TTAG - Thai AIDs Treatment Action Group
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soi 40 Chatuchak, Bangkok 10900 Thailand
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What’s new at TTAG!

TTAG Releases 'Stakeholder Views on Biomedical Trials' Report

TTAG is happy to present a report that documents the views of a broad range of stakeholders on issues related to biomedical HIV prevention research. Dozens of stakeholders in Thailand were interviewed. These included researchers and research site staff, staff from non-governmental organizations (NGOs) and community-based organization (CBOs),and community members, among them biomedical HIV prevention trial participants. Methods, findings and key recommendations are summarized in the report, downloadable in Thai or English here: "

PDF (Thai version): Download
PDF (English version): Download

New research points to the need for policy reforms and harm reduction programs for people who inject drugs in Bangkok, Thailand

Bangkok, Thailand (September 1, 2011­) –Today, the Thai AIDS Treatment Action Group (TTAG), the Urban Health Research Initiative (UHRI) of the British Columbia Centre for Excellence in HIV/AIDS (Vancouver, Canada), and Chulalongkorn University (Bangkok, Thailand) released a report, “Reducing Drug-Related Harm in Thailand: Evidence and Recommendations from the Mitsampan Community Research Project (MSCRP).” A collaborative effort between the three entities, the report summarizes two years of research findings on HIV risk behaviors and barriers to accessing HIV and harm reduction services among people who inject drugs (PWID), and provides evidence-based recommendations calling for the expansion of harm reduction programs in Thailand.

“Thailand sorely lacks current, quality data on barriers to accessing HIV care and harm reduction services for injectors, and we wanted to urgently address that need, especially from a policy development perspective. Our research shows clearly the pressing need to expand harm reduction programs in Thailand” said Paisan Suwannawong, the founder of the Thai AIDS Treatment Action Group (TTAG), which provides direct services to PWID.

The Mitsampan Community Research Project, currently in its third year of data collection, is a unique, peer-driven public health project that aims to investigate the experiences of PWID in the areas of health care, the criminal justice system, drug use patterns, and HIV risk behavior. Key findings include high rates of syringe sharing due to difficulty with sterile syringe access and high rates of overdose. As well, several studies point to the harms caused by the current emphasis on criminal justice interventions. For example, one study revealed that 48% of local PWID reported having drugs planted on them by police. Further, 78% of participants reported a history of imprisonment, and these individuals were five times more likely to have been in compulsory drug treatment and twice as likely to have shared syringes compared to those not in prison. Recommendations to the Royal Thai Government include urgently developing alternative regulatory frameworks for drug control which give primacy to public health and human rights concerns; providing harm reduction and human rights training for law enforcement officials and prosecutors; and providing a full range of harm reduction services in police detention facilities and prisons.

Dr. Thomas Kerr, an Associate Professor with the University of British Columbia and the principal investigator of the research, commented on the findings from the report. “The evidence from this body of research is clear. High rates of preventable disease continue to occur among people who inject drugs in Thailand. These problems persist due to the fact that harm reduction programs, such as syringe distribution programs, which are recommended by the World Health Organization and have been proven to be effective, have not been widely implemented in Thailand. This gap, combined with the overreliance on ineffective criminal justice interventions, has meant that Thailand has been left behind in the fight against HIV infection among people who inject drugs. Sadly, this inaction has resulted in immense, preventable human suffering, human rights abuses, and untold costs to the public. Clearly a more effective response is needed.”

Thailand has experienced unrelentingly high HIV and HCV prevalence rates among PWID for more than two decades. Continuous, repressive police crackdowns on people allegedly involved with drugs combined with an overreliance on incarceration and ineffective compulsory drug detention and “treatment” systems for people who use drugs create the conditions for the routine violation of basic human rights of PWID and increased HIV and HCV risk.

Karyn Kaplan, the Policy and Development Director for the Thai AIDS Treatment Action Group, and a co-investigator of this research project, commented on the recommendations contained in this report. “The evidence summarized in our report points the way forward. We have offered recommendations to the Royal Thai Government, the United Nations, and other international donors. Collectively these recommendations call for the immediate implementation of evidence-based harm reduction programs, alternative regulatory legal frameworks which serve to decriminalize people who use illicit drugs, and reforms to police practices. These actions have been implemented in various settings with success. Given the ongoing problems experienced by PWID in Thailand, it is clear that a new direction is needed. Continuing with the status quo will not result in meaningful changes and is simply not acceptable.”

