Bangkok—A new study reveals a striking lack of social and political commitment to control tuberculosis, a leading cause of death in Thailand.

According to the study, released by Mahidol University and the Open Society Institute, there is little understanding of how TB is spread and that it can be cured. Many patients do not seek treatment because of social stigma, lack of information, and prohibitive costs. Because of these factors, some patients fail to complete treatment, leading to an increased threat of drug-resistant TB and extremely drug-resistant TB (XDR-TB).

“The general perception in Thai society and among political leaders is that TB has been completely eradicated,” said Dr. Amara Soonthorndhada, the author of the report. “ The reality is that this curable disease killed 12,000 people last year, and approximately 90,000 more will become infected this year.”

In response to the report’s findings, representatives from Thailand’s Ministry of Public Health, international donor agencies, and HIV/AIDS organizations are meeting today to discuss how to address the epidemic more effectively.

While TB rates had fallen by 50 percent from 1985 to 1991, the HIV/AIDS epidemic has fueled a dramatic resurgence of TB. The disease is also a leading cause of death for people with HIV/AIDS, although most TB cases can be cured with six months of standard treatment.

According to Dr. Soonthorndhada (biography available below), stigmatization of people living with TB and TB/HIV, and of women in particular, is a great concern. In Thailand, TB is perceived as a male disease, associated with a high-risk lifestyle and behaviors such as drinking, smoking, and an active nightlife. Women infected with TB are seen as being at odds with cultural norms and expectations of female behavior, intensifying the level of stigmatization they experience. As a result, Dr. Soonthordhada fears that women are more prone to “self-medicate” and delay seeking treatment from medical clinics.

Dr. Soonthordhada’s study, TB Policy in Thailand: A Civil Society Perspective, is part of a larger international series on TB policy in Bangladesh, Brazil, Nigeria, and Tanzania, that was published by the Open Society Institute ’s Public Health Watch project. The series highlights how TB, HIV/AIDS, and poverty combine to cause almost two million preventable deaths globally each year.

Dr. Soonthorndhada is the deputy director of Mahidol University’s Institute for Population and Social Research.

Download a copy of TB Policy in Thailand: A Civil Society Perspective in English or in Thai.

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