Thailand and America build on their success in fighting Aids; Eric G. John, U.S. Ambassador to Thailand; Op-Ed in The Nation; Thailand

December 1, 2010

World Aids Day is both a day of remembrance and a day of celebration. We must all remember those who have lost their lives to Aids. It's in their honour that we work each and every day to provide HIV prevention, treatment and care to millions across the globe.

Yet, it's also a day to celebrate those whose lives have been improved and saved in Thailand, thanks to outstanding efforts by the Royal Thai Government to fight this devastating disease. On this World Aids Day, it is important to remember that we have a shared responsibility to build on the success achieved to date by making smart investments that will ultimately save more lives.

US support continues, despite difficult economic times. Building on the success of the US President's Emergency Plan for Aids Relief (PEPFAR) and other global health programmes, President Barack Obama also put forward an ambitious Global Health Initiative, which supports coordinated programmes aimed at reducing lives lost to HIV/Aids and other health challenges.

Through US investment in the Global Fund to Fight Aids, Tuberculosis, and Malaria, many more people will benefit. PEPFAR supported Thailand in 2010 with US$5.5 million (Bt162 million) and will provide the same in 2011.

While great strides have been made in HIV prevention, care and treatment, Thailand is vulnerable to a resurgence of its HIV epidemic, especially in men who have sex with men, who make up the highest number of new HIV cases in the Kingdom. In addition, HIV prevalence rates among injecting drug users are still quite high. Responding to these trends, over the past five years US government agencies, the Ministry of Public Health and non-governmental organisations (NGOs) have focused on new ways to prevent HIV in Thailand.

PEPFAR is only one part of extensive regional health cooperation conducted by the Centres for Disease Control and Prevention (CDC), the US Agency for International Development (USAID), and US Army Medical Component-Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS). The US Peace Corps has worked in Thailand since 1962, and has 90 volunteers here, some involved with HIV/Aids.

The US National Institutes of Health also has a long history in Thailand, and the National Institute of Allergy and Infectious Diseases funds over 30 projects, including the HIV/Aids Clinical Trials Networks. The US brings together our best minds to respond to the epidemic, learn from one another, and share best practices learned in Thailand, supporting Thailand's increasing leadership role.

CDC, in collaboration with Thai government partners, conducts ongoing clinical preventive research among men who have sex with men, a population whose risk level is increasingly high. CDC works with the Ministry of Public Health to design, implement and evaluate programmes that have been used as models by other countries.

Together, USAID and CDC work to identify priority issues, develop and evaluate model programmes, and incorporate programmes into routine systems. While CDC focuses on the public sector, USAID builds capacity with non-governmental organisations and peer-to-peer approaches in HIV prevention. These approaches are effective in reaching highly stigmatised communities - such as men who have sex with men - through behaviour change messages, condoms and outreach.

USAID partners, Pact and FHI, work with provincial offices linking community groups to HIV counselling, testing and community care, which supports earlier access to treatment and longer life.

Another successful US-Thai collaboration is the groundbreaking Phase III HIV vaccine trial conducted in Chonburi and Rayong provinces, known as RV144. For the first time in over two decades of research, a trial has shown that an HIV vaccine can be safe and effective - providing a light at the end of the tunnel.

AFRIMS plans to build on the findings of RV144 next year with two follow-on trials to further understand the body's immune response to the vaccine that helped prevent HIV infection, continuing close collaboration with its trial partners, the Ministry of Public Health, the Thai Aids Vaccine Evaluation Group, and other research institutions.

On this World AIDS Day, we honour the lives lost and celebrate the lives saved, but we cannot rest. Working together, we must remain dedicated to building on success by making smart investments to save even more lives.

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