The report launch and panel discussion will be held at 9 a.m. at “Bualuang Innovation” (a room in Technopreneurship and Innovation Management, Chulalongkorn University), 14th floor, Office Tower, Chamchuri Square (Phayathai Road, Pathumwan, Bangkok, 10330). Following the report presentation, a panel of officials from the Ministry of Public Health (MOPH), the Office of the Narcotics Control Board (ONCB), and the United Nations will respond to policy recommendations proposed from the research findings.

Reducing Drug-Related Harm in Thailand PDF: Download
Reducing Drug-Related Harm in Thailand (Thai version): PDF Download

People Who Use Drugs Demand Better Leadership From The Ministry Of Public Health In Support of Harm Reduction Policies and Programming

PHOTO: Kanna Hayashi

Bangkok, Thailand June 24th, 2011 – Over 100 harm reduction advocates including members of the civil society network, “12-D,” which works on Drugs and HIV issues, will present an open letter to the Minister of Public Health, H.E. Mr. Jurin Laksanawisit addressing the need for improved leadership on harm reduction in Thailand. “In advance of the International Day Against Drugs, June 26, we are here to protest the lack of evidence-based, community-based, and voluntary approaches for dealing with harms related to drug use, such as HIV, viral hepatitis, and overdose,” said Jirasak Sripramong, who runs a health promotion center for people who inject drugs in Bangkok.

At 3 p.m., prior to the 5 p.m. meeting with the Minister, the advocates will hold a rally outside the Department of Disease Control (DDC) at the Ministry of Public Health. The advocates include people who use drugs and their allies, all seeking improved leadership, further policy development, cross agency co-ordination and the involvement of current and former drug users in harm reduction policy development and programming.

With an unresolved, devastating HIV and viral hepatitis epidemic due to unchecked transmission among people who inject drugs, the constant police crackdowns on drugs makes public health and prevention work among this population nearly impossible, advocates say. Intravenous drug users (IDUs) have suffered mammoth rates of HIV and HCV since the 1980s, yet with policy in 2002 stating drug users are “patients, not criminals,” people who use drugs continue to be arrested as criminals under consumption and possession laws. “It’s really hard for us to implement life-saving services like HIV counseling and needle/syringe programs (NSP) when the police are empowered to walk into our centers and arrest who they like. Who would want to come into a drop-in center where safety and confidentiality cannot be ensured? We need backup. The police are too powerful, and no one has trained them in the value of harm reduction services,” said Karyn Kaplan, whose organization, Thai AIDS Treatment Action Group (TTAG) has advocated for harm reduction since 2002.

Thai public health services often discriminate against those who use drugs, and the police force constantly interfere with drug users’ rights to health and the ability of advocates and campaigners to do their work.

“Drug use is a health issue, and harm reduction services, such as access to clean injecting equipment and opiate substitution therapy like methadone, are fundamental to promoting the health of people who use drugs. We need the Ministry of Public Health to stand up and be a vocal and effective national leader on harm reduction, and to help us do away with laws and policies that actually increase harm to drug users and society at large,” said Paisan Suwannawong, former Chairman of the Thai Network of People Living with HIV/AIDS and a member of the Thai Drug Users’ Network (TDN).

Fight for your rights! On World AIDS Day, TTAG, Asia Catalyst (New York) and Korekata AIDS Law Center (Beijing) launch "Prove it: Documenting Rights Abuses"

