SEATTLE — On June 7, the World Health Organization (WHO) congratulated Thailand on eliminating mother-to-child transmission of HIV and syphilis, guaranteeing an HIV-free generation. Thailand is the first country in the Asia-Pacific region to successfully transform an HIV-ravaged society into a model for how to address the global HIV/AIDS epidemic.
Thailand has a much higher prevalence of the virus than other countries due to its booming sex industry and previous lack of HIV treatment and prevention services. This lack of prevention services was due in part to the 1997 Asian economic crisis that led to a 10 percent reduction of Thailand’s AIDS budget.
In 2000, Thailand began seriously confronting their HIV epidemic. The Joint United Nations Program on HIV/AIDS (UNAIDS) published an outline of HIV services offered during the following year which shows the prioritization of anti-retroviral therapy. Thailand started offering free antiretroviral drugs to pregnant women with a CD4 count of less than 200 cells–one of the first countries in the world to do so, according to the Thai National AIDS Committee.
A CD4 count is a laboratory test that measures the number of CD4 T-lymphocytes, also called T-helper cells, in order to assess the strength of a patient’s immune system. The lab test is the strongest predictor of HIV progression. As the virus attacks and destroys T-cells, it’s crucial to monitor how susceptible an HIV-positive patient is to opportunistic infections.
When antiretroviral therapy (ART) is implemented, the risk of mother-to-child transmission of HIV is significantly lowered and HIV-positive patients have a brighter prognosis. Recognizing that early ART is crucial to lowering transmission rates, Thailand made a progressive move to offer ART to all pregnant women with HIV regardless of CD4 count in 2014.
All HIV services are currently covered by Thailand’s national plan, even if pregnancy is not a factor. Thai citizens who are HIV-positive can expect to take three different antiretroviral medications and a plasma HIV viral load assessment twice a year until their CD4 count reaches the normal range of 500-1,200 cells, according to AIDS Research and Therapy.
About 98 percent of pregnant women living in Thailand with HIV choose to undergo ART. If left untreated, expectant mothers have a 15–45 percent chance of transmitting HIV to her child. However, if both mother and child participate in ART, the chance of transmission is lowered to less than one percent, according to UNAIDS.
In light of Thailand’s accomplishment, there are still approximately 36.9 million people living with HIV/AIDS, according to AVERT. More than two-thirds of those who are HIV-positive reside in sub-Saharan Africa and developing nations where HIV counseling and treatment is inaccessible or too expensive.
By looking to Thailand’s overwhelming success with preventing the spread of HIV/AIDS, there’s hope that even developing countries ravaged by HIV will see an AIDS-free generation in the future.
– Daniela N. Sarabia