Interview with Mechai Viravaidya,
Yuli Ismartono [time 29:42]
Yuli Ismartono: Khun Mechai, thank you for being with The Leaders program.
YI: After successfully battling the problem of rapid population growth rate in Thailand you then focused on fighting HIV/AIDS and now you are seeking innovative approaches to eradicating poverty in Thailand.
First of all, share with us your success in bringing down the HIVinfection rate from 140,000 to 20,000 a year. How did you manage to break the barriers that existed?
Mechai Viravaidya: Everything began earlier in family planning. We were very strong at trying to educate the public. It must be an educated decision for them to practice family planning and to reduce the number of children. And we were able to get a distribution of contraceptives program into all the villages. From seven children, it now became 1.2 by over a 20 year period. So that was the beginning and the population growth rate came down from 3.3 to 0.5. So that was the beginning of working with them, with family planning, with sex education and with contraceptives of which condoms were part of.
When HIV came along, the Thai public was sort of aware of all the contraceptives, condoms and so on, so it wasn't that difficult. We didn't have to start anew. We sort of used 'Gone with the Wind' using technicolor and stereo sound. But the principle is that public education was very important. It was not only the doctors and nurses who had to be involved, anyone who could change attitude behavior had to be involved. In this case, the health and education sectors, religious and business sectors, everyone was involved. Every government official was trained so that they could answer questions if asked.
Budget was increased throughout the Aids program until tremendous change in attitude and behavior - much safer sex - was attained. Ninety percent of the money was Thai money. It wasn't outside money coming in. It was our own. So, the principle was that you must have political commitment and financial commitment to get it going. So if you're a poor country financial commitment doesn't mean big money, but some money. You cannot expect the world to save you when you don't put up your own money. When there's a fire you don't lie back and watch television and say please help up my house is on fire. So you have to show that. And get everyone to be involved, schools, universities, businesses, the whole works. So we believe condoms is very important. Condoms were given everywhere and there was a very strong change. So after about 13 years, according to the UN, the new cases of HIV came down by 90 percent. And according to the World Bank, the effort introduced by the government and the NGO sector and subsequent governments since 1991, had prevented 7.7 million Thais from being infected. So those were the figures which simply showed that you can manage HIV and you don't have to use too much money, but don't sit back, don't fall asleep at the wheel.
So what happened after all that success, after everyone talked about it? We had a government for five years that went to sleep at the wheel in terms of public education. But treatment went on so now we have pushed it again and I reminded the country that for every case that you can take care medically, six new cases occur. So prevention is very important. We are now doing it with youths, with kids, getting them to have a major role. The effort then was strong government support. I asked and the Prime Minister accepted to be the chairman of the National Aids Committee. I was not the Minister of Health, I was the Minister in charge of the Prime Minister's Office which meant tourism, broadcasting but I thought that everyone had to be involved in doing something about HIV, not just the Ministry of Health.
YI: Ok, let's go back just a little bit. You mentioned that the use of condoms or the introduction of condoms was when you tried to bring down the growth, introducing the family planning program. Was the use of the condom at first a sensitive issue with religious figures, perhaps not with Buddhists, but certainly Catholics.
Mechai Viravaidya: Actually, the Catholic church, the Imams, the Buddhist monks didn't do anything. It was the diamond-fingered ladies who were the problem. They said, "Mechai, you must not do that. It's bad for Thai society, you're corrupting them and so on." So I went to them, I apologized to them, I am a young person, just turned 30, don't expect me to know everything. Look at their own husbands. So, give me a chance. Thank you for telling me and I went back to doing the same thing and they didn't say anything. In other words, they wanted you to kowtow to them, to say that I respected them. I don't confront. So that was the first effort in family planning.
I went to the Buddhist authority and asked them about Buddhist family planning and they said they didn't know. So I got some scholars to look at the Buddhist scriptures and there were many examples of what Buddha said about family planning. There is one very strong quote and it was not caused by Buddhist institutional religion and I gave this quotation to every Buddhist temple and I also had a picture of the Supreme Patriarch who signed it, wishing us luck in our endeavors to help people in family planning and sent that in a calendar to everyone. So it became a basic norm and the Catholic Church didn't say anything. The Imams didn't say anything, because basically what we told them was that we were trying to help people.
YI: Maybe that's the message that is not getting across to religious leaders and society figures in other countries, because they have a difficult time accepting the fact on the use of condoms for that purpose. They see it as encouraging promiscuity or something like that. What is it so difficult in other countries?
Mechai Viravaidya: I'm not a citizen of those countries but I can speak as a Thai and citizen of the world, promiscuity was there before democracy and before condoms were invented. So, let's get everything straight. I keep on saying, if you're embarrassed by the condom, you must be more embarrassed by the tennis ball because there's more rubber in it. Why are you embarrassed by something that can cure, aren't you embarrassed by bombs, by guns? You are embarrassed by this wonder product made from a rubber tree used in Wimbledon and the Australian Open, the French and American Opens, tennis championships. So many tons of rubbers are used for that, why are we embarrassed by that? It's just rubber. We must be realistic. Today, this is what could save you from being infected with HIV or from other sexually transmitted diseases and of course, it's a live saver so let's wake up.
YI: I wish it was that easy in countries like Indonesia, Malaysia. They look at all the regulations and their interpretation is always, no, it is not possible.
Mechai Viravaidya: I have learnt to take no as a question. And I would say that in the countries you mentioned that people there are not working hard enough to push it. A lot of people say, I better not do it, I have my job to worry about, I have my reputation. I have absolutely nothing to lose. There are 60 million other Thais who can take my place. So why worry? Don't look at yourself as being indispensable. You are totally dispensable. Go ahead and do it. And what's what we did. We took no as a question not no as an answer.
YI: From your success in family planning, you now continue with HIV/AIDS prevention program. And you are also focusing on community development and poverty eradication. How did that come about?
Mechai Viravaidya: It started from day one when I started my work in family planning. I was then in government, in the planning authority and I had to go around the countryside to evaluate the progress of programs for the people, be it education for the schools, universities, teachers, roads, dams - you name it -I had to report back.
One of the things I noticed was the huge number of children everywhere and I wondered whether there was any link between the huge numbers of children and the inability of the government to supply the needs of the people. So we looked into it, the World Bank looked, and sure enough we had a huge population growth rate of 3.3 percent and we could not keep up in terms of the goods and services for the people. So I thought, since we could not expand the goods and services because we had limited funds we can at least try to use less money to slow down the demand. That meant the number of births, the number of people, the number of kids per family. So that was the approach. That was how I entered it.
I tried very hard with other people for about six years to convince the government we had to do something and because in those days, they would say, "No, no, we want to be a super power, we need lots of children, lots of kids." Remember this was the early1960s. In the end, after six years they recognized the fact that it was the truth. So, if we're lucky we can do family planning but there was no money for public education.
So that's when I decided to come out and do the public education and then kept the contraceptives into the hands of the people in the villages. It's not just the information, you have to deliver the goods. So the contraceptive pills and condoms were put in the hands of selected couples so they can be trained. They were in a sense, voted by the villagers as someone they trusted so they flew around the whole county to give out pills and condoms, day or night, without having to travel out of the village. So once again, it was just appealing to the basic needs when we could not keep up with development imperatives, if the population goes to that size.