OTGV #23 - Aids Series 1/5 - On the Homefront

Broadcast Date: 02/12/02

December first, World AIDs Day.

Not a celebratory date but an important date nonetheless.

It educates and this is this year's UNAIDS campaign message.

"Don't you touch my sister",
"You're not my son anymore".
You've just experienced some of the most painful symptoms of HIV and AIDS. Help us fight fear, shame, ignorance and injustice worldwide.

Live and let live.

The greatest pain of contracting AIDS isn't physiological.

It's the pain of rejection, discrimination, and ostracism.

Hi I am Chong Ching Liang and welcome to the first of an On the Grapevine series on the AIDS pandemic.

AIDS has been a malevolent juggernaut that's not let up despite better knowledge and medication that have surfaced in the last two decades of research.

Action for AIDs' President, Dr Roy Chan provides the grim statistics during the Third Singapore AIDS conference.

"Since we last met two years ago in December of 2000, another two million people have become infected with AIDS, HIV in Asia alone. There are now over 7 million infected persons in the region, it is clear that the epidemic has well and truly taken off and the most severely affected countries in the region are Thailand, Myanmar, Cambodia, and India. But more recently the epidemic has been increasing rapidly in parts of China, Viet Nam and our neighbour, Indonesia. In Singapore in the last two years, 450 or more Singaporeans and PR were diagnosed with HIV and AIDS. This brings the total number of infections to almost 1800 and over 600 have died from AIDS."

Compared to South Africa or perhaps Thailand that's closer to home, it is easy for Singaporean to think that 450 in two years isn't great shakes.

But each digit obscures the human face that it is. Dr Chan again.

"Whilst many have the support of families and friends, others have passed away alone, and have been abandoned. Memories have often been banished from families because of shame and embarrassment. We are very happy that this time there are individuals brave and committed enough to air their fears and hopes. I would like to recall these words of Nelson Mandela at Barcelona AIDS conference in July who in calling greater visibility and positive people says 'you must not be ashamed of speaking out, because when you keep quiet, you are signing your own death warrant.'"

In Singapore where intravenous drug consumption isn't a major problem, the spread of AIDS/HIV through drug addiction is rare.

The more primal urge of sex is the main cause.

"The overwhelming majority was transmitted through sexual intercourse. The majority of infections are seen in heterosexual males with a significant minority among homosexuals and bisexuals. 9 cases out of ten are in males. The proportion of females has not changed much over the years."

Times have changed.

Contracting AIDS is less of a death sentence these days.

"Modern medicine has now rendered AIDS a treatable disease. It is no more the uniformly infections that it was in the 80s and the early 1990s. Anti-HIV drugs can be given, can give infected individuals a very good chance to live long healthy and fulfilling lives."

But these medications aren't cheap and while they keep the infected individuals a more normal life, it doesn’t cure.

Minister of State for Health Balaji Sadasivan warns a dependency on current medical advances won't derail the AIDS pandemic.

"While medical treatment has improved the quality and length of life for HIV-infected persons, it cannot cure HIV disease. Once infected, despite the best and most expensive treatment, the quality of life over time can never be as good as those who are not infected. Despite treatment, a person with the HIV virus still can spread the infection. Since AIDS is almost always spread by careless and irresponsible human behaviour, the key to prevention is to educate people to be careful and responsible."

The costs of a life-saving triple cocktail of anti-retroviral drugs are still formidable for HIV/AIDS patients.

This fact is even more crucial when you consider the Health Ministry study that shows most new cases are blue-collared working class men whose monthly income may be less than a month's prescription costs.

Unfortunately, the Singapore government doesn't provide them for free to all AIDS patients because they are considered non-standard drugs.

But the road isn't closed.

The anti-retro-viral drugs are known to reduce the mother-to-child transmission of the deadly virus during pregnancies.

Dr Balaji says the State do provide when it comes to expectant mothers and their children.

