higher. "It reduces the quantity and quality of labour and therefore the gross national product," he said, repeating a warning by Malaysian Prime Minister Mahathir Mohamad that AIDS had the potential to derail economic recovery in the region. "It decreases the volume and rate of savings and creates a vicious circle of less productive employment, lower incomes, lower growth and lower levels of GNP (Gross National Product),"  AIDS had already caused a 16 percent jump in death rates in Thailand alone, particulary among young people who should have been at the peak of their productivity. 

The sex industry was, "the dark underside of Asia's economic boom" "Whereas Southeast Asia's commercial sex scene was once dominated by Japanese and Western clients, it's increasingly being shaped by the buying power of  Taiwan, Hong Kong and other tiger economies-as well as the newly-awakened might of China." The organized crime network is involved in the trafficking of women and children. Women and children are sent to Thailand from neighboring countries: Burma, Cambodia, Laos, and China. Some work in Thai brothels and others are sent to Hong Kong, Taiwan or Japan. The other route from Thailand is to Malaysia, Australia, and the Philippines. Through the Philippines, they are also sent to big economic superpowers.

But today the profile of Aids victims in Thailand is changing, and Aids campaigners like Chiaramuch Premchaiporn, of the Bangkok based counselling group Access, say it is no longer enough just to target the sex industry."We found that can happen with every group in Thailand, and maybe we have to pay more attention to intravenous drug users and the people who have casual sex, especially young people," he said.Access counsellors say that they are getting increasing numbers of calls from married women who have been infected by husbands, who in turn were infected after having sex with prostitutes.There are also large numbers of infected children appearing, who were born to parents with HIV.

    


 ACCESS TO HIV TREATMENT IN THAILAND


HIV/AIDS is a disease that affects many parts of society. It decreases child survival and life expectancy. There is an increased number of orphans and the healthcare system is overburdened. Most people with HIV/AIDS are of working age, which means losses to business as well. The situation for people with HIV/AIDS has been made worse by the economic crisis that has affected Thailand since the middle of 1997.

In spite of Thailand's successful approach to prevention of HIV infection, about one million people are infected with HIV. In 1995 a World Bank / WHO review advised Thailand to focus its limited HIV drug resources on the prevention of perinatal HIV infection and on management of opportunistic infections. The AIDS Division has issued guidelines for prevention and treatment of opportunistic infections. Short-course zidovudine to limit perinatal transmission is also being implemented.

However these interventions alone are not an answer to the huge amount of personal suffering and social disruption caused by the HIV epidemic. The reality is that few patients can afford antiretrovirals: the monthly price of effective treatment regimens containing three drugs is in the range 18,000 baht to 26,000 baht per month.

In fact the real price of most of these drugs should be much lower. Drugs such as AZT, ddI, d4T, 3TC, efavirenz and niverapine are simple compounds which are easy to produce and formulate. The Thai Government Pharmaceutical Organisation (GPO) has supplied generic AZT (zidovudine) since 1993. The resulting competition led to a fall in the price of AZT 100mg capsule from 48 baht in 1992 to 12 baht in 1995.

Antiretroviral drugs have an expensive image because of marketing practices of the pharmaceutical industry. The industry claims that it needs to sell the medicines at a high price to recoup costs of research and development, but in fact most of these drugs were developed by US Government funded institutions, not the pharmaceutical industry.

Thailand is capable of producing good-quality cheap generic drugs, but local production has been limited by US government trade pressure. The US government regards TRIPS as a minimum standard and in bilateral discussions often asks for additional commitments, using threats of trade sanctions to achieve its objectives. The US is the destination of 25 % of Thai exports, so these threats are taken very seriously.

Thai pharmaceutical companies produce high quality, affordable generic drugs from imported raw materials. A good example is  FLUCONAZOLE.
Fluconazole is a key drug in the management of cryptococcal meningitis, a lethal opportunistic infection affecting one in five AIDS patients in Thailand. Until recently Pfizer was the sole supplier of fluconazole in Thailand, charging a daily price (dosage: 400mg) of more than 500 baht. In 1998, fluconazole was released from SMP protection in Thailand and is now supplied by three local pharmaceutical companies. The price has fallen to five percent of the 1998 price, which represents a huge potential annual saving to Thailand in the treatment of cryptococcal meningitis. HIV physicians have reported improved compliance with treatment now that the treatment is more affordable. Medicine Sans Frontiere is examining, if the experienced decline in cryptococcal meningitis can be scientifically documented.

