Thailand Successfully Eliminates Mother-to-Child HIV Transmission

Thailand became the first Asian country to eliminate mother-to-child transmission of HIV (MTCT), thereby, achieving the targets of the World Health Organization (WHO) for MTCT elimination strategy.

This was achieved by the early and concerted multi-sectoral response of Thai society, which was backed by strong political leadership and an increase in government investment, according to a study published in Paediatrics and International Child Health.

The WHO strategy is a 4-pronged approach that addresses the primary prevention of HIV in women of childbearing age; unintended pregnancy prevention in women with HIV; prevention of MTCT; and provision of appropriate treatment, support, and care for women and children living with HIV.

Initiatives to promote condom use, provide information about the risk of transmission, and introduced testing for pregnant and postpartum women was successfully implemented in Thailand. In the early 1970s, the highly successful Thai Population Programme for family planning services was introduced. The program helped increase contraception rates from 14.8% in the 1970s to 79.6% in 2009.

Thailand also introduced the 100% Condom Programme, as well as other public health education campaigns to encourage safe sex. The Condom Programme promotes 100% condom use by male patrons of commercial sex workers. Collectively, the initiatives played a crucial in preventing HIV infection in women of reproductive age, according to the study.

The interventions were successful due to strong political leadership and commitment, heavy government investment, and a pragmatic multi-sector response by Thai society, the authors wrote. In 1991, the national AIDS policy of Thailand was transferred from the Ministry of Public Health to the Office of the Prime Minister. After 1991, the government significantly increased investment in the national HIV/AIDS programme. The spending increased from $684,000 USD in 1988 to $82 million USD in 1997.

Another key player in reducing MTCT rates in Thailand from 20% to 40% in the mid-1990s to 1.9% in 2015 was the high rate of antenatal care provision.

“The high rate of antenatal care provision in Thailand is also key,” the authors wrote. “A voluntary HIV test with same-day results is offered at the first clinic visit, followed by re-testing later in pregnancy for HIV-negative women. For HIV-infected pregnant women, antiretroviral therapy (ART) is provided as soon as possible. Such treatment is now available at much lower cost, thanks to legislative changes which have allowed the non-commercial production of generic ART in Thailand. Counselling services at antenatal clinics also promote the use of dual methods of contraception to prevent unintended pregnancy in women with HIV.”

Study author Usa Thisyakorn added, “Thailand has achieved WHO elimination of mother-to-child HIV transmission targets with early and concerted efforts of all sectors of Thai society. This provided numerous lessons learned in working together to safeguard children. Since children are the country’s future, how the country responds to the problems created for them indicates how highly the country values its future.”