In addition to the obligatory red ribbons, the logo for the XV International AIDS Conference features three Asian elephants raising their trunks as if in welcome. The world’s most important gathering of AIDS specialists will be held this July in Bangkok, a location chosen not only because Asia is thought to be the site of the next big wave of HIV infections but because Thailand is one of only a few developing countries that have thus far seemed able to control them.
International experts have hailed Thailand’s 100 percent condom program, which in the 1990s distributed some 60 million condoms free to sex establishments, engaged brothel owners and government officials alike to make sure they were used and helped bring down rates of HIV and sexually transmitted infections as much as fourfold. Thailand is also the first developing country to create a functional program to stop mother-to-child HIV transmission, providing free prenatal care and preventive medication to more than three-quarters of pregnant women testing positive for HIV. Last June Kofi Annan’s praise of Thailand was one of the few bright spots in an otherwise grim report to the UN General Assembly on lack of global progress against AIDS.
Yet the elephant–icon of long memory–is an ironic symbol for the AIDS conference in one respect. Conference organizers and UN officials alike seem to want to forget that, to the group at highest risk for HIV across Asia–injection drug users–what Thailand offers looks less like innovative AIDS prevention than old-fashioned, barrel-of-the-gun repression. In February 2003 the governing Thai Rak Thai (Thais Love Thais) party launched an all-out war on drugs that has included forced urine testing at nightclubs and bars, arrest quotas and mass roundups of alleged dealers and addicts.
While ostensibly focusing on dealers of “ya-baa” (“crazy drug”), the methamphetamine made in cottage labs across Thailand and flowing in vast quantities from nearby Myanmar, the campaign has forced hundreds of thousands of Thais who are on government blacklists, including many with no history of drug use at all, to report to the police. “Panic is so strong that mothers who have never used any drug are reporting to treatment centers to clear the family name,” says Paisan Suwannawong of the Thai Drug Users’ Network. Less than three months after the crackdown began, more than 43,000 “drug traffickers” had reportedly been imprisoned and as many as 230,000 Thais interned in military-run “treatment” centers, where they were drilled in boot-camp-style exercises and made to chant antidrug propaganda. Even more ominously, nearly 2,600 men, women and children–most of them ethnic minorities from the north–have been gunned down during the crackdown. Government officials insist that all but a handful of the deaths are “cut off” killings perpetrated by drug dealers trying to prevent incriminating testimony. Human rights observers say the murders–accomplished with the neat efficiency of professional hit men, sometimes as victims are in handcuffs or returning from police interrogation–look more like systematic extrajudicial executions.
Prime Minister and former police officer Thaksin Shinawatra–who last year enjoyed rising popularity ratings, the fastest-growing stock market in Asia and a spate of visits with President Bush unblemished by public discussion of human rights violations–has declared the war on drugs a “beautiful success.” Not surprisingly, however, the crackdown’s effect on programs serving drug users, including HIV prevention and research efforts, has been immediate and ugly. A study led by researchers at Chiang Mai University last June found that more than a third of Thai drug users going to rehabilitation clinics had stopped attending, with many likely to have returned to injection and high risk of HIV infection. In the north, AIDS researchers working with hill tribes pulled their teams for fear of being caught in the crossfire. Paisan of the Thai Drug Users’ Network sees the crackdown as the latest in a series of HIV-prevention missteps that have included cancellation of the country’s only needle-exchange program and failure to implement countrywide methadone maintenance programs in spite of clear evidence of their efficacy. As a result, while rates of HIV have fallen among Thai sex workers, they have been climbing steadily among injection drug users.