Here is an important press release from Human Rights Watch:
(Bangkok, November 29, 2007) – Thailand’s failure to address the HIV epidemic in the hardest-hit population, drug users, is jeopardizing its record as a leader in the global fight against AIDS, Human Rights Watch and the Thai AIDS Treatment Action Group said today in a report released in advance of World AIDS Day.
In violation of its constitutional and international human rights obligations, the Thai government has systematically failed to prevent and treat HIV infection among drug users. The Thai government estimates that 40 to 50 percent of injection drug users are living with HIV in Thailand – virtually unchanged over the past two decades.
The 57-page report, “Deadly Denial: Barriers to HIV/AIDS Treatment for People Who Use Drugs in Thailand,” found that routine police harassment and arrest – as well as the lasting effects of former Prime Minister Thaksin Shinawatra’s 2003 drug war – keeps drug users from receiving lifesaving HIV information and services that Thailand has pledged to provide. The report also documents how drug users face discrimination from health care workers, who continue to deny antiretroviral treatment to people who need it based on their status as drug users.
“Thailand wants to be seen as a success story in the fight against AIDS, yet it is failing to address the epidemic among the population hit hardest by HIV,” said Rebecca Schleifer, advocate with the HIV/AIDS and Human Rights Program at Human Rights Watch. “The Thai government has recognized that the HIV infection rate is ‘unacceptably high,’and it has the expertise to address this public health emergency.”
Thailand has been lauded as a global leader among developing countries for its aggressive HIV prevention programs and its efforts to provide universal access to HIV treatment. Yet Thailand never reached out with prevention programs to injection drug users.
In 2003 the government of former Prime Minister Thaksin launched a repressive “war on drugs” that resulted in the extrajudicial killings of at least 2,275 extrajudicial killings of drug users or dealers. A lasting consequence of this campaign has been to drive many drug users away from effective HIV/AIDS prevention and treatment, out of fear of arrest and police violence.
In response to drug users’ advocacy, the Thai government has taken some steps to reduce some of the barriers for drug users to HIV services. In 2004, Thailand rescinded a national policy that explicitly permitted the exclusion of injection drug users from antiretroviral treatment programs.
But drug users still face serious obstacles in accessing needed health care. Many health care providers do not know or do not follow HIV/AIDS treatment guidelines, and continue to deny antiretroviral treatment to drug users, even those in methadone treatment programs.
“An HIV diagnosis is still a death sentence for most drug users in Thailand,” said Paisan Suwannawong, director of the Thai AIDS Treatment Action Group. “Thailand must stop discrimination against drug users seeking health care services, or it will never meet its promise to ensure access to AIDS treatment to all who need it.”
Out of fear of reprisal, drug users who do receive antiretroviral treatment are unlikely to tell their physicians about their drug use, or to seek information about drug dependence treatment from their antiretroviral treatment provider. This fear is not unfounded: the report confirms that many public hospitals and clinics share information about drug use with law enforcement, both as a matter of policy and practice. Some clinicians operated a “don’t ask, don’t tell” policy toward drug users, refusing to inquire about patients’ drug use or drug treatment history, in some cases despite knowledge or suspicion of current drug use or methadone treatment.
The government’s failure to ensure conditions in which safe exchange of information is possible compromises drug users’ access to adequate HIV and other health care services. As a result, drug users face harmful drug interactions without health care workers to consult about the dangerous potential consequences for their health and, ultimately, their lives.
The Thai authorities have provided minimal support for harm-reduction services for drug users, notwithstanding their proven effectiveness. These limited harm-reduction programs are seriously undermined by the government’s ongoing, repressive anti-drug campaigns. Police regularly interfere with drug users’ efforts to seek health care by harassing clients outside of drug treatment centers. Police also use possession of sterile syringes, or presence at a methadone clinic, as a basis for drug-related criminal charges.
“The Thai government pays lip service to its official policy, which is to treat drug users as patients rather than criminals,” said Suwannawong. “In reality, police collect information about drug users from health clinics, and arrest peer outreach workers outside drug treatment clinics. Dug users risk criminal charges if they seek health care services which are theirs by right.”
The report also found that incarcerated drug users have an even harder time obtaining needed HIV prevention, care and treatment services. Antiretroviral therapy is available only on an extremely limited basis to prisoners. Many Thai drug users spend time in pre-trial detention or prison, often cycling in and out of government detention facilities. The government has also failed to take measures to ensure that fundamental services (antiretroviral treatment and other HIV-related medical care, harm reduction, drug-dependence treatment, and psychosocial services) are coordinated in the general community, or with services provided on entry to or exit from prison.