Thai AIDS Treatment Action Group (TTAG), with partners Asia Catalyst and Korekata AIDS Law Center, have launched the English-language version of their human rights documentation training manual and trainer's supplement, to help marginalized groups respond effectively to rights violations in their communities (see below). Thai and Chinese-language versions will be ready in January 2011.
"Prove it: Documenting Rights Abuses" is 2nd in a series of 3 manuals/supplements that provide tools in understanding and using the human rights framework and tools to advocate against rights abuses. The entire series is called, "Know it! Prove it! Change it!" and "Prove it..." is the first to be published, as the documentation of the victims' experience is at the heart of human rights work. The manual/supplement was developed through a unique collaboration among the three groups over a year, and included in-depth consultations with Thai and Chinese marginalized groups wanting to advocate for improved treatment: people who use drugs, sex workers, LGBT communities, and migrants. A workshop to pilot the manual was held for advocates from Thailand and China in Bangkok in September 2010. "We wanted to demystify the human rights documentation and advocacy process. You don't need to be a lawyer or a human rights expert to do this work. The tools are straightforward, and the experts can just as easily be the very people who have experienced these violations and who are committed to ending further abuse in their community," said Karyn Kaplan, one of the collaborators.

Prove It : Documenting Rights Abuses [pdf]
Prove It : Documenting Rights Abuses Trainers Supplement [pdf ]
Prove It : Documenting Rights Abuses (THAI) [pdf]
Prove It : Documenting Rights Abuses Trainers Supplement (THAI) [pdf ]

TTAG Co-sponsors Regional Asia HIV/HCV Treatment Access Meeting

PHOTO: Rico Gustav

On June 22-23, 2010 Thai AIDS Treatment Action Group (TTAG), with the Asia Pacific Network of People Living with HIV/AIDS (APN+), 7 Sisters, World AIDS Campaign (WAC) and Medecins Sans Frontieres (MSF), co-sponsored the 1st South and Southeast Asia Regional Community Meeting on HIV/Hepatitis C Co-infection with community activists from six Asian countries: China, Vietnam, Thailand, India, Nepal and Indonesia. HIV/HCV co-infection across Asia ranges from 60-90% among people who inject drugs, yet national harm reduction programs are scarce and HCV treatment priced out of reach for most who need it. Meeting participants, who included allies from Lawyer’s Collective/India, Open Society Institute/New York, and Bangkok, discussed country situations as well as strategies for improving access to funding to support urgently-needed community education and awareness-raising, mobilization against the Roche/Schering-Plough patent “duopoly” and resulting high cost of treatment and diagnostics, and other advocacy. The meeting was sponsored by WHO/WPRO and WHO/SEARO, and the report can be accessed below. Presentations are available upon request (attention: karyn@ksc.th.com) National-level follow-up includes lobbying government for inclusion of HCV treatment minimums in Round 10-11 Global Fund grants, and community actions on July 28, the new annual “World Hepatitis Day.”

Check out Final Report_Regional HCV meeting [ pdf ]

HIV/HBV/HCV Co-infection Campaign Taking Off

(From left) Noah Metheny, JD, TTAG HCV Campaign Coordinator, and Tanyaporn Wansom, MD (and former TTAG volunteer!)

TTAG is thrilled to have received a grant from Open Society Institute’s Access to Essential Medicines Program, to hire Noah Metheny, JD, a graduate of Berkeley Law School, in the position of “Hepatitis C Treatment Access Campaign Coordinator.” Last year, Noah worked in Thailand as a Luce Fellow on access to essential HIV medicines, with Consumer Protection Foundation and Chulalongkorn University. This year, Noah will work with TTAG, Medecins Sans Frontieres – Belgium/Thailand, Asia Pacific Network of People Living with HIV/AIDS (ANP+) and others to help mobilize advocacy for improved access to HIV and Hepatitis C treatment access nationally, regionally and globally.

TTAG interviewed Noah about his 2010 plans…

TTAG: Tell us about your role as HCV Treatment Access Campaign Coordinator, and what are your plans for the upcoming year?

Noah:
In the next year as a treatment access campaign coordinator at TTAG, I hope to do three main things. First, I hope to help build legal capacity within Thailand for access to medicine campaigns by going around the country and training Thai lawyers about intellectual property issues and public health issues. Second, I hope to work with Thai activists to develop legal strategies to overcome barriers to Hepatitis C treatment, which now costs approximately $25,000 USD. Third, I hope to connect and work with activists in the region and globally to fight for better access to HCV treatment.

TTAG: What do you see as the biggest obstacle to HCV treatment, and strategically, how should we begin to address it?

