Debate on public health and right to health in and outside United States has occurred over time and again. Cost implications are the main cause of these political debates. In countries where public health institutions are not developed, mortality rates are high (Gostin, &Powers, 2006). United Nations recognized the right to health in 1966; however, United States never ratified it despite having a stronger economy than the countries which ratified it like Canada, Brazil, India, Australia, China, Russia and most African countries. Public health improvement involves multi-sector reforms and high budgetary allocation in the concerned countries (Steen, 2008). HIV/AIDS has been the biggest threat to public health especially for developing countries in the recent past. If not properly managed it becomes expensive to individuals and governments.
In United States, more than two thirds of HIV/AIDS transmissions occur through sharing of syringe among drug users. HIV/AIDS is transmitted mainly through sex in most developing countries. Human rights activists and health proponents proposed the use of Syringe Exchange Programs to help reduce HIV transmission among drug users. This program was aimed at encouraging drug users to return used syringe in exchange for new ones hence avoid sharing. It was initially opposed by government but with time it gained legitimacy (Tempaldki, et al. 2007). In most developing countries, this kind of program is unthought-of. Drug Users have not been considered as people who require medical attention but as criminals. In the United States, the main opposition of the program came from police, politicians, district attorneys and beat officers but supported by right activists and public health practitioners. No other countries has discussed or even suggested such intervention.
Majority of people facing HIV/AIDS and STDs challenges in developing countries (mostly sub-Saharan Africa), do not have access to prevention and treatments programs. It has been noted that pregnant women in these countries do not have means to prevent mother to child transmission. Only about 20 percent of people in developing countries like Kenya, Nigeria and South Africa have access to HIV testing and counseling while only 40% of the population get HIV/AIDs and STDs education. In the United States, the situation is better since the institutions are fully developed with facilities to cater for most challenges facing people living with HIV/AIDS and STDs.
People living with HIV/AIDs and those infected by Sexually Transmitted Diseases in developing countries especially India and Africa are stigmatized. For instance, in Botswana stigma has made people living with HIV/AIDs to avoid treatment despite the fact that it is provided in public hospitals. In United States, stigmatization of HIV/AIDs and STDs victims is negligible.
How to prevent HIV/AIDS and Sexually Transmitted Infections in Thailand
The emergence of HIV /AIDs in Thailand in the late 80s caused un-presented alarm within the Thai population. Most people did not associate HIV/AIDS with sex. Instead, it was associated with drug users. The government initiated nationwide campaign to educate sexually active and risk groups. These groups included males and female commercial sex workers (Viddhanaphuti, 1999). Education focused on change of behavior and how the disease spread. Government used mainly mass media advertisements and educational campaigns to deliver their messages to the target groups.
Ministry of public health started a campaign to help increase the use of condoms among sexually active people. Though there was resistance due to cultural believes, the initiative recorded commendable success after sometimes (Buckingham, 2005). “No Condom No Sex: 100% Condom Program” was initiated in Ratchaburi Province. In 1991 the campaign strategy was implemented in the whole country. In this campaign, sex workers and sex establishment owners were educated and supplied with free condoms. The government has so far made use of condoms a requirement in all sex establishments, while provincial governments and police are tasked to ensure that it is followed. Any establishment which cannot adopt the policy is shut down.
The Thai government use tracing contact supplement strategy to identify sex workers who have been infected with STDs before it is too late. Men who seek medical attention for STDs are asked to name sex establishment they have used. Proper measures in line with the law are taken against establishments which allow infected worker to spread disease. The measures include closing down the establishment.
References
Buckingham R.W, et al. (2005), Factors associated with condom use among brothel-based female sex workers in Thailand. AIDS Care. 17, 640–647.
Gostin, L & Powers, M. (2006).What does social justice require for the public’s health? Public health ethics and policy imperatives. Health Affairs, 25,1053-1060.
Steen J. (2008), Human Rights and Social Justice in the Vision of Public Health, Washington State Journal of Public Health Practice, 1
Tempaldki,B., Flom., Friedman,S., Desjarlais,D., Friedman,J., McKnight,C., et al. (2007).Social and political factors predicting the presence of syringe exchange programs in 96 U.S. metropolitan areas. American Journal of public Health, 97, 437-447.
Viddhanaphuti, C. (1999), A Cultural Approach to HIV/AIDS Prevention and Care: Thailand’s Experience Country Report Studies and Reports, Special Series, 6