Thailand’s new National AIDS Plan – launched in 2007 under the current military government of Prime Minister Surayud Chulanont – recognizes the authorities’ failures in combating HIV and AIDS among drug users and prisoners, and proposes to scale up efforts to ensure access to HIV and AIDS prevention, care, and treatment services to them. This commitment follows a number of other similar public undertakings that have, remained unfulfilled, however.
“Thailand needs to translate its written commitments on HIV/AIDS into action,” said Schleifer. “If the authorities don’t immediately address the systematic human rights violations committed against drug users by police and health care providers, the government will be contributing directly to the continued spread of HIV.”
10 responses so far ↓
1 Grasshopper // Nov 29, 2007 at 9:08 pm
What a load of rubbish. I thought the only interesting mention in the article was that the military govt has a more forgiving policy towards sick people. Otherwise, the core of this tirade can be applied to every government in the world. HRW is hilarious. Can I please have some chai tea…? oh and a sandalwood candle thanks.
2 Bob // Dec 1, 2007 at 12:47 pm
Nice touch of compassion Grasshopper.
Today is World AIDS day.
http://en.wikipedia.org/wiki/World_AIDS_Day
3 Grasshopper // Dec 1, 2007 at 9:32 pm
Bob, of course I am going to say “I’m not not being compassionate”.
I do not think bleeding away with Human Rights Watch is any sort of virtuous occupation; more it is endemic of the gross laziness that besets believers in overarching solutions through the application of exceptionalised and particular rights. How can people be compassionate in situations where they are not directly involved? By condemning actions and inactions in far off lands I can still sleep in a comfortable bed at night. HRW epitomizes those people who can call the kettle black yet still find that they are able to ‘fight the good fight’. I have as much compassion for those people who found themselves in situations that have resulted in them contracting AIDS as I do with the people whose blood has been spilled for my car trips to university. Is that then no compassion because of my own inaction? Thanks HRW writers for detailing our ending.
If you have AIDS Bob, then I cannot express anything beyond this honesty that could be found sincere enough to be peaceful with.
4 Bob // Dec 2, 2007 at 7:40 pm
Fortunately I don’t have AIDS. But I know people in Thailand who do. There, unlike in our comfortable west, it is still a virtual death sentence for most.
At the current rate, just under 1000 of their fellow suffers worldwide died of AIDS today.
Your attempted justification for lambasting others’ efforts against AIDS, and rationalization of your own inaction, only confirms my original assessment.
5 Grasshopper // Dec 2, 2007 at 11:29 pm
Bob, watching, as in Human Rights Watching, takes a whole lot of effort. Really productive all that watching.
I am not lambasting peoples practical efforts to combat AIDS at all. I am attacking desensitization; 1000 people a day – I can’t imagine all these peoples lives so it just seems like a block of cheese has gone in the bin. Makes it easier to drive to uni. If I were to imagine them all I would not bother getting up. You can only have compassion for people you meet, and not because of some words from some wankers living in (or are from) Manhatten drinking latté’s and claiming all ills of (wo)man as violations of human rights. If you really believe in this human rights thing, maybe Thai drug addicts need some civil rights before all this love can be bestowed upon them. Just like the African-American civil rights movement – didn’t those American ‘citizens’ have universal human rights before they had civil rights?
Sure, HRW provides information and inspiration for cosmopolitan people to go out and do something, those cosmopolitan peoples who can travel anywhere and spread the righteous word of the human rights religion – come home and go back to lattes, sleeping in a good bed, earn valuable money, care about the football, protest to governments and find that rage you felt while that little girl who died of typhoid while her aunt gave birth in a ditch (OK a little personal) become sickeningly distant… Or these people could just turn on the news for 2 mins, be inspired, realise that their beliefs don’t mean anything till they’ve walked them and decide to go physically help an organisation with non-contradictory principals like Medecins Sans Frontiers so they can actually feel some un muted compassion.
6 landofsnarls // Dec 4, 2007 at 3:08 am
Looks to me as though you’re a latte-slurper, Grasshopper. Maybe you should get out more. Have you thought of riding a bike to uni? Australia is a good place to do this. (You MUST be an Australian. Only a hung-up middle-class Australian undergrad could write such drivel.)
Organizations like HRW do have a productive function in the enormous field necessary to effect change, just as Medecins sF., at their end of the complex. People do have to be informed of issues like those outlined in the release above before they can put pressure on governments to (hopefully) force them to do something. And how would MsF get their funding if there were no research and information dissemination.
You prattle on about ‘those people over there’ as if they have nothing to do with you, and Human Rights as if it is different from Civil Rights, & as if they are both different from your rights. Getting control of HIV/AIDS is very much to do with your rights and your life. Have you lived in a time when it was safe to have sex without a condom?
