December 2008

Meet Our Featured Guest Columnist:
Mechai Viravaidya

is a former minister of the prime minister's office, Thailand, responsible for AIDS prevention coordination. After years promoting condoms—first, as a family planning advocate and later as part of his AIDS-related work, he has become known “the Condom King” across the country.

Q: What does "health and human rights" mean to you?

A: Just as Human Rights are attributed to every human being by birth, the right to access decent health services should be common to all people, regardless of the size of their wallets.
Q: How/why did you get involved in HIV/AIDS prevention?

A: When the HIV/AIDS crisis emerged in Thailand, many lives could be at risk. However, denial was the order of the day. The people leading Thailand at the time believed that dealing with AIDS would be bad for the country's image and would affect the tourism industry. I stood on the exact opposite side. If we do nothing, one day the whole world will be scared away because Thailand will be full of AIDS. In 1991, when the new interim government led by Prime Minister Anand Panyarachun came into power, things changed completely. He asked me to be the minister for tourism, public information, and mass communication. But, I proposed one addition to the portfolio: that I become the temporary AIDS czar and that the Prime Minister become the real AIDS czar. He was a very enlightened person. He listened to me and agreed to wage total war on HIV/AIDS.

Q: Describe some of the successes you have seen in this work.

A: A study in 1990 estimated that without the aggressive public education to tackle the impending HIV epidemic led by PDA, by 2000 up to four million Thai people would have been infected--at least 460,000 deaths were prevented. The World Bank estimated in 2005 that for every dollar spent by on prevention, forty-three dollars were saved on treatment, saving the Thai government a total of US$18.6 billion. But, the battle against HIV/AIDS is never won. There are signs that the Thai government's commitment to controlling HIV/AIDS is wavering, especially after the Asian financial crisis in late 1990s where public expenditure on HIV/AIDS has fallen by fifty percent. Moreover, we have seen a resurgence of HIV infections particularly among adolescents and pregnant women.

Q: What are some of the challenges?

A: The most important challenge is to change the mindset and behavior of people. Fighting HIV/AIDS requires strong support from the country's top leadership. You cannot solve the multifaceted issues surrounding HIV/AIDS. HIV prevention is not a health problem. It is a behavioral problem, a societal problem. The resurgence of HIV infection has come from the fact that the past government seized the budget for HIV/AIDS. We need to put this issue to the top of the agenda again, but we cannot wait for the government to act for us. I mobilize the media as they are a powerful tool to transmit information to the people. Private companies use the media to sell their products and to influence behaviors. We must use the same methods to change behaviors for better health. We have to be equally, if not more, creative because our message is more complex. We had to come up with things that the media found interesting, that they would like to publish or publicize. If we could get free media coverage, it would be worth millions, and millions of lives would be saved.

Q: How can young people make a difference in the global campaign against HIV/AIDS?

A: Young people have been the main focus in our social development work. The evidence comes from what we did in family planning. We worked with kids in fourth and fifth grades who were about nine to ten years old. We taught them about population and family planning. We gave them lessons about arithmetic, where instead of saying, "How much is ten divided by two?" we would ask, "If a farmer has two children and owns ten acres of land, how many acres will each child get?"  Then we would ask, "What if the same farmer with ten acres has five children? What if he has ten children?"  In this way children learned about math and population issues simultaneously. Now these children are in their 40s and they live their lives carefully. They would have one or two children instead of seven to ten like 30 years ago. Thai men are not shy about using condoms with their partners. They have been familiar with condoms since they were nine years old. And, you can apply this strategy to any social issue. We are now having a program called 'The Joy of Doing Public Good' where we invite school children to work in the social development sector for a period of time, just enough for them to build a new mindset. So when these children grow up, they will be asking questions like "Why should my company launch a CSR (Corporate Social Responsibility) program? What do we get in return?" If we wish to build a new generation of people, we need to start now. Start when the children are young, and never stop because new generations are born every day. If you start with young kids, by the time they have hair on their legs you will not have to worry too much.