THAILAND - Previously lauded as a successful country in combating the Aids epidemic, Thailand's attempt to fight HIV/Aids is facing a big challenge as funding support from international agencies continues to drop.
This concern, raised by health advocates, has prompted the National Aids Committee to consider setting up an Aids Prevention Fund, supported by domestic financial resources, to support its campaign.
Aids activists worry that the reduced international budget will affect their massive HIV campaign - the launching of HIV-testing mobile units in 30 provinces to help people know their HIV status and to get earlier treatment.
"The HIV/Aids-prevention campaign has deteriorated during the past few years," said Dr Sorakij Bhakeecheep, director of the National Health Security Office's Bureau of Secretary and Tertiary Care Support.
The reason: Thailand faces financial problems caused by the external financial donors reducing their support.
In 2011, the country's spending on HIV/Aids-prevention was only 13 per cent of the total national Aids programme. It mainly relied on external resources like the Global Fund, an international financing institution to fight AIDS, tuberculosis and malaria. Most money under the fund was distributed to non-governmental organisations working on HIV/Aids.
In 2010, Thailand's expenditure on the campaign was Bt7.7 billion (S$300,000), and in 2011 Bt9.9 billion. About 73 per cent of this amount was allocated for treatment and 13 per cent on prevention.
During 2003 to 2008, as a low-income country, Thailand received about US$170 million (S$211,000) in funding to support campaigns and activities against HIV/Aids. As Thailand was classified as a low middle-income country by the World Bank, it was eligible for funding support for the HIV/Aids-prevention programme by the Global Fund. The allocation was based on the recipient's financial condition and HIV/Aids prevalence, as well as the effectiveness of disease-control programmes.
When the World Bank placed Thailand in the middle-income country category for 2011-2014, Thailand won only $63 million for HIV/Aids-prevention programmes.
The amount is set to fall further due to the country-ranking upgrade by the World Bank. Thailand will be allowed only 30 per cent of the total fund of the Global Fund. That means Thailand has to consider relying more and more on domestic financial resources.
"Of course, non-government organisations would face a crisis as their financial resources also relied mainly on international donors like the Global Fund," said Dr Nakorn Premsri, a director of the principal recipient administrative office of Thailand's Global Fund.
Nimitr Tian-udom, director of the Aids Access Foundation, said his organisation now plans to expand the HIV-testing mobile units programme to 30 provinces. People who test positive would be able to get the anti-retroviral treatment at an earlier stage.
Because of the lack of funds, channels to communicate with people for such a service are limited, he said.
To boost the campaign against HIV/Aids in Thailand, the National Aids Committee has initiated the setting up of a national Aids fund to support both governmental and non-governmental agencies' work on HIV/Aids-prevention programmes. They aim to reduce new HIV infections from 10,000 cases per year to 2,000 cases within five years.
Citing calculations by the Disease Control Department, Sorakij said the government would allocate Bt200 million to Bt300 million for the first year of the fund's establishment.
The spending under this fund would focus on preventing the spread of disease among the key affected populations - such as men who have sex with men, sex workers, injecting drug users and teenagers.
Nakorn also supported the idea of setting up the Aids Prevention Fund, saying it was time for Thailand to rely on its internal financial resources.
"We should no longer depend on external resources forever. We should take ...advantage of this crisis and think about how to stand on our own two feet," he said.
The general secretary of the Rak Thai Foundation, Promboon Panichpak, commented that the foundation's attempts to fund an HIV/Aids campaign had been in a rocky state for years.
Fortunately, the foundation has managed to get funding from the Global Fund to Fight AIDS for about a decade now for its HIV/Aids campaign, which also assists migrant workers.