In 1992, under threat from the US to limit textile imports, the Thai government passed a law banning parallel imports (parallel imports will be allowed again with the amended patent law going in effect 1999). In 1993 Thailand introduced pipeline protection for pharmaceuticals under pressure from the United States. As a safeguard, the Thai government created the Pharmaceutical Patent Review Board, which had authority to collect economic data, including the production cost of pharmaceuticals. The US Trade Representative Office objected and in 1998, under threat of higher tariffs on imports of wood products and jewellery, the Pharmaceutical Patent Review Board was disbanded and measures were taken which led to banning the right to issue compulsory licenses for pharmaceuticals.

SEPTEMBER 2001 - Pfizer Inc. announced that it will offer Diflucan antifungal medicine at no charge to HIV/AIDS patients in the fifty least-developed countries as identified by the United Nations where HIV/AIDS is most prevalent. Diflucan is not an anti-retroviral medication such as those that make up what is known as "AIDS cocktails," used in HIV-infected patients to prevent them from getting full blown AIDS. Instead, it is used to treat such opportunistic infections as cryptoccal meningitis, a life-threatening illness often seen in AIDS patients. 


THAI AIDS "CURE" DISPUTED

June 2001 - A treatment touted as a "miracle cure" for Aids by a Bangkok pharmacist has been attacked by official agencies tackling the disease. Local people infected with HIV, or who have developed full-blown Aids, have been flocking to see Vichai Jirotthi-tikal, to get supplies of his drug "V-1 Immunitor". However, the drug has never undergone any clinical trials, and although Vichai says that some patients have enjoyed radical improvements in their health, this has not been independently verified.

I have a great deal of sympathy for those who want treatment, but it is misleading to make these sorts of claims.

Instead the pharmacist has been criticized for "offering false hope" to the estimated 1,2 million in Thailand who have HIV/Aids.

The drug is a mixture of calcium, magnesium and traces of the virus itself.

When a week's supply was offered free of charge in the city last week, 4,000 people, many seriously ill with the disease, tried to get hold of the drug.

Vichai said : "The data from the blood tests show we can help patients who are HIV positive to develop themselves and have a healthy life. They are normal - they can work."

He claims that the virus has been "eliminated" in two patients, and that symptoms have been eased in other patients.

However, there have not only been no clinical trials of V-1 to test its safety and efficacy, but it is not licensed as a treatment by the Thai government.

Bernard Gardiner, regional manager for HIV/Aids for the Red Cross, said: "I have a great deal of sympathy for those who want treatment, but it is misleading to make these sorts of claims."

That country's health ministry says it plans to study the drug, and has been urged to do so quickly by Prime Minister Thaksin Shinawatra.

Vichai says he will continue to dispense it as long as there is a demand.


BIG PHARMA

Therefore the druggist multinationals come calls, the colossus that produce medicinal and that they dictate their law to the governments of all the world. The first one to defy the Big Pharma has been Nelson Mandela when, in the ' 97, promulgated the "Medical Act ", a norm that would have concurred with the South Africa to use copied  that is " generic " anti-Aids drugs ", on which the not satisfied patent royalty and therefore to low cost. The so-called one cocktail of medicinal that it serves to slow down the course of the disease, is in fact " property " of the multinationals and the costs you set up from Big Pharma are absolutely prohibitive for the governments and the inhabitants of Africa (that it records 25, million persons suffering from Hiv on calculated 36,1 million in the world) and the other poor Countries. Although Big Pharma has carried in court the South African government with large waste of means, in this case has lost the game: it has had to withdraw the citation and in the meantime other Countries have decided of to revolt to the hard law of the business: Kenya, India, Brazil, Thailandia. where the AIDS kills thousand of persons every year. they have begun to import generic drugs, although Big Pharma at all has not surrendered and obstacles in any case " the copied " import of the cocktail. Strongly, moreover, of the international regulations on the rights of the intellectual property. But it can be worth this norm of forehead to epidemics as those provoked from the AIDS, the malaria, the hepatitis? The World Health Organization says not and this clause has been appealled also from Brazil for being able auto-production the anti-Aids drugs. The Brazilian druggist industries sell the cocktail (and evidently they gain a profit) to 700 dollars for annual administration. The patented version of Big Pharma costs instead between the 10.000 and 15.000 dollars. But because much difference of price between home product drugs and those " officials " of the multinationals? The British writer John Le Carre explains with great clarity'. Its last novel " Constant Gardener " is developed around a cruel case of experimentations on human guinea-pigs
that give to the Kenya door in the elegant offices of some druggist multinationals. Like always, before writing, celebre the author has passed a period to study the truth that then he would have told in the novel. And on purpose of the costs " swollen " of drugs Le Carre'  explains that the great companies patent not only the substances that compose it, but also the fabrication process, the posology, the type of administration. A compound can be bound from ten, twelve licences: a system in order to hold to attends the generic drug producers. " Why until when the licence is in the hands of Big Pharma. Le Carre' has said. the profit margin is astronomical ".