This is not about ‘bleeding hearts.’ It’s about coming to grips with all sides of a huge problem that includes medical, behavioral, etc.,etc., AND in this case, Human Rights issues.
You are misinformed, by the way, in you assertion that ‘the core of this tirade can be applied to every government in the world.’ Take the time to contact the Victorian Aids Council (or that of any other state in Oz) and ask them to brief you on the situation re. drug users.
They’ll be able to inform you where to look for info on other countries also.
BTW, your ‘ more it is endemic of the gross laziness that besets believers in overarching solutions through the application of exceptionalised and particular rights,’ apart from being pretentious & pedantic is meaningless. (look up ‘endemic’ in your dictionary, if you have one. )
I do hope you’re not one of those eager little ex-private schoolchaps who is hoping for a career in the U.N. or an NGO over here. King Bhumipol might call you ‘ngo.’
7 Grasshopper // Dec 4, 2007 at 11:40 am
landofsnarls, I am a latte slurper and I do have a bike. I am a little ex private school chap too.
Organizations like HRW do have a productive function in the enormous field necessary to effect change, just as Medecins sF., at their end of the complex. People do have to be informed of issues like those outlined in the release above before they can put pressure on governments to (hopefully) force them to do something. And how would MsF get their funding if there were no research and information dissemination.
I have a problem with the whole concept of human rights , and therefore that there is a body that ‘watches’ them, I find ridiculous. Medicins Sans Frontiers gets the little funding it does primarily through donors actually. Do you think that most of those donors are going to check up on HRW? The most major donor for MsF is Zayed al Nahayan who by all accounts, is not that perturbed about Human Rights.
You prattle on about ‘those people over there’ as if they have nothing to do with you, and Human Rights as if it is different from Civil Rights, & as if they are both different from your rights. Getting control of HIV/AIDS is very much to do with your rights and your life. Have you lived in a time when it was safe to have sex without a condom?
I don’t prattle on about those people over there as if they have nothing to do with me. I’m prattling on about the fact that they have everything to do with me and my position as someone who can afford to be post-materialist. Rights have nothing to do with controlling AIDS/HIV. As in, it can be controlled without having this overblown, idolatrous rights concept lauded to people who have no meaning associated with it. Having been out in the world, I am quite sure that people would prefer that their AIDS is dealt with before discussing the details of Kantian dignity. (Even before discussing Kantian dignity, maybe civil rights are needed too so this whole concept of dignity is not laughed at) It’s about an order. I thought that was plain, but maybe for you it was lost in your ad-hominem rebuttal.
This is not about ‘bleeding hearts.’ It’s about coming to grips with all sides of a huge problem that includes medical, behavioral, etc.,etc., AND in this case, Human Rights issues.
Yes, these issues make my heart bleed. I don’t know about you. I have come to grips with it and you have failed to read what I wrote. Maybe you should have attended a little private school.
You are misinformed, by the way, in you assertion that ‘the core of this tirade can be applied to every government in the world.’ Take the time to contact the Victorian Aids Council (or that of any other state in Oz) and ask them to brief you on the situation re. drug users.
They’ll be able to inform you where to look for info on other countries also.
Having been a little private school drug user, and even a deferred from uni drug user (this makes my opinion less valid, so please counter it), the problem, I thought, is with having a system that is not relaxed enough towards people who are not functioning or are able to see beyond themselves. This is even a symptom seen in insincere Australian governments whose sitting members have no empathy with introvenus drug users because they have never been in a situation that demands it and consequently, cannot see beyond giving priority to low unemployment statistics. I’m pretty sure if I asked the Victorian AIDS Council, whether or not they would like more funding I would be getting only one answer.
BTW, your ‘ more it is endemic of the gross laziness that besets believers in overarching solutions through the application of exceptionalised and particular rights,’ apart from being pretentious & pedantic is meaningless. (look up ‘endemic’ in your dictionary, if you have one. )
It’s not meaningless. Overarching solutions are lazy, yet exceptionalised, group based solutions create issues of injustice. For instance, should Typhoid sufferers be afforded the same opportunities for treatment as AIDS sufferers? This is where it is endemic for people who are uncritically educated within the confines of human rights policy to laud its moral sanctity. Are you one of these people?
I do hope you’re not one of those eager little ex-private schoolchaps who is hoping for a career in the U.N. or an NGO over here. King Bhumipol might call you ‘ngo.’
I especially wouldn’t want to work for the UN. I especially don’t hope for anything. But there you go, I’m a little ex private school chap and I don’t really need too.
