In Thailand, WHO (2007) indicates an adult mortality⁷⁹ rate per 1000 population of 265 for males and 155 for females. Life expectancy for males is 67; for females 73. Healthy life expectancy is 58 for males; 62 for females.⁸⁰

According to the Statistical Yearbook, Thailand, 2007⁸¹ produced by the National Statistics Office,⁸² 10,185 people – 15.6% of the population – are living with a diagnosed chronic condition. This represents 12% of the male population and 18.6% of the female population.

During 2005, there were 395,374 deaths (6.4 per 1000 population); 225,622 were male (7.3 per 1000 population) 169 were female (5.2 per 1000 population). Malignant neoplasm was the most common cause of death among both groups (Table 8).

Table 8 Percentage death by leading cause and gender, 2005

Source: Statistical Yearbook, Thailand, 2007

HIV/ AIDS

In December 2007, UNAIDS reported that the global HIV prevalence appears to have levelled off. However, the number of people living with HIV has risen to an estimated 32 million in 2007 from 29.0 million in 2001. Some 2.5 million people were newly infected with the virus in 2007 and 2.1 million died of AIDS-related illnesses

In Asia, an estimated 4.9 million people in were living with HIV in 2007, including the 440,000 people newly infected in the past year. Approximately 300,000 people died from AIDS-related illnesses during 2007. This same year, there were almost 20% more new HIV infections in East Asia than in 2001. HIV prevalence is highest in South-East Asia, with wide variation in epidemic trends between different countries. Myanmar, Thailand and Cambodia show declines in prevalence, but the epidemic is growing at a particularly high rate in Indonesia and in Vietnam.⁸³

The most recent figures from Thailand’s National Statistics Office highlight the declining number of people with AIDS: down from 20,194 in 2005 to 12,884 in 2006, with evidence of a further reduction during the first quarter of 2007 (Table 9).

Table 9 Number of people with AIDS resulting from risk behaviour and sex: September 1984-May 2007

Source: Statistical Yearbook, Thailand, 2007

The UNAIDS situation analysis for Thailand (2006) highlights a range of initiatives and issues.

The Royal Thai Government used the opportunity of the United Nations (UN) High Level Meeting on HIV held in New York, United States of America, in June 2006 to announce its renewed commitment to universal access to HIV prevention, treatment, care and support. This announcement included the ambitious goal of decreasing by 50% the annual number of new HIV infections in Thailand by 2010.

Laudable success continues to be achieved by Thailand in scaling up prevention of mother-to-child transmission ‘plus’ programmes (i.e. including treatment for women) and antiretroviral therapy services to those in need. This has been brought about through the integration of antiretroviral therapy into the National Health Security Scheme. As of the end of 2006, more than 100,000 people are estimated to have been provided with antiretroviral drugs (Department of Disease Control, Ministry of Public Health, Royal Thai Government, 2007). Thailand has issued two compulsory licenses for antiretroviral drugs, in the hope of bringing under control the steeply increasing costs of the provision of and access to these drugs.
A new National Strategic Plan on AIDS 2007 – 2011 has been developed and costed through a broadly consultative and inclusive national process. The National Strategic Plan focuses on scaling up HIV prevention efforts, particularly for people most likely to be exposed to HIV and difficult to reach populations. It is accompanied by a detailed implementation plan that reflects the Thai road map to universal access, as well as an additional civil society plan that highlights the detailed action civil society partners in Thailand have selected as priority needs.
Despite all the achievements, however, complacency by national and local political leaders still risks overshadowing the activism of the National AIDS Programme and civil society partners in responding to AIDS in the country. The national response remains primarily health-sector focused, with slight evidence of substantive movement in other critical sectors (most particularly education and the security services).
Antiretroviral therapy services, while expanding, still only reach around two thirds of those estimated to be in need of treatment. As many as three quarters of the 500 000+ people estimated to be living with HIV in Thailand are thought to be unaware of their HIV status. The vast majority of investments on HIV-related activities are for treatment, care and support, with approximately 10% being invested in prevention programming.
According to the Asian Epidemic Model, the estimated rate of HIV infection in Thailand continues to decrease. However, serosurveillance reports of HIV infection rates indicate increasing levels of infection in groups presumed not to have significant risk behaviour (such as female spouses) as well as in those more likely to be exposed to HIV (e.g. men who have sex with men; sex workers; and military recruits). Experiences of stigmatization and discrimination continue to be reported by up to 40% of people living with HIV, and economic livelihoods for people living with HIV are still severely restricted due to social stigma and ostracism.⁸⁴

Figures held by UNAIDS estimate that in Thailand, around 950,000 adults and children may be living with HIV (Table 10). An estimated 60% of HIV-infected men and women are receiving antiretroviral therapy, and in the population at large, 30.6% of pregnant women are receiving treatment to reduce mother-to-child transmission.

Table 10 Estimates of people living with HIV in Thailand

Source: UNAIDS 2006 report on the global AIDS epidemic