"All the women who are HIV positive, who have to deliver children, have been given the medication because KK Hospital they have special funds that they collected through fund raising projects which they use to give these women so that they get their medication. Likewise, every child in Singapore who has had HIV, all its treatment has been paid for. What is more, KK has got some funds to help their parents. These children fall sick. ETC"

However, the greatest tragedy of it all is that after over two decades, males haven't learnt the prevention and cure for AIDS/HIV isn't too expensive, if they are intent on sowing their wild oats.

Feeling frisky? Got a dollar?

The condom is the surest way to avoid contracting AIDS at an average cost of 1 dollar apiece.

Tune in to the next installment as I look at the global AIDS pandemic.

This is Chong Ching Liang for Newsradio 938.

=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg
http://www.moh.gov.sg/corp/about/newsroom/speeches/details.do?id=29294601

World AIDS Conference 2004
http://www.aids2004.org/

United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/en/default.asp

OTGV #22 - Aids Series 2/5 - The World Outside

Broadcast Date: 09/12/02

The HIV/AIDS infections is now a pandemic and no longer an epidemic.

It now covers almost the entire world, and yet it keeps growing and growing.

According to UNAIDS statistics, the number of people living with AIDs is now at 42 million.

Hi, welcome to On the Grapevine with me Chong Ching Liang.

Despite having been tracked and studied for nearly two decades, the rate of increase just keep accelerating.

Dr MeeChai Viravaidya is the appointed Ambassador for UN-AIDS.

He has been an incessant presence in the fight against AIDS in Thailand and he paints for us the extent of the growing pandemic.

"AIDS death each year is 3 million and going up. I mean, the whole of Singapore is dying every year. Can you imagine that? The whole of Singapore dies every year! But that's the current situation in many, many parts of the world."

AIDs/HIV threatens not just economically but socially.

Director of HIV/AIDS Research Division, University of Natal, South Africa Alan Whiteside explains.

"AIDS can either be extremely divisive to a nation or it can be a nation-building force. It depends on how the nation responds to it. In the worst situation, what you find is that people are not open about HIV. They know there's a problem in their midst. They don' know the magnitude of their problem. They can see their friends dying and falling ill. They're not entirely sure why. There's no leadership."

Countries must look at AIDS issue as a humanitarian problem, not mere statistics to be cast aside if the infection rate is too small.

President of Action of Action for AIDs, Dr Roy Chan revisits the AIDS situation in Singapore.

"While the absolute numbers in Singapore may not be very high, per capita infection rates tell a different story. When we compare these stories, we find that HIV here is more prevalent than many other developed countries in Europe, in Asia. Our HIV prevalence is 0.146 percent amongst adults compared to 0.12 in Australia, 0.12 in the UK and a much lower rate in Japan. But numbers do not the full story. More important than numbers is the fact that AIDS have now touched the lives of thousands of Singaporeans. We have lost and continue to lose friends, family members, fellow workers and fellow citizens to AIDS."

But the adults aren't the most at risk, warns UN-AIDS' Senior Epidemiologist Bernhard Schwartlander

"AIDS hits young people in ages when they are the most productive. That leads to traumatic impacts on development, on economies and on households in many parts of this world. You can imagine the impact this has on economies for example. In a company, when a quarter, or more than a quarter of the labour force is HIV positive, that company may run into serious trouble in the future."

Sadly and most unfortunately, it is only when the economic costs of AIDS becomes obvious, then will actions be taken.

One of the largest mining companies in South Africa, AngloGold estimates up to 30 percent of its workers.

Faced with this challenge to its future productivity, the company is now dispensing the expensive "triple cocktail" of anti-retroviral drugs to its AIDS infected employees for free.

In Southern Africa, where the AIDS problem is at its most acute, it’s political and business leaders are stirring from their stupor.

Executive Director of UNAIDS, Dr Peter Piot.

"I believe we are now at a turning point in the 20-year history of the AIDS epidemic in Africa. Everywhere I go, I hear the top African leaders speaking out about AIDS as the major threat to the continent’s development. This gives me grounds for hope that in the coming years, we will see stronger, more effective responses to AIDS in many more sub-Saharan African nations."