 

PRIORITY THAILAND

As those infected in the past fall ill, there is an increasing demand for AIDS-related medical care -palliative care, prevention and treatment of opportunistic infections, anti-retroviral therapies, and end of life care. At the same time, the sustained response on prevention appears to be in danger. Overall public expenditure on the national AIDS program has declined by 28% since 1997 and the prevention budget has declined by half.

The new National Plan for the Prevention and Alleviation of HIV/AIDS in Thailand has two key objectives. Firstly, it aims to prevent the spread of HIV in the general public and secondly, the plan is aims to reduce the impact of the AIDS epidemic on the population. Success in overcoming the epidemic is going to require the joint efforts of many partners in government, the private sector, and the population in general.

Three activities have been identified by the government as a priority in tackling the HIV/AIDS epidemic in Thailand. Firstly, there must be renewed efforts to sustain condom use in commercial sex as well as increasing condom use and encouraging safer sexual behaviour amongst other groups at high risk. As Thailand recovers from an economic crisis, rising incomes are likely to lead to renewed demand for commercial sex. With 17% of brothel - based sex workers already infected, any lapse in condom use could have an explosive impact on the epidemic. Condom use has never been universal among 'indirect' sex workers, and sex workers who have been trafficked from neighbouring countries are a potential gap in the 100% condom programme. Behaviour change and condom use among other high-risk groups, like men who have sex with men, male sex workers, prisoners, fishermen, and others at high occupational risk would have a relatively large impact on the epidemic relative to their cost.

As part of the general effort to increase condom use the government plans to subsidise the cost of condoms as well as selling them in vending machines. Their sale through vending machines will save shy Thais the embarrassment of a visiting a shop such as a supermarket or drug store, where most shop assistants are women. The government has said that in 2001 they will start selling subsidised condoms at five baht ($11 cents) for a pack of two, compared with the usual price of 20 baht. The subsidised condoms will be sold in public facilities, such as factories, police stations and military barracks, but good spots to install the vending machines will have to be found, as otherwise the condoms will loose their quality or be destroyed by insects.

The second priority for the government is to set up a major initiative to prevent transmission by injecting drug use. HIV prevalence has been high and rising among injecting drug users (IDU). It has been estimated that a quarter of all new adult infections result from transmission by injecting drug use. HIV spreads not only among addicts but also to their partners and wives, and then to their children. However, HIV prevention for IDU and their sex partners has never been a priority in Thailand, despite the fact that IDU transmission is an important feature of the AIDS epidemic in almost all countries. To have a major impact on the epidemic, the same kind of policy that has been used in prevention of HIV among sex workers needs to be extended to injecting drug users. It is unlikely that the IDU transmission cycle can be broken unless there is a continuous effort to prevent HIV transmission in prisons and to improve the legal environment for behaviour change among IDU.

The third priority is to ensure that people with HIV/AIDS have access to cost-effective prevention and treatment of opportunistic infections. People with HIV/AIDS can fall seriously ill and die from curable infections that people with normal immune systems can resist. The most important of these infections in Thailand is tuberculosis (TB), but there are many others, for example pneumocystis pneumonia (PCP). Ensuring access by people with HIV /AIDS to prevention and treatment of the major opportunistic infections would be inexpensive and cost-effective. It would extend life and improve its quality, and particularly benefit poor AIDS patients who otherwise might well not have their infections treated.

