July 31, 2009
Dear Aj Udom,
Many thanks for the explanation, especially the "driving force" behind the AIDS program. Even people may speculate some issues you raise, however, your opinion make the point much clearer to me.
Shall I make a simple conclusion as follows: If thalassemia patients want to get the same support like AIDS patients, they should make noise and public campaign the same as what had happened to the AIDS patients before? That is quite easy. I believe with a little campaign and input there will be thousands of thalassemia patients rally for more support. But I don't think that is the right way!!! What will happen IF patients with many kinds of acute or chronic diseases campaign and force the government to provide more support for them. It will be a chaos.
What I did post in the web were questions to all administrators/decision makers about their justification in the allocation of budget. I trust and believe they should have better decision base on information NOT to base on emotion or political forces only. Some health economist told me that part of the justification is base on DALYs information. I wonder when I look at the DALYs data from Thailand many chronic diseases including thalassemia were not on the list while drowning and many kinds of cancers were on the high rank. To me it reflects that the diagnosis, especially underlying diseases, is not accurate enough. Then how can we rely on unreliable data for the justification and allocation of budget?
Suthat Fucharoen
Quoting Udom Likhitwonnawut <
apochana@ksc.th.com>:
> Referring to e-mail from Ajarn Suthat about the
> special program and
> budget for AIDS patients, I'd like to answer his
> question as follows.
> But his question should be quoted in full to prevent
> misunderstanding
> and/or being quoted out of context.
>
> Ajarn Suthat wrote, "Thailand has a special program
> and budget for
> AIDS patients, but not much to some chronic disease
> like thalassemia.
> WHY? Yes, I understand that HIV is contagious
> disease but once they
> get infect only few of them can maintain normal
> productive life. For
> thalassemia, if they have received proper care they
> can have normal
> productive life and almost normal life expectancy.
> But when you look
> at the support for thalassemia program it can not be
> compare with
> AIDS. Please kindly understand here that I don't
> mean to stop program
> for AIDS patients BUT I am asking for better
> justification and
> reallocate budget for other diseases as well as what
> we are doing for
> AIDS patients."
>
> In my opinion the success of AIDS programs in
> Thailand and other
> countries can be traced back to the early days of
> gays and lesbians
> right activism. In the beginning, most of the
> reported case in USA
> were gay men and, thus, AIDS was wrongly called
> gay-related immune
> deficiency (GRID). And in most people mind AIDS or
> GRID became
> associated with immoral behaviors. So another social
> fuel was added to
> the fire. Even before AIDS, gay and lesbian movement
> had became an
> important political force due to their activism in
> the earlier sexual
> revolution in the west. They had learned their
> lessons well and
> applied them to the new challenge - AIDS. Because of
> the US government
> policy of denial at that time, gay activists took
> their concerns to
> the streets and city halls across the country. Their
> actions forced
> Reagan to utter the four letter words, AIDS, in
> public for the first
> time in 1987 after five years of denial and silence,
> and rapidly
> increased number of reported cases and deaths. The
> activism of gay and
> lesbian and AIDS patients also forced the National
> Institutes of
> Health (NIH) to speed up the process of approving
> drugs for AIDS
> treatment and to include representatives of people
> living with HIV/
> AIDS in NIH's funded research.
>
> Another key player in AIDS activism is human right
> activists. Because
> AIDS is being associated with certain populations
> and behaviors deemed
> immoral for the mainstream society, HIV positive
> people became
> stigmatized and marginalized and their basic human
> rights were denied
> or violated. And this required the involvement of
> human right activists.
>
> The two combined forces have managed to create a
> broad-based
> constituencies that politicians and policy makers
> cannot ignored. The
> lessons and movement also spread to other countries.
> And of course,
> having the rights to vote or the ability to mobilize
> the community
> isn't enough. The activists and affected people also
> learn to equip
> themselves with knowledge and skills that can
> empower them for the
> tasks and expectations.
>
> One more important factor is the driving forces of
> HIV can be linked
> to various socio-economic forces such as poverty,
> gender inequity and
> gender-based violence, and political or economic
> instability
> (resulting in migration). These drivers are
> intertwined and caused HIV/
> AIDS to transcend the boundary of medical and public
> health. HIV/AIDS
> is now belonged to social and development as well as
> political (and
> security) domains. And one important condition of
> international aid
> program is contributions of the host country.
> Therefore the host
> government has to come up with its own program and
> budget to match or
> partially match the donated money. No money no
> international assistance.
>
> So if lessons from AIDS activism can be applied to
> other chronic
> diseases, it will force policy makers to reconsider
> the current
> policies. This shouldn't take as long as AIDS to
> produce comparable
> results considering the existing resources and
> aspiration that can be
> drawn from AIDS.
>
> Best regards,
> Udom
> >
>
-------------------------------------------------
This mail sent through MU-Webmail: webmail.mahidol.ac.th
--~--~---------~--~----~------------~-------~--~----~
* ท่านได้รับข้อความนี้เนื่องจากคุณเป็นสมาชิกกลุ่มสานเสวนา "ผู้สร้างสรรค์ระบบสุขภาพไทยและผู้ปฏิบัติการฉุกเฉิน" หากประสงค์ปรับเปลี่ยนหรือยกเลิกการรับข้อความกรุณาเข้าไปที่ website:
http://groups.google.co.th/group/thaiemp/subscribeกรณีต้องการอ่านการสานเสวนาย้อนหลัง โปรดไปที่กลุ่มสานเสวนานี้โดยคลิกที่
http://groups.google.co.th/group/thaiemp?hl=th หรือ
http://groups.google.co.th/group/thaiemp/topicsกรณีต้องการเสนอหัวเรื่องใหม่ กรุณาส่งอีเมลไปที่
thaiemp@googlegroups.comกรณีที่ท่านเห็นสมควรเรียนเชิญบุคคลเข้าร่วมกลุ่มสานเสวนานี้ กรุณาเรียนเชิญให้เข้าไปที่
http://groups.google.co.th/group/thaiemp แล้วเลือก "เข้าร่วมกลุ่มนี้" ในเมนูด้านขวามือครับ
-~----------~----~----~----~------~----~------~--~---