Noah: There are two main obstacles to HCV treatment. First is the expensive cost of the treatment; second is the lack of education and understanding around HCV and how to treat it--from injecting drug users (IDU), the most at-risk group, as well as other patients, and medical providers, policymakers and Thai activists. We can overcome these barriers by building a sustainable grassroots movement in Thailand and in Asia to tackle these issues. I hope to be part of this fight over the next year as I work at TTAG.

Check out our new HCV publications!

  1. HIV/HBV/HCV Treatment Education and Advocacy Manual (English and Thai versions)
  2. HIV/HCV Policy Brief – for Thailand (English) (Thai)
  3. Look for our Regional Policy Brief at the Vienna International AIDS Conference in July 2010!
  4. HCV Treatment Pricing doc

SOLIDAYS 2009!

In June, TTAG participated in the Solidarite SIDA-sponsored trip to participate in Solidays (http://www.solidays.org/) in Paris. One of France’s largest festivals, Solidays is a major AIDS-awareness-raising event drawing over 100,000 youth (and “less young” people) spanning three days and including music concerts from dusk til dawn, the showing of the AIDS quilt, dynamic discussions and meetings with PLWHA and AIDS activists from Europe, Asia and Africa, and an overall great time. TTAG participated in an ACT UP-Paris action to spur France to contribute more to the GFATM (Le Sud compte ses morts; La France compte ses sous!], and made a 3-minute speech about drugs, sex and HIV to a crowd of thousands.

Figure 1Dr. Michel Kazatchkine and Dr. Swarup Sarkar and friends visit TTAG at Mitsampan Drop-in Center (Photo: Anurita Bains)

Mitsampan Harm Reduction Drop-in Center, a project of TTAG, was honored to welcome Dr. Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, TB and Malaria (GFATM) to our drop-in center, pictured here with his colleagues, Dr. Swarup Sarkar, Director, Asia Region (GFATM), and Anurita Bains, Senior Advisor, Office of the Executive Director (GFATM), and Dr. Thomas Kerr and colleagues of the University of British Columbia Center for Excellence in HIV/AIDS, after a wild rush-hour motorcycle taxi ride through the city! Dr. Kazatchkine is a long-time advocate for human rights of people who use drugs, and gave the opening plenary speech at the International Harm Reduction Conference in Bangkok. Read Dr. Kazatchkine’s related Guardian interview here:
http://www.guardian.co.uk/world/2009/apr/19/drugs-decriminalisation-aids

Figure 2Opening Ceremony Demo (Photo: M-J Milloy)

International Harm Reduction Conference, April 2009, Bangkok: TTAG and global drug user activists demand “TREATMENT, NOT TORTURE” for people who use drugs, at the 2009 International Harm Reduction Conference in Bangkok. Visit the web site below to read TTAG and Health GAP’s global petition demanding UNODC and governments act quickly to implement evidence-based drug treatment and stop human rights abuses in the name of drug treatment NOW:

http://www.healthgap.org/DrugUsersDemandTreatmentnotTorture.htm

Treatment Access for HBV/HCV/HIV co-infection! TTAG with Treatment Action Group in New York, with special advocacy guests Paul Cawthorne of MSF-Belgium (Access to Essential Medicines Campaign Asia Director) and Dr. Tanyaporn Wansom, held a 5-day training workshop with people living with HIV/AIDS and people who use drugs who are peer educator leaders in their communities. To read the coinfection education and advocacy manual developed by TTAG and TAG over the past two years, write to TTAG: karyn.kaplan@gmail.com (English and Thai versions available)

TTAG is proud to announce a new website centering on our PLWHA oral history and documentation project, in Thai: www.thaiaidscom.org

Thai AIDS Activists Receive $100,000 Leadership Award

The John M. Lloyd AIDS Leadership Award Recognizes Visionary Activists

LOS ANGELES, MARCH 30, 2009 – The John M. Lloyd Foundation announced today that AIDS advocates Paisan Suwannawong and Karyn Kaplan of the Thai AIDS Treatment Action Group have been selected as the co-recipients of the $100,000 annual John M. Lloyd AIDS Leadership Award.