It's about time, says Dr Meechai.

He says AIDS has the potential to de-stabilise a country.

"In most part of the world, national security issues is are from the inside. HIV/AIDS is already changing not only individual fate but fates of nation. In many African countries, a quarter of the adults is affected. The workforce is being depleted. The most skilled people are dying. Teachers, engineers, doctors, soldiers, the whole works. Probably the next Prime Minister will be younger than William Pitt, younger than 21 because there's nobody older than that."

So far, the focus of the world when it comes to AIDS has been trained at the males.

But as the situation in Southern Africa indicates, it is the females that are increasing carrying the burden of the infection.

But going beyond gender, Asia may soon catch up with Africa in terms of infected individuals.

"AIDS is not a health problem. It’s a development problem, it’s a societal problem. For Singapore , it's a small problem today but for many, many countries, it is bigger than war. Before long we can say there will be more people who died from AIDS than all Asians that have died from wars in the whole history of Asia. That will happen."

The culprit for the spread of the AIDS isn't always an individual's lifestyle, lechery or inclinations.

The most culpable of culprits belongs to those in charge of governance says Dr Meechai.

"Why we have allowed this to happen? It is the lack of political leadership. How many leaders in the world has stood up, understood the fight against AIDS and willing to put up a good show? Some has remain totally silent. And not just the leaders of a country, leaders’ politics, business as a whole begins always with denial and then before actions takes place, so many people has been condemned."

For the anti-AIDS campaigners, the key to fighting the scourge must be transparency at all levels of society.

Only then can education takes place to dispel prejudices and discrimination.

And perhaps only then, true rehabilitation and the search for cure be more meaningful for the infected.
Tune in to the next installment as I look at how the pandemic can be combated.

This is Chong Ching Liang for Newsradio 938.



=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg
http://www.moh.gov.sg/corp/about/newsroom/speeches/details.do?id=29294601

World AIDS Conference 2004
http://www.aids2004.org/

United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/en/default.asp

OTGV #21 - Aids Series 3/5 - Media's role

Broadcasted on 16/12/02

AIDS can be seen as a disease, a social problem or a public policy planning headache.

In whichever guise, AIDS isn't dirt that can be swept under the metaphorical carpet.

Hi, I am Chong Ching Liang and welcome to On the Grapevine.

There's no carpet big enough for the problem to be swept under.

The plight of the infected has to be brought to light.

Dr MeeChai Viravaidya is the Ambassador for UNAIDS and has been an incessant voice in the fight against AIDS in Thailand.

"We have very little time. The pandemic has leapt upon us with appalling sadness. In 1980, we knew nothing about AIDS, right now, 20 million have died."

For nearly two decades, Dr MeeChai has been educating his fellow Thai on the cheapest and most effective ways to prevent AIDS is the humble condom.

He feels governments should do more even if AIDS isn't a big problem yet.

"Once AIDS takes hold, it explodes. Don't wait for it to happen. Enjoy the luxuries of doing a bit too much, too soon. Enjoy the luxury of that."

The media is one tool where policy planners and governments have tried to harness in their fight against AIDS

When he opened the Third Singapore AIDS conference, Minister of State for Health Balaji Sadasivan took the Singaporean media to task for not doing enough to educate the public on AIDS prevention.

"I was greatly disturbed by a 2 Oct report in the New Paper that highlighted the plight of a young lady who had unprotected sex with a man dying with AIDS because and I quote 'I didn't want him to feel that there's a barrier between us'. In a similar article, a doctor had stated that he had known people who wanted to be HIV positive just to be equal to his or her positive partner. What disturbed me was the article covered in a rather neutral manner. While we empathize with those suffering from HIV/AIDS, we and in particular the Media, must send a clear message to young people that it is not OK to get AIDS."

Dr MeeChai issued a similar call to governments and the media to do more.

"It's now as never before, not only to advocate for the afflicted, and pressed for more effective, more effective treatment but also to turn back the time. There's no cure. There's no vaccine. The only way to end this pandemic is to end new infections. We have to say this loudly and often, and we have to back it up with action, not just with words."

