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Steps that people can take to combat AIDS have taken root in the northern Thai province of Phayao, in line with a recently completed five-year project initiated by the Japan International Cooperation Agency.

Thailand experienced explosive growth in the number of people infected with HIV during the 1990s but has since transformed itself into an “advanced nation” in combating AIDS.

As of 2001, a cumulative total of 1.09 million Thais had contracted HIV, and 344,000 of them have died, according to a government estimate based on reports from hospitals and physical examinations for pregnant women and military recruits.

Newly infected people totaled 26,000 in 2001, down from the peak of 27,000 reported in 1998. The number further dropped to about 15,000 last year, while AIDS orphans totaled 55,000.

The government’s campaign against AIDS is paying off as the use of condoms is spreading. It has drastically reduced HIV infections. Experts say, however, that the country is in a new stage in which it has to pay more detailed attention to such matters as AIDS prevention, patient care and measures to cope with AIDS orphans at the regional level.

JICA has helped Thais organize local-level public health staff, develop human resources and foster a public health system in areas in Phayao where AIDS has been a serious problem.

Officials believe the system could become a model for stemming AIDS in developing countries. The Thai government is considering expanding it not only to the rest of the nation but promoting its use in China, India and other countries.

There has been a predominantly higher AIDS rate in northern Thailand, including Phayao and Chiang Mai, than elsewhere in the country.

Farmers work as migrant laborers during slack agricultural periods in Phayao, a province with a population of about 510,000. Many women go to Bangkok to engage in prostitution.

The number of males in Phayao infected with HIV started rising in the early 1990s. Men with AIDS totaled about 7,800 as of June 2001.

Officials said the province had the highest number of people with AIDS in the country.

Recalling the situation in the latter half of the 1990s, Purapan, a 46-year-old member of an AIDS task force in the Bantam district in Muan County, said: “There was a funeral for an AIDS victim almost every day. Members of a funeral music band were busy walking from village to village.”

People returning home in those days meant death, he said, adding that villagers held strong prejudices against the disease. In some cases, neighbors refused to attend funerals.

Japanese physicians worked in the district, trained local public health staff and helped local residents independently organize moves to fight AIDS.

They formed a task force about two years ago. About 30 people with AIDS live in the Bantam district at present. They participate in the task force’s meetings and discuss AIDS problems once every three months.

“Our biggest problem now is educating and providing mental care for about 40 children whose parents died of AIDS,” Purapan said, adding that public understanding of the disease has improved and prejudice against people with AIDS is almost nonexistent.

Dr. Tadashi Yasuda said: “AIDS in Thailand has already become a family-level problem involving couples and their children. State-level measures are not sufficient. A network of hospitals . . . is indispensable.”

At a day-care center next to the hospital in Chun County, about 50 patients met in an open room for their regular Thursday gathering to receive medicine and counseling.

“We talk about good things and bad things and share (our feelings) among us patients,” said Charan, 41, whose wife died of AIDS three years ago.

He emphasized the advantage of the weekly get-together, calling it a time of mental and physical recreation for the patients.

On the other hand, a 30 percent cap in an antipoverty measure that Prime Minister Thaksin Shinawatra’s government adopted for patients to pay for their medical treatment at national hospitals is a heavy burden for regional authorities dealing with AIDS. Hospitals are being pressed to run on small budgets and rein in treatment costs.

AIDS-related drugs are expensive. Dr. Suchan of Chun County hospital said, “We won’t be able to offer attentive medical service if this (situation) continues.”

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