Struggle persists in Aids fight despite depleting funds

The International AIDS Society Conference 2025, held in Kigali, Rwanda, saw a pressing concern being raised about the impact of funding cuts on HIV/AIDS care in Thailand.

The cuts, primarily from the US President's Emergency Plan for AIDS Relief and the US Agency for International Development, have disproportionately affected key populations such as men who have sex with men, transgender women, sex workers, migrant workers, and people who use drugs. These groups are already at a higher risk of contracting HIV due to legal and social factors affecting their access to healthcare services.

Mr Satayu, the director of the CAREMAT Foundation, stated that his organization has been partially affected by the funding cuts. However, they have managed to continue their work, thanks to funding from the National Health Security Office. Despite this, they still face the challenge of covering costs for providing services to non-Thais or those outside the key populations.

The Tangerine Clinic, which has been a significant provider of HIV/AIDS healthcare for key populations, has lost up to a quarter of its clients due to the funding cuts. Some of these clients were PrEP users, a medication used to prevent HIV transmission. The clinic's research physician, Mr Jakkrapatara, mentioned that USAID and PEPFAR funded the majority of the Institute of HIV Research and Innovation's work on integrating trans health with HIV-related services at the Tangerine Clinic for the past 10 years.

The funding freeze has also obstructed plans initiated by civil society organizations to provide comprehensive healthcare and continue advocacy work against HIV/AIDS-related stigmas. Many key populations prefer not to seek HIV/AIDS healthcare from normal hospitals due to fear of stigmatization, making community clinics like Tangerine crucial.

The Thai Women Living with HIV Foundation's "People Living with HIV Stigma Index 2.0" found that 16% of participants reported experiencing discrimination in healthcare services within the past 12 months. The rate of reported discrimination was higher among transgender individuals, sex workers, and people who use drugs.

Transgender clients are now required to pay out of their own pocket for laboratory monitoring (estradiol and testosterone levels), a main gateway to access care for trans and other gender-diverse individuals. Mr Jakkrapatara suggested the Thai government should provide more grant opportunities for community-led initiatives in designing the health system and implementation research.

The future of funding for civil society organizations working on HIV/AIDS in Thailand is uncertain following the US President's decision to cut funding. However, discussions at the International Aids Society Conference 2025 in Kigali by Thai civil society groups suggest that increased support from international donors, regional partnerships, and possibly local or private sector funding may be possible.

Mr Satayu emphasized that eliminating AIDS will only be possible if civil society takes a leading role in the effort. The funding cuts have highlighted the need for continued support and advocacy to ensure that key populations have access to the healthcare they need.