Paisan Suwannawong, a native of Bangkok, has been living with HIV for 18 years. A former injecting drug user and graduate and former staff of Rebirth Drug Treatment Center in Ratchaburi, Thailand, Suwannawong is one of Thailand’s leading harm reduction advocates. He is the co-founder of the Thai Drug Users’ Network (TDN), founding chairman of the Thai Network of People Living with HIV/AIDS (TNP+), and, with award co-recipient Karyn Kaplan, co-founder of the Thai AIDS Treatment Action Group (TTAG) which strives to build leadership and advocacy capacity among people living with or at high risk for HIV. Suwannawong serves as TTAG’s executive director.

Karyn Kaplan, a native of New Jersey, has been involved with fighting the AIDS pandemic in the US and Thailand for over 20 years. In the US she worked with the International Gay and Lesbian Human Rights Commission (IGLHRC), and in Thailand she has campaigned for harm reduction and conducted drug policy advocacy with the Thai Drug Users’ Network (TDN), including helping to secure a historic US $1.3 million grant to drug user groups from the Global Fund to Fight AIDS, TB and Malaria (GFATM) for the country’s first peer-driven harm reduction project in 2003. Kaplan is the co-founder and Director of Policy and Development for the Thai AIDS Treatment Action Group (TTAG) in Bangkok.

“Their outspoken courageousness is undeniable and humbling for all of us,” said Robert Estrin, President of the John M. Lloyd Foundation. “This award is given with the Foundation’s admiration and respect for all that Paisan and Karyn have accomplished, and with the hope that it will help them to achieve even more success as leaders in the AIDS advocacy community.”

“It is such a huge honor for us to receive this recognition, and you have no idea how much this means to our organization in terms of its sustainability,” said Karyn Kaplan. Paisan Suwannawong added, “This is an honor not just for us, but for all of the activists working so hard in Thailand to fight AIDS and the discrimination around it.”

Renowned AIDS Activists Commend Suwannawong and Kaplan

Leading AIDS experts applauded the selection of Suwannawong and Kaplan for the second annual John M. Lloyd AIDS Leadership Award.

Gregg Gonsalves, formerly of the AIDS and Rights Alliance of Southern Africa (ARASA) as well as Gay Men’s Health Crisis (GMHC) said, “Karyn and Paisan have done critical work in Southeast Asia to protect the rights of drug users and secure access to AIDS treatment for all who need it under very difficult political circumstances.” Gonsalves was the first recipient of the John M. Lloyd AIDS Leadership Award in 2008.

Dr. Praphan Panuphak, director of Thai Red Cross and HIV Research Network, said, “Both of them are bold enough to give constructive criticism to the local authority and to the world which eventually leads to better respect and better care for marginalized, underserved population with HIV infection in Thailand."

Jutatip Dechaboon, from the Health and Development Networks (HDN) and noted leader among activists living with HIV/AIDS in Thailand, said, “It is incredible that Paisan and Karyn, who have led a very long walk on the HIV and AIDS road, have been awarded the John M. Lloyd AIDS Leadership Award. Their passion and intention on helping their friends allowed them to get the reward."

Shiba Phurailatpam, the Director of the Asia Pacific Network of PLWHA (APN+), said, “Ott and Karyn have been fantastic, they are fun to work with. Their commitment, determination and enthusiasm have been a constant source of inspiration for many people who have worked with them on drug use and HIV/AIDS.’’

Paul Cawthorne, Director, Access to Essential Treatments Campaign, Asia for Médecins Sans Frontières-Belgium/Thailand, said, “I am so pleased to hear that Paisan and Karyn are to receive the 2009 John M. Lloyd AIDS Leadership Award. I can think of few others that deserve such an award for the years of dedication they have given to the cause of improving access to treatment and care for people living with HIV and in particular those from the drug using community who have faced such enormous difficulties if gaining access to the treatment and care that should be theirs by right.”

The John M. Lloyd AIDS Leadership Award was established to recognize, support and empower effective leaders in AIDS advocacy who have not yet been extensively recognized. There is no application process for the award – the selection is made by the board of the John M. Lloyd Foundation. The $100,000 award will be split among Paisan Suwannawong, Karyn Kaplan and the Thai AIDS Treatment Action Group as an unrestricted gift to help build leadership capacity.

