The Thai authorities are working alongside UN companies to not simply enhance the provision of providers following the change in the best way individuals are sentenced for medicine crimes, but in addition cut back the stigmatization of people that use medicine and guarantee they’ve entry to providers the place they really feel comfy.
UN Information spoke with the UNAIDS Nation Director, Patchara Benjarattanaporn, and Karen Peters, Regional Medication and Well being Programme Officer for the UN Workplace on Medication and Crime (UNODC), in regards to the alternatives for individuals who use medicine to entry care.
UNAIDS Nation Director in Thailand, Patchara Benjarattanaporn.
Patchara Benjarattanaporn: New HIV infections in Thailand are on the decline, in comparison with 2010. Nevertheless, the decline isn’t practically sufficient to attain the tip of AIDS by 2030, which is a dedication made by all nations below Sustainable Growth Aim three, SDG 3. So, HIV nonetheless a vital well being concern.
There are about 57,000 individuals in Thailand who inject medicine. Based on our most up-to-date survey in 2020, 7.8 per cent of these individuals are contaminated with HIV. One other an infection that is quite common amongst individuals who inject medicine is hepatitis C, which impacts the liver. Some 42 per cent had been contaminated, which is extraordinarily regarding to UNAIDS.
Karen Peters, UNODC.
Karen Peters: At UNODC, one of many points we give attention to is lowering the well being and social penalties linked to drug use by supporting hurt discount interventions. Individuals who inject medicine are at a better danger of contracting HIV as a result of sharing of needles and different dangerous behaviours, for instance, partaking in sexual activity with out utilizing a condom.
Patchara Benjarattanaporn: Analysis means that individuals who inject medicine are 35 instances extra prone to purchase HIV than people who find themselves not injecting. The prevalence is excessive as a consequence of these dangerous behaviours, nonetheless there are different important structural boundaries to accessing therapies. The extraordinarily punitive authorized framework that existed prior to now in addition to stigma and discrimination have been essential components stopping individuals from accessing care and providers.
Karen Peters: UNODC has been supporting the nationwide hurt discount response by convening a variety of stakeholders, authorities, civil society organisations, and UN companies to debate plans to implement hurt discount measures below the auspices of the brand new regulation. Ozone Basis, for instance, which has its headquarters within the capital of Thailand, Bangkok, is a peer-led community-based organisation aimed primarily at lowering the hurt attributable to medicine. It was established and is run by individuals who have expertise utilizing medicine, who present recommendation and providers in a non-judgmental, non-discriminatory atmosphere. Purchasers who come to Ozone recognize being counselled by like-minded individuals.
A well being employee on the Ozone Basis in Bangkok, Thailand prepares a hepatitis C check.
Patchara Benjarattanaporn: Locations like Ozone assist to cut back the stigmatization that individuals who use medicine face and encourage them to hunt remedy. A big transformation of Thailand’s well being system has additionally performed an essential function. Common well being protection (UHC) was launched in Thailand in 2002 and has paved the best way for complete care, together with important providers like HIV testing, pre-exposure prophylaxis, or PrEP, remedy referrals, and screening and remedy for sexually transmitted infections (STIs) and hepatitis C.
There may be nonetheless a number of work to do; fairly a low proportion of people that inject medicine are enrolled in antiretroviral remedy, or ART, which is used to deal with HIV. Within the common inhabitants, round 90 per cent of people that have HIV obtain ART, however it’s under 50 per cent amongst individuals who inject medicine.
Karen Peters: A brand new narcotics regulation launched in December 2021 has additionally shifted the narrative in a constructive approach round individuals who use medicine. Traditionally, Thailand has had very punitive legal guidelines which criminalize drug offenders. The brand new regulation offers for differentiated sentencing on drug crimes and alternate options to imprisonment for some offences. For the primary time, it appears the well being and wellbeing of people that use medicine are being thought-about.
Patchara Benjarattanaporn: We’re engaged on HIV prevention throughout a number of UN companies in Thailand, particularly UNAIDS, UNODC, the UN Growth Programme (UNDP) and the World Well being Group (WHO). We’re specializing in these key teams, these hidden populations, by selling community-led providers, which have to be delivered near the individuals who want them in a state of affairs the place the purchasers don’t really feel stigmatized. Integrating hepatitis C and HIV testing collectively as a part of a remedy bundle below UHC encourages extra individuals to get examined. This built-in strategy also can embody hurt discount providers.
The Ozone Basis gives a spread of hurt discount measures to forestall the unfold of HIV.
Karen Peters: We’re discussing methods and frameworks for implementing community-based remedy. The Ministry of Public Well being, the Workplace of the Narcotics Management Board, totally different civil society organizations, and worldwide donors and technical consultants are all sitting across the desk advising and suggesting methods during which this may transfer ahead in a extra sustainable approach to have higher outcomes for Thai individuals.
Patchara Benjarattanaporn: We’re additionally specializing in supporting the Thai authorities in a nationwide technique to assist these underserved teams, utilizing state-of-the-art analysis and evidence-based options with a purpose to generate a excessive impression intervention. A multisectoral strategy and neighborhood engagement are vital to deal with the problem.
When the federal government demonstrates a dedication to going through as much as challenges, good issues occur when it comes to creating each equitable entry to providers and the combination of providers, and, much more so, when civil society and companions just like the UN have a voice on the desk. On this respect, Thailand could be thought-about a mannequin for the area.
