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The Thai authorities are working alongside UN companies to not simply enhance the provision of providers following the change in the way in which individuals are sentenced for medication crimes, but additionally cut back the stigmatization of people that use medication 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 Medicine and Well being Programme Officer for the UN Workplace on Medicine and Crime (UNODC), concerning the alternatives for individuals who use medication to entry care.
![UNAIDS Country Director in Thailand, Patchara Benjarattanaporn. UNAIDS Country Director in Thailand, Patchara Benjarattanaporn.](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Index/22-06-2023-UNFPA-teen-pregnancy-04.jpg/image1170x530cropped.jpg)
UN Information/Daniel Dickinson
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 shouldn’t be practically sufficient to realize the top of AIDS by 2030, which is a dedication made by all nations beneath Sustainable Growth Purpose three, SDG 3. So, HIV nonetheless a essential well being concern.
There are about 57,000 folks in Thailand who inject medication. In line with 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 medication 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, UNODC.](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Collections/Embargoed/10-05-2023-UN-News-Bangkok-08.jpg/image1170x530cropped.jpg)
UN Information/Daniel Dickinson
Karen Peters, UNODC.
Karen Peters: At UNODC, one of many points we deal with is lowering the well being and social penalties linked to drug use by way of supporting hurt discount interventions. Individuals who inject medication are at the next danger of contracting HIV as a result of sharing of needles and different dangerous behaviours, for instance, participating in sexual activity with out utilizing a condom.
Patchara Benjarattanaporn: Analysis means that individuals who inject medication are 35 occasions extra prone to purchase HIV than people who find themselves not injecting. The prevalence is excessive attributable to these dangerous behaviours, nevertheless there are different vital structural obstacles to accessing remedies. The extraordinarily punitive authorized framework that existed prior to now in addition to stigma and discrimination have been vital elements stopping folks from accessing care and providers.
Karen Peters: UNODC has been supporting the nationwide hurt discount response by way of convening a variety of stakeholders, authorities, civil society organisations, and UN companies to debate plans to implement hurt discount measures beneath the auspices of the brand new legislation. 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 brought on by medication. It was established and is run by individuals who have expertise utilizing medication, who present recommendation and providers in a non-judgmental, non-discriminatory setting. Shoppers who come to Ozone recognize being counselled by like-minded folks.
![A health worker at the Ozone Foundation in Bangkok, Thailand prepares a hepatitis C test. A health worker at the Ozone Foundation in Bangkok, Thailand prepares a hepatitis C test.](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Collections/Embargoed/22-06-2023-UNAIDS-Thailand-02.jpg/image1170x530cropped.jpg)
© UNAIDS Thailand/Cedriann Mart
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 medication face and encourage them to hunt therapy. A major transformation of Thailand’s well being system has additionally performed an vital function. Common well being protection (UHC) was launched in Thailand in 2002 and has paved the way in which for complete care, together with important providers like HIV testing, pre-exposure prophylaxis, or PrEP, therapy referrals, and screening and therapy for sexually transmitted infections (STIs) and hepatitis C.
There may be nonetheless quite a lot of work to do; fairly a low proportion of people that inject medication 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 beneath 50 per cent amongst individuals who inject medication.
Karen Peters: A brand new narcotics legislation launched in December 2021 has additionally shifted the narrative in a optimistic method round individuals who use medication. Traditionally, Thailand has had very punitive legal guidelines which criminalize drug offenders. The brand new legislation supplies 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 medication are being thought of.
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 should be delivered near the individuals who want them in a state of affairs the place the shoppers don’t really feel stigmatized. Integrating hepatitis C and HIV testing collectively as a part of a therapy package deal beneath UHC encourages extra folks to get examined. This built-in method can even embrace hurt discount providers.
![The Ozone Foundation offers a range of harm reduction measures to prevent the spread of HIV. The Ozone Foundation offers a range of harm reduction measures to prevent the spread of HIV.](https://global.unitednations.entermediadb.net/assets/mediadb/services/module/asset/downloads/preset/Collections/Embargoed/22-06-2023-UNAIDS-Thailand-01.jpg/image1170x530cropped.jpg)
© UNAIDS Thailand/Cedriann Mart
The Ozone Basis gives a variety of hurt discount measures to forestall the unfold of HIV.
Karen Peters: We’re discussing methods and frameworks for implementing community-based therapy. The Ministry of Public Well being, the Workplace of the Narcotics Management Board, completely different civil society organizations, and worldwide donors and technical consultants are all sitting across the desk advising and suggesting methods during which this could transfer ahead in a extra sustainable solution to have higher outcomes for Thai folks.
Patchara Benjarattanaporn: We’re additionally specializing in supporting the Thai authorities in a nationwide technique to help these underserved teams, utilizing state-of-the-art analysis and evidence-based options with the intention to generate a excessive impression intervention. A multisectoral method and group engagement are essential to deal with the problem.
When the federal government demonstrates a dedication to dealing with as much as challenges, good issues occur when it comes to creating each equitable entry to providers and the mixing 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 might be thought of a mannequin for the area.
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