The cost of these plans has yet to be worked out. However, going ahead with the plans will require increased public spending on prevention in general, and greater targeting of subsidies to NGOs for prevention among hard-to-reach groups at high risk of contracting HIV and spreading it further. The public finance implications of wider access to HIV prevention and treatment of opportunistic infections are difficult to pinpoint, as there is still uncertainty about the existing level of access, use, and finance.

AT THE FOOTSTEP OF BUDDHA

Isolated at the bottom of a hill from nearby communities, far from the scrutiny of the public life lies wat phrabat Nampo, a Buddist Temple in central Thailand that houses more than 300 patients dying from AIDS and over 3000 waiting to be admitted. The temple is Thailand's largest AIDS hospice and was founded by a monk who witnessed hundreds of Thais dying without proper care in hospitals around the country. Despite a major education  campaign AIDS  is still misunderstood in Thailand and as a result people who are infected are often ostracized by their community, many patients are abandoned at the hospice by their families leaving them to die alonely death. Monks infected with the HIV virus are among the residents at the hospice, many of whom arrive from other temples where they were told to leave once they were found to be infected. for the monks the hospice is arefuge where they can die in peace. Professional caregivers and volunteers try to make the patient's final days as comfortable as possible at the hospice supplying  medicine and beds made possible with donations from around the country. At Wat Phrabat Nampo an average of 2-3 patients die everyday from AIDS.

  

    

International Activity Report 2001

Drug Therapy and Home Care Help AIDS Patients MSF's work in Thailand focuses largely on relieving the suffering of some of the 750,000 people living with AIDS by tackling the issues of access to medicine and sustainable care.

MSF's successful campaign for local production of generic antiretroviral drugs (ARVs), run in collaboration with a network of Thai NGOs, provided direct benefits to the Thai population in spring 2001. Triple therapy ARV treatment began for ten home care AIDS patients and 30 in the hospital in Surin in May.

In the Bangkruai area, MSF provides ARV drugs to 40 patients; it is hoped this program will expand to 250 patients. MSF is committed to the project for at least five years to ensure quality and continuity of care. In Bangkok, MSF makes regular home care visits to another 70 people, 20 of whom also receive antiretrovirals.

MSF is also campaigning for access to drugs to treat opportunistic infections and has run a series of training sessions for Bangkok pharmacists.

These projects are complemented by the ongoing work of MSF in offering technical assistance, training, and support to community hospitals, health stations, and local NGOs in the Ban Laem and Panom Thuan districts.

MSF assists Karen refugees from Burma in camps near the border towns of Mae Sot and Ratchaburi, and the Mons refugee community in Sangklaburi. Teams provide basic medical care, prenatal consultations, and vaccinations.

Since 1999, MSF opened a health center for tuberculosis patients in Mae Sot. The program targets illegal migrant workers. Teams treat patients in the health center, at home or in the places where they work.

MSF has been in Thailand since 1983.

HIV/AIDS RESOURCES IN THAILAND


Anonymous Clinic – Thai Red Cross 
1871 Thanon Rama IV, 
Bangkok. 
Tel. 256-04109 

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Bodang Drop-in Center 
830 Galaxy Lane, Thanon Rama IV 
Bangkok. 
Tel. (66-2) 236-8421, 236-8422. 

Hours: Mon.-Fri. 12.00 to 17.00; Sat. 09.00-12.00. This Wednesday Friends Club-sponsored center of-fers services for people with HIV/AIDS that include a hostel, weight room, support groups, counseling, vitamin shop, karaoke. Most services are free. Hostel is Baht 30- per night. 

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Counseling Centre & HIV/AIDS Clinic Hotline 
Tel. (02) 276-2950, 277-7699. 
Fax (02) 691-4057 

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Doctors without Borders/Medecins sans Frontiers 
Bangkok Tel. (02) 375-6491 
“We provide healthcare for people with AIDS. If you or your friend has HIV and is ill, please contact us. Our service is free, confidential, and friendly.” 

