Thailand's medical community has earned for the country new stripes as a leader in the fight to stall the spread of HIV — by working on a new drug regimen designed to further cut the virus' transmission rate from mother to child.

This latest effort adds to a list of other achievements in fighting the HIV/Aids pandemic — one that already includes plans to conduct an HIV vaccine trial and the production of the world's cheapest anti-AIDS drug.

This week, doctors at a government university hospital revealed efforts to reduce to three percent the transmission rate of HIV from infected mothers to children. Hitherto, the transmission rate of the virus pregnant women to infants had hovered around 11.7 percent in Thailand.

''The drug regimen is also less harmful than before, with minimal side effects,'' says Dr Pongsakdi Chaisilwattana, head of the gynaecologic endoscopy division at the Bangkok-based Siriraj hospital. ''And the newborn baby has to be given only one course of the medication within eight hours of birth.''

An equally significant part of this anti-retroviral regimen is its cost — about 1,800 baht (US$42) a month for each person, adds Pongsakdi, who led a team of the hospital's doctors studying patients being treated under the new regimen.

He says the team is using the generic anti-Aids drugs produced by the government's pharmaceutical section.

Breakthrough

Reports in the local press on Tuesday drew attention to this achievement as a ''breakthrough'' in efforts to cut mother-to-child infections and one that made HIV treatment ''affordable to low-income people''.

''In the new procedure, from the 34th week (of pregnancy) onward, mothers are treated with a combination of AZT (500mg) and 3TC (150mg) every 12 hours until the onset of labour,'' the independent English-language daily The Nation reported. ''After that they are given drugs every three hours until delivery.''

The study that used this regimen was conducted among 109 HIV-infected pregnant women from central Thailand and Bangkok, who were given the anti-retroviral drug Zidovudine (AZT) combined with Lamivudine (3TC).

The findings of this trial, which was done over the last five years, are before the national health board, says Dr Taweesap Sirapratasiri, director of the Aids division at Thailand's Communicable Disease Control Department (CDC). ''The results have to be tested before it is approved to be available at all hospitals.''

But such a wait should not take away from what this trial has already accomplished, says Thazin Oo, regional project officer for mother-to-child transmission at the East Asia-Pacific division of the United Nations Children's Fund (Unicef). ''It adds to what the country is doing to cut mother-to-child transmission. It is far ahead of other Asian countries.''

Vindication

Thailand currently has some 670,000 adults and children living with HIV/Aids out of a population of 63.5 million people. Since HIV, the virus that causes Aids, was first detected in the 1980s, more than 300,000 people have died due to the disease.

Last year, some 2,200 to 3,300 children between the ages 0-14 years died of Aids in Thailand, according to a global report on the pandemic released early July by the Joint United Nations Programme on HIV/Aids (UNAIDS).

According to Dr Pongsakdi, not all children born to HIV-infected women have HIV. ''About 25 percent of the children can be infected,'' he says.

This week's breakthrough is a further vindication of the move by Thailand's public health authorities to begin work years ago to stop mother-to-child transmission of HIV.

''After a few years of experimenting, it was made part of the national health policy in 1998,'' says Thazin Oo. ''The prevailing drug regimen is available to HIV-infected pregnant women in all hospitals.''

Thailand was the first country in the developing world to head down this road, demonstrating that it had the will and capacity to pursue health programmes that had already been incorporated in the developed world.

''Thailand is doing its part as a global citizen. This is a big step forward in its very important effort to help children,'' says Anthony Lisle, head of the UNAIDS Southeast Asia division.

This demonstration by Thailand of what UNAIDS calls ''best practices in the fight against HIV/Aids'' is the case in related fields, too.

Taking responsibility

In early July, at the 14th International Aids conference in Barcelona, Thai public health officials revealed plans to conduct the world's first ''Phase Three HIV vaccine trial.'' Expected to get underway at the end of this year, the trial will involve 16,000 Thais from eight districts.

That comes on the heels of another Thai contribution to the global battle against HIV/Aids. In April, the Government Pharmaceutical Organisation (GPO) released its first batch of the world's cheapest generic anti-Aids drug, called GPO-VIR and sold for 20 baht (about 45 US cents) per tablet.

A monthly dosage for a patient afflicted with HIV will amount to 1,200 baht (US$27).

Over the last decade, the GPO has succeeded in producing generic versions of 16 types of anti-retroviral drugs recommended by doctors to inhibit the spread of HIV in the body.

''We cannot wait for others to come up with solutions,'' says CDC's Dr Taweesap, in explaining Thailand's drive to be in the vanguard of combating the deadly march of HIV/Aids. ''We had to take the responsibility to help the large number of Thais being infected.'' — IPS