Thailand's success in battling the HIV/Aids epidemic has been due, in part, to two major sources of funding from the United States: the US President's Emergency Plan for Aids Relief (PEPFAR) and the US Agency for International Development (USAID).
The country has been making sure HIV/Aids patients get treatment and those with high risks of contracting HIV including men who have sex with men (MSM), transgender women (TGW), sex workers (SW), migrant workers, and drug users all benefit from these funds.
However, the recent presidential executive order to freeze humanitarian funding across the world has hindered Thailand's effort to protect its citizen's health as well as contributing to the United Nations' goal to end the HIV/Aids pandemic by 2030.
STATS MATTER
Surang Janyam, director of Service Workers in Group Foundation (SWING), said Thailand's success in HIV control was due to the outreach effort by civil organisations especially to those with limited access to HIV/Aids treatment.
Nearly 600,000 individuals were targeted by the RRTTPR (Reach, Recruit, Test, Treat, Prevent, and Retain) framework by civil organisations, the National Health Security Office said last year.
The government, meanwhile, reached just under 100,000 people with its efforts.
Ms Surang said NGOs were largely funded by PEPFAR and USAID, which allowed them to provide blood testing and other HIV/Aids related services for free.
The funding is mostly spent on buying HIV testing equipment, paying office rents and salary. US President Donald Trump's executive order, however, led to many community-led services shutting down, said Ms Surang.
A 2025 report by Thai civil organisations estimates the cut in US funding would affect 93,186 individuals -- 92,970 MSM/TGW/SW and 650 drug users -- who receive RRTTPR services provided by civil society clinics.
Over 52,000 of those who seek blood tests and treatment for HIV, sexually transmitted infections, and hepatitis C at NGO-run clinics would lack access to services. Some 4,372 transgender people who seek gender affirmation healthcare at their clinic would be affected as well.
Ms Surang added that although NGO-run clinics could reimburse their money from the National Health Security Office after providing PrEP-related services, hiring staff is not covered as their salaries are supported by USAID.
PrEP stands for Pre-Exposure Prophylaxis services that are available free to eligible high-risk individuals. That includes medication, counselling, HIV testing, and support. Ms Surang said around 101,305 PrEP users would be affected by aid freeze.
Surang: Many PrEP users will be affected
GOALS FALL BACK
Achara Pakdeepinit, psychosocial development head from the Thailand Public Health Ministry's Aids and STIs Division, said Thailand National Aids Plan has three goals -- cutting new infections, cutting the death toll, and battling stigma for people living with HIV, with an overarching goal of ending Aids by 2030.
The government approved around 10 million baht to create a campaign ending Aids nationally while 50 million baht was approved to buy STIs and HIV prevention tools like condom and testing kits this year. She said civil society organisations are a key partner in the division's effort, and both drew heavily on funding from the US.
The division had been working on a "Provincial Model", combating Aids at the provincial level in 14 provinces since June 2024, which was supported by PEPFAR in equipment costs and salaries. However, she said the project may now be put on hold owing to the executive order, which would make it harder for the division and civil society organisations to achieve the national strategy.
Achara: Project may now be put on hold
Patchara Benjarattanaporn, Thailand UNAIDS Country Director, said many countries rely heavily on USAID and PEPFAR to help address their HIV/Aids challenges and help save the lives of those living with HIV.
UNAIDS reckons that if PEPFAR was not reauthorised between 2025 and 2029, and if other resources are found for the HIV response globally, the results will be devastating.
The result could be another 6.3 million Aids-related deaths between 2025-2029; an additional 3.4 million Aids orphans; an additional 350,000 new HIV infections among children; and another 8.7 million new HIV adult infections globally.
She said PEPFAR support had been key in reducing new HIV infections since the global peak of the disease in the early 2000s, and many countries are close to achieving the "95-95-95" goal of HIV control -- 95% diagnosed, 95% of people living with HIV getting treatment, and 95% of people living with HIV getting the virus suppressed to an undetectable level.
If the fund suspension continued for the next two years, UNAIDS projected it would cause 10 years of regression in combating HIV that the world had achieved up until 2025: including a 97% to 144% increase in new HIV infections, and 17% to 28% increase in HIV-related deaths in the next two years.
If the fund is frozen until 2030, it would cause 25 years of regression including a 148% to 247% increase in new HIV infections, with 4 million new HIV infections. This would mean more than 1 million additional HIV-related deaths.
"This means the 25 years of progress we have made in combating Aids would be eradicated perfectly, and the world return to the 2000s," she added.
Thailand is still fortunate, she said, that 91% of HIV responses are funded domestically, while 4% come from the US government. The rest comes from the Global Fund, an international financial organisation.
However, only 2%-5% of the entire HIV/Aids budget was dedicated to community-level organisations, and less than 1% was dedicated to stigma and discrimination intervention, an area mainly supported by foreign funds, mainly from the US.
Ms Patchara suggested Thailand needs to rely on itself for HIV/Aids funding by increasing domestic funding to 95% as soon as possible, citing India, which has relied on similar funding patterns.
She also suggested should prioritise primary care, and encourage the community to provide comprehensive HIV health services to ensure HIV protection among vulnerable groups.
Patchara: Thailand needs to rely on itself