 HOSPICE
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Baan Peuan Cheewit 
183 Moo 4, behind Wat Mai Huay Sai, 
Suthep sub-district, 
Muang, Chiang Mai. 
Tel. (053) 283-272 or 01-952-5944. 

Phra Phongthep Dhammagaruko, a Thai Buddhist monk, established a temple hospice for people with AIDS in the Northern Thai city of Chiang Mai. The hospice is called Baan Peuan Cheewit [House of Friends of Life], it also assists people with AIDS who are abandoned by their families and provides training to families in proper care of people with AIDS. 

PEOPLE WITH HIV/AIDS 
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Wednesday Friends Club 
Hotline (02) 253-2666. 
Support and social organization for people living with HIV/AIDS. 

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Life Giving Life Group 
Pastor Apidech Chairacha 
Runruang Dhamma Church, 
Moo 4, Tambon Chaechang, Sankampaeng District, 
Chiang Mai 
Tel. (053) 880-144. 

People with HIV/AIDS are organizing themselves to help one another but they receive little help from society. The Life Giving Life Group is an organization of People with HIV/AIDS. This group cares for more than 200 patients in Chiang Mai and Lamphun. The project is however short of funds and needs help. 

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People with HIV/AIDS Coordinating Center 
Khun Prasert Dechaboon 
Tel. (053) 495-571. 
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Life and Hope Club, 
No. 5 Soi 2 Seree 1, Seree 2 Road, 
Suan Luang, Bangkok 10250, THAILAND 
Tel. (02) 318-5600. Pager 152: call 472-925. 

Khun Ittirak Smithsuwan is an HIV-positive person who bravely went public. Khun Ittirak established the Life and Hope Club to dispel myths and fight discrimination against people with HIV and AIDS. 
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Welcome House 
G.P.O. Box 2878, 
Bangkok 10501 
Tel: (02) 234-2381, 234-8258. Fax: (02) 635-0334 
Contact person: Ms. Komkai Hamamool, Welcome House director 

People with HIV and AIDS arrive at Welcome House rejected and scared. At this shelter, they find a home that is welcoming and free of discrimination. 

Savings account name: Catholic Mission AIDS (Welcome House) 
Savings account number 031-3-07241 (-7) 
Bank name and branch: Thai Danu Bank, St. Louis Hospital Branch 

MEDICINE BANK 
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New Life Friends Center 
9/57 Suthep Road, 
Tambon Suthep, 
Chiang Mai 50200 
Tel./Fax: (053) 808-233 
Founder: Khun Samran Takan 

In 1998 the government stopped subsidizing virtually all AIDS drugs. This group of people with HIV/AIDS in Chiang Mai organized an AIDS medicine bank to help each other get access to the ex-pensive lifesaving drugs. 

Savings Bank account name: New Life Friends Centre 
Bank account number: 504-022863-6 
Bank name and branch: Bangkok Bank, Suthep Road, Chiang Mai 

HIV/AIDS NGOs 
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Thai Youth AIDS Prevention Project - Chiang Mai 
P.O. Box 287, 
Chiang Mai 50300 
Tel. (66-53) 220-924 
E-mail: tyap@loxinfo.co.th 
Hours 09.00-24.00. Northern Thailand is hardest by HIV. This nongovernment agency, set up in 1995, targets young people for its HIV-prevention programs. 

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Duang Prateep Foundation 
Lock 6, Art Narong Road, Klong Toey, 
Bangkok 10110 Thailand 
Tel. (02) 249-4880, 249-3553, 671-4045(-8). 
Fax (602) 249-5254 
E-mail dpf@internet.ksc.net.th 
Web: http://www.capcat.ksc.net/org/duang.html 

The Duang Prateep Foundation has numerous development and assistance programs in Bangkok slums, and your support and donations will be used well. Their AIDS Project work combines AIDS education with caring for people who are suffering from AIDS related illnesses. AIDS education is targeted at all sectors of Bangkok slum society and at sex workers living and working around Bangkok slum communities. 
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Community AIDS Care Project 
NorthNet Foundation 
225/112 Sintana Village, Moo 2, 
Tambon Sanpranate, Amphoe San Sai, 
Chiang Mai 50210 
Tel: (053) 380-566 
Contact persons: Ms Siriphan Garagate 
or Mr. Pasakorn Intoo-Marn 

This NGO coordinates rural programs to assist people with HIV/AIDS in Thailand’s Northern region, which has been the most affected by HIV/AIDS. 
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Health Hotline Fund 
Tel: 01-978-2127 or 01-606-5347. 
Contact person: Dr. Boonriang Chuchaisaengrat. 