The next world AIDS conference will be held in Thailand and Dr MeeChai wants it to be a major coming-out party

As host, Thailand plans to raise some eyebrows

"When you land on the airport, I hope I can have the airport authorities to have the red ribbon on the tarmac. So every pilot landing, whether you are bringing people to the conference or not, the red ribbon is there. And when you hand in your passport, instead of just smiling stamping, they'll stick a condom in your passport. We will have children marching, the whole of Bangkok will know what's happening, and we will also have our policemen working with us, any parking ticket will also have a condom attached to it. We'll call that our 'cops and rubbers' programme."

The next step is to educate.

Education will break stereotypes, prejudices and most of all myths.

Dr Meechai's team has produced an information booklet that they had mass-distributed in the past.

"Well they were given a book that we produced earlier. Questions and answers on HIV, questions such as can you get AIDS in a swimming pool? Well you can get it anywhere. It not where you are, it's what you do. You can get it on a kitchen table as well. And we trained them so they were aware of AIDS and when people talk to them, [they say] 'yes it's real. and here's a book and you can't get it from kissing. Well, in a way I guess you could but you have to kiss and exchange saliva for 50 litres!"

AIDS is a sensitive topic because it affects cultural sensibilities and dampens the tourist trade

So, statistics may be manipulated to give a false indication of the AIDS problem

"And then one day, yeah just a few, yeah a little bit more. And then they still lie about the figures. Just keep the figures low and the fewer people you tests, the fewer HIV positives. In many counties, the testing is low, that's why the figures is low. But that's not the issue, the issue, and it is the most evil element in government, is denial, because denial means you lose time and you lose lives unnecessarily."

But times are changing.

Political leaders are acknowledging the problem.

In southern Africa where the problem is at its worst, Nelson Mandela has been a tireless campaigner.

"There can be no doubt that humanity faces a major challenge. The severity of the economic impact of the disease, is directly related to the fact that the most infected persons are in the peak productive and reproductive age groups."

Famous movie stars have also joined in the fight.

Elisabeth Taylor in her speech to the UN two years ago petitioned for cheaper drugs for AIDS sufferers.

"When will the world find the human and financial resources to replicate these life saving programmes across the region if not the world? How much longer can we afford to wait? Our hopes for effective treatments are surely closer to us than ever before."

Perhaps star power can open more eyes than dreary educators or politicians.

Only when the veil is lifted can the society see AIDS as a disease that can be controlled.

Here's actor Danny Glover's message.

"I have to say something. If I am disappointed with the take, we go again. Shoot it again. But with AIDS, the movie's over. It's the last show. It's up to you and me. Lend your voice, to break the silence."

Tune in next week for a look at the social implications behind not providing cheap medication.

This is Chong Ching Liang for Newsradio 938.



=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg
http://www.moh.gov.sg/corp/about/newsroom/speeches/details.do?id=29294601

World AIDS Conference 2004
http://www.aids2004.org/

United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/en/default.asp

OTGV #20 - Aids Series 4/5 - The Rationale for Cheap Drugs

Broadcasted on 23/12/02

AIDS hasn't a cure.

Well, not just yet anyway, but the capacity to fend off the most debilitating effects of the scourge is here.

Unfortunately, most of the afflicted has no access to the much-needed medication because of one thing:

The huge costs.

Hi welcome to On the Grapevine with me, Chong Ching Liang,

Although Africa has been hogging the headlines when it comes to the AIDS pandemic,

Asia is fast catching up.

Estimates from UN-AIDs projects Asia will lose more lives through AIDS than all of its wars put together.

What puts this in even sharper perspectives is that there is medication to fend off this calamity to humanity.

Veteran actor and AIDs activist, Elisabeth Taylor just developing medicines is useless.

"Our enthusiasm for these drugs should also not distract us from another gloomy reality; that under healthcare systems, the issues of costs and access will mean that these drugs will not be available to those that need them the most. As a result, terrible discrimination will both in the US and elsewhere, between the rich and the poor, the Haves, and the Haves-nots, those that can afford Protease inhibitors, those cannot."