(P/S, whats with you attacking my social status, yet mentioning what the great Bhumibol might say to me as though it is a representation of lower Thai social status? Man of the people?! Oh! – Bhumibol and me, we’re tight…)
8 Lleij Samuel Schwartz // Dec 4, 2007 at 2:20 pm
Organizations like HRW do have a productive function in the enormous field necessary to effect change, just as Medecins sF., at their end of the complex. People do have to be informed of issues like those outlined in the release above before they can put pressure on governments to (hopefully) force them to do something.”
Here, here! Snarly, my boy! Just look at how productive HRW has been informing cosmopolitan academics in America and Europe, effecting change to transform them in to frothing-at-the-mouth anti-Semites.
Wait. Walt and Mearsheimer tell me that such sentiments are mere Zionist McCarthyism? I guess I’ll have to ignore that recent research out of Yale University that shows an overwhelming stastical correlation between anti-Semitism and anti-Israel sentiment. [At least in Europeans.] Or as one of the researchers state: “Say you’re at one of those anti-Israel rallies. Say you ask them whether they are anti-Semitic. Say all of them say no. Statistically speaking, more than half of them are lying.”
9 jeplang // Dec 6, 2007 at 1:02 am
I’m a HIV/AIDS doubter.
AIDS is an umbrella term for 29 diseases[viral,bacterial and fungal] that have been in existence long before HIV appeared on the scene,and the vast majority of medical men would not be able to recogonise a retrovirus ,as HIV is supposed to be, even if it bit them on the bum.
One day many years ago the Center for Disease Control in Atlanta changed the definition of AIDS by adding 3 diseases to the previous 26.Lo and behold,tens of thousands of US citizens acquired AIDS overnight.
The criteria determining the seropositivity or seronegativity of the HIV test[ Western Blot test] vary from country to country ,and as was discovered many years ago ,from one path lab to another,for example ,a HIV +ve in Africa would be a HIV-ve in Australia.
What criteria does Thailand use to determine if a person has AIDS?
HIV -ve[though the manufacturer of the Elisa test and of the Western Blot test warn that the tests are not to be used to test for AIDS]?clinical symptoms [persistence fever,persistent cough and 2 others that I've forgotten]?
I’ve yet to locate an article that appeared in Science a number of years ago that seem to suggest that some female Thai prostitutes were acquiring an immunity to HIV.??????
And don’t forget the co-discoverer of HIV[Gallo] previously discovered a virus that turn out not to exist ,had spent many years trying to find a viral cause of cancer.
Modern biomedical research is reductionist science gone mad.
10 Teth // Dec 6, 2007 at 11:53 am
I find it incredulous that anyone doubts there is an HIV/AIDS epidemic when scientists and doctors, who are undoubtedly much more qualified than yourself and your dilettante conspiracy theories are saying there is one!
For your information, no one would know when a retrovirus has bit their ass unless properly isolated and detected with appropriate instruments. The clinical implications, however, are clear enough. The fact that HART has been clinically tested to work also shows that there is a certain set of patients who are being correctly categorized and are being correctly treated. Do you understand the biochemical mechanism in which HART interferes with viral reproduction (which categorises it as a retrovirus)? Or will you continue to deny that “medical men” would be unable to spot a retrovirus if it bit them on the ass? Seeing as you yourself have not even managed to remember the presentation of HIV infection nor understood the subtlety or its clinical presentation.
For you information, the CDC defines AIDS using a defined CD4 count, but previously defined AIDS through progression of associated ‘diseases’, which constitute the syndrome. Be sure you understand the definition of a syndrome versus a disease. Tens of thousands did not acquire AIDS overnight unless they already had corresponding presentations of the syndrome, which means they are not ten thousand new people. What’s more, the widened net probably has helped discovered more people who need the treatment.
For you information, HIV RNA has been isolated. Surely the character of the discoverer of HIV will have no effect on such microbiological standards? Let me repeat that, the genetic material of the virus has been isolated and identified.
For your information, as with all medical tests (and as with all things in life), there is a statistical margin of error. ELISA and Western blots alone do not diagnose HIV, it is a combination of both tests that gives an extremely accurate diagnosis for HIV antibodies. 0.0004% to 0.0007% false positive rates and 0.003% false negative rates. Better than the efficacy of condoms.
For your information, if the patient has seroconverted and there is evidence of HIV antibodies, that is a positive result.
For your information, there is a vaccine available worldwide for protection against the most common HPV strain, a virus which, causes cervical cancer. Many more viruses are also implicated as a cause of cancers. If you want to quote scientific papers, why not quote them all.
The world has gone mad when they can’t trust the verifiable, experimentally proven, observable world of the microbiologist/biochemist.
This rebuke brought to you courtesy of major wikipedia pages, all of which are well referenced and have been put through thorough vetting.
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