Thailand first Asian country to eliminate HIV in newborns

baby-428395.165702Thailand achieved a major advance in the response to the HIV and AIDS epidemic last week becoming the first country in Asia to eliminate mother-to-child transmission of HIV, the virus that causes AIDS, after years of hard work by public health officials and nongovernmental organizations.

The announcement was made by the World Health Organization, which called Thailand’s progress a “remarkable achievement” and said the Kingdom had “demonstrated to the world that HIV can be defeated.”

His comments were echoed by Michel Sidibe, the executive director of UNAIDS, who said, “Thailand’s progress shows how much can be achieved when science and medicine are underpinned by sustained political commitment.”

Thailand is one of the four countries in the Asia-Pacific region most affected by the HIV epidemic, and was the first country in the region to record cases of HIV infection in 1984, although many years later evidence would emerge that the first infections may have actually taken place in neighboring Myanmar. The early days of the epidemic were grim, as effective treatments such as anti-retrovirals (ARVs) had yet to be developed or were not available in the Kingdom.

Without effective medicinal tools to work with, public health officials focused on awareness raising and behavior change programs, such as a program to promote 100 percent condom use.

UNAIDS and others have regularly praised the Thai response an offered it as a model for how developing countries can cope with the epidemic. Thailand has a well-developed public health system compared to many countries at a comparable level of wealth and development, and that has proven an essential help.

Around the turn of the millennium, Thailand introduced a universal health care system, and in a pioneering move it provided ARVs to all pregnant women who were diagnosed with HIV. The widespread availability of testing for HIV infection was another important element in curbing the spread of the virus.

Prior to the development and availability of ARVs, pregnant women who were infected with HIV stood a roughly 45 percent chance of passing on their infection to their child during pregnancy, childbirth or breastfeeding.

Research and trials showed, however, that placing pregnant women on ARVs at crucial points during pregnancy, childbirth or breastfeeding could dramatically cut the risk of infection to as low as 2 percent.

Although WHO classifies Thailand as having eliminated mother-to-child transmission, a very small percentage of transmission still take place. Last year 85 children in Thailand were born with HIV, but that is a steep drop from the 1,000 infections recorded in the year 2000.

Cases still exist because ARVs are not 100 percent effective, and some pregnant women have not been tested or have not been able to access prevention and treatment programs, often because they live in remote areas.