It seems only when the AIDS affect a country's or a multi-national corporation's economic future, then definitive actions will be taken.

AngloGold, one of the largest mining companies in the world, has decided to provide free anti-retro-viral drugs to its workers.

Some 30 percent of its 40 000-strong workforce could be severely weakened.

The alternative of not doing anything for Anglogold, is imponderable as a business entity.

Anglogold has been able to provide the life-saving "triple cocktail" to AIDS patients because South Africa have been granted the right to produce cheap generic "copies" by the pharmaceutical companies.

But such actions are far and few in between because of the strong copyright laws protecting the giant pharmaceuticals.

Elisabeth Taylor made this poignant plea to the UN a couple of years back.

"When will the world find the human and financial resources to replicate these life saving programmes across the region if not the world? How much longer can we afford to wait? Our hopes for effective treatments are surely closer to us than ever before."

Unfortunately, this is something that Singaporean AIDS sufferers cannot look forward to say Action for AIDS or AFA, Benedict Jacob-Thambiah.

"The protection of generic drugs itself is protected by several international agreements for example TRIPPS under the WTO and also under several patent laws. I do not see Singapore allowing the production of generic drugs. One is for the protection of the pharmaceutical companies; second, is the numbers in Singapore are too small for us to actually set up a generic drug production service or a centre. So right now, many patients buy their drugs from Thailand or from, you know, their friends who come from India who made drugs as well. I don't foresee Singapore ever having generic drug production centre."

Singapore has grown to be a world-leading medical hub.

But Ambassador for U-N AIDS, MeeChai Viravaidya says perhaps more can still be done in Singapore to help the AIDs patients.

"On the treatment, yes, you are doing a great deal but the costs is still high. Luckily in Thailand, as of next March, the government, government-owned pharmaceutical organisations would be able to produce cocktails at the price of 75 U-S cents per day so no more than around US$300 the whole year. Sometimes you can't even come out of a Chinese restaurant under that in some cities. We can't export it but if Singaporeans want to come over, no problem. We'll really help you that way."

How expensive is the AIDS medication in Singapore?

Benedict paints the grim picture.

"HIV drugs in Singapore are among the costliest in the world. The drug companies charge Singapore what they charge countries in the North like America and in Europe. They do not realised that the per capita income of Singaporeans on average in comparison to income of people from North America and Europe. They charge Singaporeans the same prices. The cost of medication here can cost anything between 800 dollars a month, 1500 to as much as 2000 depending on the kinds of cocktails you are on. And it also depends on how severely affected you are with the HIV virus. 70 percent of the patients in Singapore are not on medication because they cannot afford HIV drugs."

If you analyse the Health Ministry's AIDS statistics, most of the infected belong to the lower economic classes, i.e. the blue collared workers.

Therefore it's no wonder that 70 percent of them are without medication since their wages will be much lower than the costs of treatment.

To compound things, the AIDS medication cannot be subsidised by the government since they are not on the schedule of standard drugs.

However, Minister of State for Health Balaji Sadasivan says there'll be help for those most in need.

Expectant HIV-positive mothers are given the anti-retro-viral drugs as some studies have shown that it will significantly reduce the transmission to the unborn baby.

"All the women who are HIV positive, who have to deliver children, have been given the medication because KK Hospital they have special funds that they collected through fund raising projects which they use to give these women so that they get their medication. Likewise, every child in Singapore who has had HIV, all its treatment has been paid for. What is more, KK has got some funds to help their parents. These children fall sick. ETC"

In summary, here's where Singapore's is:

The AIDS patients wish and hope that the government could do more to help reduce the costs of treatment,

the AIDS activists wish that cheaper medicine will lead to a much lower infection rate because more HIV- patients will come out of the closet for treatment and counseling.

And this may in turn contribute to the government's wish to eradicate AIDs in Singapore.

This is Chong Ching Liang for Newsradio 938.


