Thailand and neighboring countries to boost migrants' access to HIV treatment
BANGKOK – Thousands of migrants from Cambodia, Lao PDR and Myanmar who live with HIV in Thailand will have better access to health services as part of a commitments made last month.
Government representatives agreed to examine ways to use intellectual property rights and free trade agreement flexibilities to lower the cost of treatment services and increase coverage for migrants. They also agreed to harmonize treatment and medical referral protocols across countries and ensure that in addition to treatment, migrants have better access to HIV services overall.
Thailand has taken steps to ensure that migrants have access to HIV treatment. Dr. Petchsri Sirinirund, Director of the National AIDS Management Centre at the Ministry of Health’s Department of Disease control said that “in the new national strategy for 2012-2016, we aim to provide access to quality HIV treatment and care for any person living with HIV in Thailand, regardless of their nationality.”
The commitments came at a meeting organised by the UN Development Programme (UNDP) in partnership with the Government of Thailand and Raks Thai Foundation, a local non-profit organization.
“Thailand is a pioneer in implementing the human principle that migrants can access the same quality of HIV services and medicines that are available to citizens, and we are pleased to work in partnership with governments and civil society across borders to address the challenges that will allow all migrants in need to access vital HIV treatment,” said Rathin Roy, Manager of UNDP’s Asia Pacific Regional Centre.
Migrants play a key role in Thailand’s economy and society: They are five million coming mostly from neighbouring countries like Cambodia, Lao PDR and Myanmar. Some 2,300 migrants with temporary papers receive anti-HIV drugs through Thailand’s Global Fund project. But around 1,500 to 3,000 migrant workers with temporary papers are on a waiting list to access treatment in the country, according to the Raks Thai Foundation.
A new study in Thailand’s six most HIV-affected provinces has shown that Cambodian migrants bear the highest burden with a prevalence of 2.5 percent followed by the Burmese with a prevalence of 1.16 percent. The estimated adult prevalence in the country as a whole is 1.3 percent.
Although migration is not in itself a risk factor for HIV, a number of issues can increase vulnerability, such as exploitative working conditions, which may include sexual violence, overcrowded and bad housing conditions and separation from families, spouses/partners and established social and cultural norms and values.
When harsh work and dire living conditions are common, migrants are found to be at increased risk, especially those engaged in deep sea fishing and the fish processing industry.
Currently, migrants who are officially registered can pay a fee for universal health coverage, which includes HIV treatment. However, many are not in a position to access such treatment. Such public health scheme cost to individuals ranges from US$45-90 a month, with a long waiting list for treatment. A number of those who are unregistered never come to the attention of authorities and therefore receive no help.
“While we need to focus our discussion on availability of antiretrovirals, what also needs to be in place is a comprehensive system of medical and social care that is backed up by national and regional policies,” said Promboon Panitchpakdi, Executive Director of Raks Thai Foundation.