Honoring Thailand's Exuberant AIDS Czar

By Nora Boustany
Washington Post Foreign Service
Friday, June 1, 2007

Thailand's condom czar and patron saint of prevention programs last night accepted the $1 million Gates Award for Global Health on behalf of a group that used showmanship, public education and once unmentionable devices to slash birth and HIV infection rates in the Southeast Asian kingdom.

Mechai Viravaidya's initial forays into Bangkok's red-light district to distribute condoms for safe sex led to some imaginative promotion techniques. Gas station attendants and traffic police, for example, were given supplies to pass on to motorists.

"Safety on the streets and in the back seat" was Mechai's motto. "I called it the cops and rubber program," he quipped in an interview Thursday morning. And in the five hotels his organization owns, housekeepers place condoms, not chocolates, on the pillows.

The man who popularized condoms and birth control pills in more than 15,000 villages across Thailand, Vietnam and Laos is full of catchy one-liners.

Founder and chairman of Thailand's Population and Community Development Association, winner of this year's Global Health award, Mechai praised President Bush's call Wednesday for Congress to allocate $30 billion toward combating the global AIDS crisis.

"We must put more money into prevention," he said. "It is very good to talk about abstinence, but for each one who abstains, there must be seven who don't. So this becomes like a dog chasing its tail."

The Patch Adams of the AIDS pandemic has achieved sometimes astounding results, health officials say. Mechai's HIV-prevention programs helped cut infections in Thailand by 85 percent between 1990 and 2003, according to the Global Health Council.

In Thailand alone, 7.7 million people were protected from infection, Mechai said. Still, 2 percent of Thailand's 65 million people are HIV-positive. "That is a lot of people," he acknowledged.

What first made his organization legendary were dramatic results in slashing Thailand's ballooning population growth.

When he was still in government service, Mechai recalled, he realized that with each woman bearing an average of seven children, the resulting 3.3 percent growth rate was preventing workable development strategies, poverty reduction and any increase in income levels. He helped cut the rate, he said, by ensuring that local shopkeepers could dispense contraceptives without a doctor's prescription, a practical approach in a country with only one doctor for every 3,000 people.

The change helped bring down the birthrate to 0.5 percent, or 1.2 children per couple.

Born to a Scottish mother and a Thai father and educated in Australia, Mechai returned to Thailand and began his crusade 33 years ago, he said.

"All life forms are born with an interest in sex, even bacteria. We have to master it and not let it master us," he said, arguing for the importance of early sex education. He said he handed out condoms to parents at his grandchildren's kindergarten.

"We must emphasize to young people that sex has to come at the right time and with the right person, that it is not a bottle of fizz that will go away," he added, delving into his arsenal of metaphors. "If you want to start early, you make sure you have a parachute for a safe landing."

© 2007 The Washington Post Company