=========================
Related Websites:

Newsradio938
http://newsradio.mediacorpradio.com

Action for Aids
http://www.afa.org.sg

Ministry of Health, Singapore
http://www.moh.gov.sg

OTGV #19 - Aids Series 5/5 - Voices

Broadcast Date: 30/12/02

Their voices are silent.

Even if they speak, sometimes, family members don't hear.

And when they are gone, families sometimes force themselves to forget.

These are the voices of the HIV positives.

Hi welcome to On the Grapevine with me Chong Ching Liang.

I spoke with Royston Tan, the director of the remarkable film, 48 on AIDs, on why he decide to do this project.

[There're really of a lot of the misunderstood theories of this disease. [It is] Something that I have always been wanting to explore. The opportunity came when Channel NewsAsia approach me to do a special documentary for the 20th anniversary of AIDs. Well I think it was overwhelming for me because I didn't really know what I was getting into. This is definitely one of the most challenging projects that I have ever done because people are not so open about this topic and there were people who shun me because they knew I was in contact with the AIDS patients so they didn't want to talk to me. That three months in the production was a lonely journey for me but I really enjoy the whole process because I think personally for myself, I have misunderstood a lot of things about this disease and I have got a clearer picture [now] and that helped me a lot. I hope it is for the viewers who had seen this film. So Royston, tell me, what is the one big thing that you have gained from this remarkable endeavour? When I am in contact with the AIDs patients, I felt the way they live their lives; they cherish every moment they have. All the little things like the sound of raindrops and the colours of the grass and things like that. And that is something that I have never appreciated and it makes appreciate things even more now.]

48 on AIDS was shown on Channel NewsAsia on World Aids Day at the beginning of this month.

Here are the voices of the afflicted, beginning with two young boys who symbolise the innocents who’re swept into the AIDS maelstrom.

[Twinkle twinkle little star, how I wonder what you are.][I think for most of us AIDS is still very distant, very unknown you know. It's a disease that happens to other people or other countries but you know when it strikes home, then you think of it very differently. And when you have knowledge of someone, whom you knew, who is so full of life, so talented, who actually succumbed to it, then you feel the full impact. You know, the pain, and ... and the sense of loss and my greatest wish if I can ever make a wish is that I never again have to know of any other who's succumb to this disease.][I never know that I would become a transgender okay? Or I will become a sex worker and caught HIV. Okay, so now I feel like, maybe it's still a dream. Maybe one day I'll wake up and it's not real. I never feel sorry for being HIV now because that changes my life from a sex worker to a skilled worker. So that's something that I never thought I can be.] [You appreciate all these little things because somehow having this is sort of an awakening I guess like 'Hey!' you know you gotta open your eyes and don't take things for granted anymore and every little things is so meaningful like just turning on the tap and watching the water flow through, taking a shower and all these types of things. I always like to pass on a very positive type of thinking to show them that it's not a death sentence after all and with the will and a lot of positive thinking, life just goes on.] [To me, I feel even if you've contracted the disease, its better not to know because more often than not, if it turns out that if you do then it changes your whole perspective on life. It's like the same as... same reason why people don't want to know about their future lah.] [I don't think that I will live beyond the age of 55 because by then, I think I should have AIDS and I am sure that ten years down the road, on this day, will be lighting a candle for me because I am not here any more.] [I do have friends who are gays and I ....] [To those who thinks that AIDs is a moral disease, it may surprise you to find that the husband didn't contract the virus by fooling around but the entire family, husband, wife and child all have HIV. And how do you look them in the eyes and say you did something wrong and being punished for it?] [People themselves cannot change the perception. We have to tell them how. So we have to give a face to AIDs. Today people only see when they hear AIDS, to see drug addicts, a dirty, smelly very sick drug addict but they don't see the loving husband, the mother, the little child who are suffering from AIDs. We are using...]

This brings us to the end of On the Grapevine's 5-part look at AIDS and the lives it touches.

This is Chong Ching Liang for Newsradio 938.

====================

Newsradio
http://newsradio.mediacorpradio.com/

Action for Aids
http://afa.org.sg