Phuket Island’s health chief, Dr. Boonriang Chuchaisaengra, set up a fund to battle HIV/AIDS with education and the bigotry that comes from misinformation; to tackle wider social problems, such as poverty and prostitution; and organizes people for mutual support. 
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The Sangha Metta Project 
Mahamakut Buddhist University, Lanna Campus, 
Wat Chedi Luang Worawiharn, 
103 Phra Pokklao Road, Muang District, 
Chiang Mai 50200 
Tel: (053) 814-405 
Fax: (053) 278-551 
Email: laurie@cm.ksc.co.th 

Contact person: Mr. Lawrence Maund 

Buddhist monks are both spiritual and community leaders in Thailand. They can play a significant role in supporting people with HIV/AIDS. The Sangha Metta Project encourages monks to offer practical and spiritual help to people with HIV/AIDS and to assist their communities to be more understanding and caring. 

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Pearl S. Buck International (Thailand) 
6th Floor, Interlife John Hancock Bldg., 
364/30 Sri Ayudhaya Road, Ratchathewi, Bangkok, 10400 
Tel: (02) 642-6357 (-8) 
Fax: (02) 642-6359 
Under the auspices of the Pearl S. Buck International association, a group of people with HIV and AIDS work to support others with the virus and spreading the important safe-sex message. 

Contact person: Khun Yowalak (Thiarachow) Tatichotioan. 

 WOMEN
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Thai Red Cross Save A Child's Life for AIDS Project 
1871 Rama IV Road, 
Bangkok 10330. 
Tel. (66-2) 256-4107-9. Fax. 254-7577. 
The Thai Red Cross Society helps provide HIV-positive pregnant women a free AZT, which will dramatically reduce the newborn's chances of getting HIV from their mothers. Baht 50 (US$1.35) means one day's dose of AZT for one woman. 

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Ban Huay Sai Ruam Jai 
58, Moo 6, Ban Doi Siew, 
Huay Sai, San Kamphaeng, 
Chiang Mai 50130 
AIDS Widows struggle to make ends meet and are oppressed by social discrimination. Ban Huay Sai Ruam Jai (The Huay Sai Togetherness House) helps them. 

Contact persons: Mrs Surapi Panchote or Mrs Urai Fonchan 

CHILDREN
Estimates are that by the year 2000 Thailand will have over 120,000 AIDS orphans. The Sem Pring-puangkeo Foundation in Bangkok and Chiang Mai distributes donated funds that sponsor the education of orphans whose parents or guardian died of HIV. Financial needs for sponsoring a small children can range from Baht 3,000 to Baht 5,000 baht a year (US$81 to $135) and for older children Baht 4,000 to 6,000 baht a year (US$108 to $162). 
Sem Pringpuangkeo Foundation's Children Fund 
219/28-31, Asoke Tower Building, 9th floor, 
Sukhumvit 21, Bangkok 10110. 

Tel. (02) 260-0229. Fax. (02) 260-2606. 
Contact person: Khun Somporn Pinaksornskul. 

Sem Pringpuangkeo Foundation's Children Fund 
225/164 Baan Lomnam, Moo 2, 
Chiangmai-Lampang Road, 
Tambon Nongpueng, Sarapee district, 
Chiang Mai 50140. 

Tel. (053) 423-862. Fax. (053) 438-017. 

Sem Pringpuangkeo Foundation 
300/301, Grand Ville Village, 
Chiang Mai-Hang Dong Road, 
Chiang Mai 50200. 

Tel. (053) 805-838, Tel./fax (053) 807-220. 

