Dr. Praphan Phanuphak: Thailand’s Medical Pioneer in HIV/AIDS Explains the Path to Elimination

Thursday, November 29, 2018
Dr. Praphan Phanuphak,Thailand's HIV champion, addresses a recent event to raise awareness of how communities can act to help end HIV and AIDS.
Richard Nyberg, USAID

The U.S. Agency for International Development (USAID), with funding from the U.S. President's Emergency Fund for AIDS Relief (PEPFAR), has been collaborating with Thailand’s HIV champion, Dr. Praphan Phanuphak, who diagnosed the first case of HIV in Thailand in 1985. He has been successfully fighting for the rights of those most at risk of contracting HIV such as people who in inject drugs, transgender women, men who have sex with men and sex workers. With PEPFAR and USAID support, Dr. Praphan has successfully partnered with community-based organizations to take the lead in reaching out to Thailand’s key, most at-risk populations -- to bring timely counseling, HIV screening, and referrals as an effective way to help end HIV and AIDS. Now the Royal Thai Government is investing in PEPFAR-supported, community-based outreach and screening activities -- a significant step in reversing the epidemic in Thailand.

We sat down with him and he told us his story. He explained how we can continue to partner with the Royal Thai Government and community organizations to eliminate HIV and AIDS in his country and beyond:

Dr. Praphan: “I always wanted to be a doctor to help people and stop suffering. I started practicing medicine before HIV/AIDS existed. Then in 1985, I diagnosed Thailand’s first case of HIV. At that time, there were no treatment options and we knew so little about HIV. For my HIV and AIDS patients, being diagnosed with HIV was essentially a death sentence.

“Today, I talk to my colleagues and while there are still major challenges like reaching those clients that still need treatment and support, or balancing screening for opportunistic infections with prescribing Same Day Antiretroviral Therapy (SDART); the landscape for HIV has completely changed. Today halting HIV and AIDS is within our grasp!

“The risks of not prescribing ARTs to patients is twofold; we may be likely to never reach those patients again and they will not maximize their health outcomes with delayed treatment.  

“It is the ideal time to reflect on how far we have come and consider how, as doctors, we can work together to stop HIV in Thailand. Now the evidence and international and national recommendations are clear: collaborating with key populations (such as men who have sex with men, transgender women, sex workers, and people who inject drugs) maximizes our ability to reach, diagnose, treat and retain those who are infected as well to protect those who are at risk to remain negative. SDART not only effectively treats HIV positive patients, by reducing their viral load and mitigating opportunistic infections, but also protects the population as a reduced viral load reaching viral suppression means that sexual transmission of HIV is not possible. SDART is an important tool doctors now have to turn HIV from a death sentence to a life that is relatively normal especially when viral suppression is reached.

“The benefits to the population are very exciting as it could fast-track Thailand to stop the spread of HIV in the population. As patients continue to take ARVs, evidence shows that up to 95 percent are able to reach viral suppression within six months of treatment where HIV is no longer detectable and it is not transmittable. This is one of the most exciting benefits of ARV we have seen to date.”

Extra: Listen to Dr. Praphan’s impassioned call for early HIV testing and treatment through the U=U campaign, "undetectable is untransmittable."

Last updated: November 29, 2018

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