Into the Field: Thailand and the Elimination of Mother-to-Child Transmission of HIV
As the Thailand team prepares to fly to Bangkok this week, we’d like to share a bit more on the impressive story we have been researching for the past year.
Thailand’s current rate for Mother-to-Child Transmission of HIV is 1.9%, making it only the second nation in the world (and the first with a generalized HIV epidemic) to meet the World Health Organization’s definition of elimination of MTCT. The team will be interviewing experts in the field this week to continue investigating the why and how Thailand has reached this impressive milestone.
Our driving research question is: how did Thailand eliminate MTCT of HIV across both the general populations and within hard-to-reach populations? And further, what are the political and programmatic drivers and processes that have led to Thailand’s successful elimination of MTCT?
In response to the generalized HIV epidemic in the 1990s, Thailand’s Ministry of Public Health rose to the challenge with the introduction of a national MTCT prevention policy in 2000. The policy was part of a wider push for healthcare reform driven by government and civil society actors. Over the next 15 years, the 1,000 children infected with HIV in the year 2000 was down to 85 children infected in the year 2015. The rate of women who were newly infected with HIV decreased from 15,000 to 1,900.
Based on our research so far, we believe Thailand’s successful reach is a combination of:
● Political will, which allowed for engagement of diverse partners including physician-bureaucrat advocates and patient rights groups.
● Social change in the form of public support for MTCT policy, including global and local HIV/AIDS norm changes related to stigma/discrimination and access to medicines.
● Improved access to antenatal care through strong public health infrastructure which included HIV prevention activities (counselling, testing, and ARV treatment) as part of the larger Universal Health Coverage movement in Thailand.
● Comprehensive monitoring & surveillance, which contributed to program accountability and informed ongoing HIV prevention activities on a national scale.
As we head into the field with a packed interview schedule, the team is excited to learn more about the Thai success story from a range of key people and organizations. We expect an enlightening, fast-paced, and very humid week in Thailand.
More updates to come!
Andrea, Aylin, Joy and Simran