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Published on December 1, 2007

Today marks World Aids Day. Leading personalities and public figures are expected to be out in full force with their best smiles for the cameras as they pass out condoms and urge people to practise safe sex. For years, Thailand's ability to contain HIV/Aids has been one of its greatest success stories. The infection rate was contained and we have succeeded in cutting the number of new infections by almost 80 per cent since 1991.

We took the lead as a global leader among developing countries in providing anti-retroviral therapy (ART), with more than 180,000 people living with HIV/Aids on ART by mid-October 2007. More than 80 per cent of people in need of ART in Thailand are receiving it, making it one of three developing countries worldwide - and the only one in Asia - to have achieved this level of coverage.

But as we have been busy congratulating ourselves, we have conveniently ignored the plight of one community in particular: the injection drug users whose status has remained unchanged for the past two decades. As pointed out by a recent report from Human Rights Watch (HRW) and the Thai Aids Treatment Action Group (TTAG), the government of Thailand has failed to systematically extend treatment to drug users. The report asks for clarification on why Thailand continues to refuse to implement proven, evidence-based strategies to reduce HIV risk among drug users as promoted by the World Health Organisation, the Joint UN Programme on HIV/Aids, and the UN Office on Drugs and Crime.

For Thai policy makers, it is just too much work to try to convince people to do the right thing. It's easier to make promises about new roads and cheap loans. But, as a responsible society, we shouldn't focus only on issues that make us feel good about ourselves - like passing out free condoms. We have a moral obligation and a social responsibility to ensure that those who seek medical attention get the treatment and counselling they require.

Successive governments have repeatedly proclaimed that they will provide access to ART for all who need it, and yet the country continues to systematically block access to HIV treatment for drug users.

Research by HRW and TTAG pointed out that 2003's drug war, which resulted in thousands of extrajudicial killings of alleged drug users or dealers, drove drug users further underground and away from effective HIV/Aids prevention or treatment programmes.

Moreover, many healthcare providers continue to deny ART to people who need it based on their status as drug users, even if they are in methadone treatment programmes. Some have the erroneous conviction that the treatment would be "wasted" on "unreliable" drug users who would fail to adhere to the medication regimen and develop a resistance to it, or spread drug-resistant HIV strains.

Besides the problem with the medical community not following through with the stated policy, there is the problem of law-enforcement anxiously waiting to make a quick score. The country risks being seen as hypocritical if we continue to pride ourselves on past successes, but do nothing about police officers who wait around clinics to bust drug users participating in needle-exchange programmes. They are just one urinalysis away from a quick bust. It's strange how our men in uniform could take pride in such arrests.

Nevertheless, the result of these irresponsible policies is an HIV epidemic among drug users that continues to mar Thailand's reputation as a success story in the global fight against Aids. This is inexcusable, because the government has admitted that the HIV infection rate among people who use drugs "has sustained itself at an unacceptably high level in Thailand".

The government has been quick to employ loaded language such as "harm reduction", but in practice little has been done to address specific challenges of providing care and support for injection drug users despite the government acknowledging in its 2007-2011 National Aids plan that it should act quickly on this very issue.

We need to realise that if we fail to help the hardest-hit population, namely the drug users, we will fail as a country. We would fail because we overlooked our obvious moral obligations and also because we chose to leave these people out in the cold knowing that unless they receive help they could pose a danger to others. By helping them, we are helping ourselves.

The Nation