###

The John M. Lloyd Foundation was established in 1991 by John Musser Lloyd (1948-1991) to seek creative, compassionate, and courageous solutions to the root causes of the AIDS epidemic. Each year, the foundation awards approximately $400,000 in mostly small grants to achieve the following objectives:

  • Increase funding from public and private sectors to address the HIV/AIDS pandemic, in the U.S. and globally
  • Improve U.S. and international AIDS policies
  • Amplify global awareness of HIV/AIDS and facilitate broad-based changes in attitudes, to reduce stigma and change behavior
  • Develop the leadership of organizations fighting HIV/AIDS, and foster collaborations among those organizations and leaders.

The Lloyd Foundation received top ranking for its support of marginalized communities in a survey earlier this month that analyzed more than 800 foundations which was conducted by the National Committee for Responsive Philanthropy for its report, Criteria for Philanthropy at Its Best: Benchmarks to Assess and Enhance Grantmaker Impact.

RIGHT TO HEALTH FOR DRUG USERS "IMPOSSIBLE TO GUARANTEE"  WITHOUT HARM REDUCTION, says former UN Special Rapporteur on the Right to the Highest Attainable Standard of Health; Governments Must Act Now to Implement Comprehensive Harm Reduction

TTAG is proud to be an official supporter of "Harm Reduction and Human Rights: The Global Response to Injection-Driven HIV Epidemics," a report submitted by the International Harm Reduction Association (IHRA) and other global advocates on November 17, 2008 to the Office of the High Commissioner for Human Rights. TTAG commits to fighting for the rights and health of people who use drugs until the situation is reversed.

Read the report (.pdf):

 
Notes from the Field.
ACTIVISTS AT New York's HIGH-LEVEL UN General Assembly Meeting PROTEST THAILAND'S DRUG WAR AND OFFER GOVERNMENT CLEAN NEEDLES at the THAI EMBASSY
 

On November 29, 2007, Thai AIDS Treatment Action Group (TTAG) in collaboration with Human Rights Watch (HRW) released their report, Deadly Denial: Barriers to HIV/AIDS Treatment for People Who Use Drugs in Thailand.” The 57-page report documents a range of human rights violations, including clinician denial of ART to people who use drugs (including methadone, in some cases) and police interference with harm reduction services, and makes recommendations to the government of Thailand, the United Nations, the USA and international donors. The report can be downloaded in English or Thai at:  http://www.hrw.org/reports/2007/thailand1107/

   

In December 2007, TTAG opened its first satellite office, in Chiang Mai district center. Currently staffed by Mr. Bunniam Wongjaikam  , former chairman of the Thai Network of PLWHA (TNP+) – Upper North. Activities include working with people in prison and local and national government actors to improve access to HIV/AIDS treatment and harm reduction services for people in closed settings and in the community, and helping to document and archive PLWHA histories and experiences as part of a multi-media, peer-driven national-level TTAG project in collaboration with ACT UP-New York activist filmmaker, James Wentzy (see below).

   

TTAG and six partner groups in Central, Southern and Northeast Thailand, have documented their experiences of working together to develop a model of peer-to-peer empowerment for advocacy. The report, 80 pages filled with personal testimony, interviews and pictures, will be released in January 2008.

   

James Wentzy, long-time AIDS activist and filmmaker from New York City, has joined TTAG for four months to initiate a multi-media documentary and archiving project on the histories, experiences and visions of PLWHA activists, old and new. James, an award-winning documentary filmmaker, will work with TTAG and local PLWHA partners to provide cameras and train people living with HIV/AIDS in regions across Thailand in basic interviewing and filming, and help develop a Thai-language web site where documented material will be publicly accessible.

 

For further information on these and other TTAG activities, please contact:
Karyn Kaplan, karyn@ksc.th.com

 To read more about our Peer-to-Peer PLWHA work
Click Here

Our Mission
To promote equal access to AIDS treatment for all through policy advocacy, coalition-building, and strengthening the capacity of people living with or highly vulnerable to HIV/AIDS to advocate for their human rights.

"Five years ago, doctors, nurses and many other people told me and my friends that ARV was an impossible dream. Recently, Thailand announced that it would provide ARV to all who need it, starting with 50,000 people by the end of this year."

Paisan Suwannawong,TTAG founder, Opening Plenary Speech, International AIDS Conference (2004)

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