Asia's tough laws work against HIV/AIDS prevention, say experts

International experts are warning that Asia is facing a new wave of HIV/AIDS partly because tough local laws are hampering disease control efforts.

A conference on the escalating health and humanitarian crises threatening billions of the world's most vulnerable - many of them in the Asia Pacific - region is taking place in Hanoi.

Radio Australias Presenter: Sen Lam.

Speakers: Mr Anand Grover, the UN special rapporteur on the right to health; Jon Ungphakorn, the founder of National Aids Alliance Thailand and AIDS Access Foundation, Thailand.

LAM: Anand Grover if I may begin with you, as the UN Special Rapporteur on the right to health can you please give us an update on the region? Is the situation particularly grim for the world's poor in accessing health services?

GROVER: Well the situation in Asia is actually not very good and it is exacerbated and turning to the worse because of the financial crisis. Also I think this light amount of downturn in the new infections in HIV, there's a bit of complacency. On top of that we hear news that there's back to the old regime kind of attitude by governments, including criminalisation of HIV transmission, return back to anti-sodomy laws in regions in Africa. And in our region in Asia where the Asia Commission's report has very clearly outlined that the marginalised groups, including sex workers, drug users and men having sex with men have to actually be protected and their rights promoted. We don't see much change and it's getting from bad to worse, that's my opinion.

LAM: Well we've move to HIV AIDS a little bit later but what are some of the reasons for this change in the region, especially in the Asian region?

GROVER: Well basically I think people have come to realise that there's not enough money available and health is an easy sacrificial goat for governments.

LAM: Jon Ungphakorn what's the story in Thailand? As I say we'll look at the battle against HIV AIDS in Thailand a little later, but have you for instance found it increasingly tough to access funding?

UNGPHAKORN: Most in Thailand we depend a lot on ourselves, there's been a long struggle for access to medicines in Thailand and for universal health insurance we have achieved both, but the danger for us is signing free trade agreements with the US and with the European Union which might make it much more difficult for us to access patented medicines or to use compulsory licensing or generic production of life saving drugs.

LAM: What about access to treatment, particularly for HIV AIDS patients?

UNGPHAKORN: In Thailand we are lucky that we have carried out compulsory licensing of the most needed drugs. However the present government has faced retaliation from the United States and it seems not willing anymore to use this measure, which is perfectly legal under WTO agreements. So the future looks a bit bleak, particularly for people with HIV AIDS who need access to second and third line anti-retroviral treatments.

LAM: Anand Grover there must be I suppose disparities even between countries in Asia in terms of a right to health, but is the gap dramatically wide?

GROVER: The gap between countries is very wide because as Jon has mentioned to you Thailand is lucky enough to have achieved fairly universal coverage as contrasted with say countries in South Asia, which is not a priority. But I want to really go back to what Jon said, and there's a very big danger of the Free Trade agreements denying access to very essential HIV medicines, and India which is a source of generic companies is also facing a lot of threat from the European Union, Japan and the US in trying to limit the flexibilities in TRIPS which are granted including compulsory licensing, which would be the only sure way of making sure that second and third line drugs are available. If that doesn't happen then a lot of the developing countries will face a lot of difficulty in getting access to otherwise patented drugs.

LAM: You're listening to Connect Asia on Radio Australia and the World Radio Network, and our guests this morning are the UN special rapporteur on the right to health, Anand Grover, and the founder of the National Aids Alliance in Thailand, Jon Ungphakorn. Both men are in Hanoi, for the International Conference on The Rights to Health & Development.

Anand Grover if I may move back to you, HIV AIDS of course is again causing concern in the region and I understand that you're advocating an end to the tough laws against drug abuse in Asia. Can you tell us more, what do you have in mind?

GROVER: Well you know the success in Asia has been by being able to protect and empower the communities of sex workers, drug users and men having sex with men. But ultimately their rights are not being protected because their right to health is being compromised by for example large numbers of drug users who because possession and consumption is illegal in most countries find themselves in either compulsory treatment centres or voluntary treatment centres where it's not the evidence based treatment which is actually resorted to, but old detoxification, which has a huge relapse rate, and they're subjected to a large number of abuses throughout the region, including in India for instance where NGOs run the centres and they're totally unregulated. And people will end up dying later on.

LAM: But you're not going as far as to advocate the decriminalisation of the drug trade as it were and drug pushing?

GROVER: It's not the drug trade that we want to decriminalise, I think that large numbers of people who are just simple drug users they find themselves being treated as criminals and their rights abused.

LAM: So you would make the big differentiation between drug users and drug pushers and traffickers?

GROVER: Well actually it's like the United States, once you actually lifted prohibition there was no question of alcohol trafficking. The thing is once you criminalise you allow traffickers to come in because the differential between the prices between the legal price of a particular commodity and the illegal price because of criminalisation allows traffickers to come in.

LAM: Jon Ungphakorn if I may move to you at this stage of the National Aids Alliance in Thailand, would that work in Thailand, decriminalising drug use?

UNGPHAKORN: I agree with Anand, in Thailand you know we have effectively reduced the number of new HIV infections each year amongst the general population. But amongst injecting drug users HIV is still extremely high, between 40 and 50 per cent, and this is because of the strict criminalisation of the drug trade, which includes criminalisation of drug users. It means that drug users find it very difficult to come for help and get protection against HIV. So I would agree that this in contrast with the very relaxed attitudes towards the sex industry, which allows, which has reduced HIV AIDS in the sex trade.

LAM: But Jon what's the mood of the current government under Prime Minister Abhisit Vejjajiva, for instance under the former Thaksin regime that government was criticised for its particularly heavy crackdown on drug peddlers, and even petty criminals a few years back killing hundreds of people. Do you think the current government under Prime Minister Abhisit is perhaps a little bit more forward looking, a little bit more moderate?

UNGPHAKORN: It's more moderate in that it's not killing drug dealers like Thaksin's government was doing. But the attitudes towards drug users haven't changed. They face police harassment all the time and that makes it very difficult for them to access harm reduction. And the Thai government doesn't allow yet needle exchange programs for drug users.

LAM: Anand Grover you're familiar with the Asia region of course and drugs and drug use are frowned upon in most Asian communities. Do you not think it's a bit unrealistic to push for an end to these tough Asian laws?

GROVER: Well actually you know traditionally in Asia drug use is not criminalised, I mean in India and other countries we had legalised cannabis use and in the British days opium was licensed. It's only the tough laws which came after the Second World War, which has increasingly criminalised people who are using drugs for recreation, and unlike alcohol, which is really bad and cigarette smoking is really bad, you have the situation with some of the soft drugs is arguably as not as very serious to health, and people using them are being criminalised. So it's a very anomalous situation which needs urgent attention because people are drying as a result of such criminal laws. And I'm very concerned with the fact that in the Asia region a large number of people are being put into jails, in cages, being mistreated, abused and end up not only being criminals, but dilapidated for a long period of time and some of them die.

LAM: So really as far as you're concerned it's all tied in with human rights, that prevention and treatment work best when the rights are respected?

GROVER: Absolutely, absolutely and we have good evidence of that in India and also in Thailand where you actually protect marginalised communities like sex workers, you can get condom usage up and then you can actually reduce transmission and the incidence of HIV has come down around the Asian region because of that. But if we actually keep on criminalising larger groups of people then the result is going to be not very successful in the long run.

LAM: Ok we'll have to leave it there gentlemen, thank you very much for speaking to us.