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AIDS Babies Center 
41/2 Bumrungburi Road, 
Tambon Prasing Muang, 
Chiang Mai 50200 
Mailing address for AIDS Babies Center: 
Care Corner Thailand 
P. O. Box 38 Prasing Post Office 
Chiang Mai 50200 

Tel./Fax : (053) 278-176 
Founder: Ricky Tan 

HIV-infected children are likely to die young, but a group of caregivers in Chiang Mai help ensure these babies' short lives are filled with love. 
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The Agape Home 
101/22 Chiang Mai-Lamphun Road, 
Tambon Nonghoy, Muang district, 
Chiang Mai 50000. 
Or 
P.O. Box 95, 
Chiang Mai 50000, Thailand. 
Tel/fax (053) 800-946. 

THE AGAPE HOME in Chiang Mai provides love and care to many HIV-positive babies. Donations and volunteers are needed.
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Consensus Statement in Opposition to Licensure of Remune As Monotherapy for HIV Infection in Thailand

"Without a large burden for past research and development ... and based on a minimum gross profit of $75 per dose of Remune sold ... gross profit potential could rise to $35 million [a year] or higher." 
-- James S. Namnath
Chief Executive Officer, Trinity Medical Group
(Source: SEC form 10KSB, 3/18/2002)

We wish to express our strong concern about pending plans for the so-called Remune HIV vaccine to be sold as a drug to combat HIV infection in Thailand. Remune is an inactivated HIV preparation that was developed by the Immune Response Corporation originally of Carlsbad, CA. The company's original plan for Remune was that it should be a vaccine to prevent HIV infection, a role for which it is ill-suited, and for which it has yet to demonstrate any form of efficacy. In recent years, Remune has been evaluated extensively in the U.S. and Europe as a therapeutic vaccine, initially by itself; more recently as an adjunct therapy in people receiving combinations of approved antiretroviral drugs. There is no scientific evidence to support the use of Remune as monotherapy; it does not work, and it is unlikely ever to be licensed by the U.S. FDA for this purpose in the U.S. Studies in both the U.S. and Europe are in progress to determine whether Remune might have some role as an adjunct therapy, but the available data are ambiguous at best, and controversial at worst. 

Remune has been licensed by the Immune Response Corporation to the Trinity Medical Group, a Thailand-based company, for development within Thailand. Clinical trials of Remune are ongoing in Thailand, in part conducted by a leading official in the Trinity Medical group who is also an influential figure in the Thai medical/business community. A recent decision was made by Trinity Medical Group to have Remune evaluated by the Thai FDA as a drug, not as a vaccine, a decision that is ill-founded in science but which has been perceived as providing the company with an easier route to licensure. The practices that have led to the now-pending licensure of Remune in Thailand would not be permitted in the U.S., due to procedural breaches. The problems appear to include, but may not be limited to, inattention to conflict-of-interest regulations that should apply to the conduct of clinical trials by a product's sponsor. 

It now appears that Remune will be licensed as a drug for use in Thailand as front-line monotherapy (i.e., the drug will be sold to HIV-infected Thai people to be used as the only therapy they are taking against HIV), despite the lack of any evidence of clinical benefit. We deplore and condemn this situation. A product developed by an American biotechnology company should not be sold to HIV-infected people in the developing world unless it has been proven to be safe and effective in the population for which the product is to be marketed, in studies which meet U.S. ethical and regulatory standards. Studies of HIV vaccine products may need to be conducted in different populations depending on the viral strains on which they were based, and taking into account the hypothesis being studied in the particular vaccine trial). That situation does not apply to Remune in this case. Indeed, all the available scientific evidence strongly suggests that Remune has no effect on the course of HIV disease when used as monotherapy. It is morally unacceptable for an American company and its Thai subsidiary to profit in any way from the sales of an ineffective drug. The sums of money spent by Thai citizens on this product will be wasted; instead, the treatment priorities in Thailand should be the provision of highly active antiretroviral therapy (HAART) and of treatment and prophylaxis for opportunistic infections and tuberculosis. 

There is an urgent need for the countries of the Western world to bring effective HIV therapies to the nations of the developing world. These efforts will be compromised if American companies behave other than ethically in attempting to sell their products. The sale of an ineffective drug in Thailand could have serious, long-term and widespread adverse implications for the reputations of Western science and industry. We therefore demand that the Immune Response Corporation and its local affiliate cancel all their attempts to make money from sales of Remune in Thailand, unless and until they develop clear evidence

 

 

 

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