Contracting HIV/AIDS in Thailand in the early ‘90s was a death sentence, but just 15 years later the condition that had been wiping out thousands is a manageable, chronic disease. And, much of the credit for that feat goes to a petite Thai woman, Krisana Kraisintu.
At just under five feet, the 55-year-old scientist seems an unlikely candidate for such a daunting task, but despite her small stature, her passion to help those suffering with AIDS has made her a warrior and a champion for those unable to fight.
Kraisintu was recently in Baton Rouge for the opening of Cocktail at the Reilly Theatre, a play about her life written by well-known playwright and performance artist Ping Chong, and LSU professor of biological sciences, Vince LiCata. Kraisinut also was invited to speak as part of the Chancellor’s Distinguished Lecture Series, and she received a medal in recognition for her work from Chancellor Sean O’Keefe.
In the ‘90s HIV sufferers took six to 22 pills a day as part of their treatment regimen, but Kraisintu’s continued work eventually led to her crowning achievement, a “cocktail” combining three different medications in one pill to be taken twice a day. It is now the global standard in care.
She also is known for manufacturing generic forms of many AIDS medications and making them universally available to all patients, not just the wealthy.
Her overwhelming success in Thailand has led her to set her sights on Africa, where approximately 26 million of the continent’s 911 million inhabitants live with HIV.
What got you involved in AIDS research?
It’s a basic human right. It is a social injustice against women and children. That’s what got me started. I didn’t know what it was going to be like afterward, but I knew that I wanted to fight for women and children. There is a prejudice against AIDS patients—that they are bad people. The ones who got infected from their husbands or the children from their mothers—what is fair about that? Does that make them bad people? Once you get into this AIDS business you can never get out. It’s a social problem as well as a public health issue.
What’s the status of AIDS in Thailand?
There are about 600,000 people who are HIV positive. Since the beginning of the epidemic Thailand has lost around 1.5 million. The prevalence rate is now 2%. When I started working it was 2.7%. There are about 20,000 new cases per year, and the country is continuing efforts to reduce that to 12,000. Out of a population of 65 million that is a lot.
When you began your work in 1992 how did you decide what your contribution would be?
Being a pharmacist, the only thing I felt I could do to help was to make medicine. At the time I worked for a research institute and felt I had all of the necessary resources to start doing research into some of the problems. I began looking at formulations, particularly which formulations were the best at preventing mother-to-child transmission. I wanted to help children because they are the future of the country. Everywhere I go I try to treat children first. I treat adults as well, but children need to grow up and build the country.
What was the first product you released?
In 1995, we released AZT, or Zidovudine. It’s used for mother-to-child transmission.
What has been your success rate with that?
If a pregnant, infected woman does not get the treatment the transmission rate is about 25%. But, after AZT you can reduce that rate to 7 % to 10%. A difference of 15% is a lot when you are talking about living a normal life versus being infected. Infection means they will have to take medicine for life, if there is medicine available.
You left your country in 2002 to help with the AIDS epidemic in Africa. How has Thailand continued without you?
The research is there, so now the government can sustain itself by producing the generic medications itself. When I first started only about 600 patients, the rich ones of course, had access to proper medication because the cost was so high. It was about $600-$800 per person, per month for treatment. When we began manufacturing generic versions that cost was cut to $27 per month. So, of course the government has decided to continue making it universally accessible to all patients with HIV.
Why leave your country for Africa?
Treatment is available to all in Thailand now, so I think my goal has been achieved for me and my colleagues, as well as the countless international organizations involved. I cannot fight alone. It would be impossible. I could manufacture the drugs, but I could not advocate at all levels for the universal access so I have to work with many people. That is why we are so successful and why we hope to transfer this success to other poor nations, primarily to sub-Saharan Africa where the prevalence rate is 12%. Plus, they don’t need me anymore, but Africa needs me, so I left.
The state of the epidemic in Africa has to be staggering compared to what you faced in Thailand.
In South Africa the prevalence rate is more than 30%. In Botswana it’s 37%. In Zambia it’s about 30%. I don’t know why, but the prevalence rates are extremely high in the southern half of the continent. Even in Tanzania it’s 12%. And, these are often underestimated figures because so many people have not been tested, but what’s the use of testing when you don’t have medicine? If you go for testing and they say you are positive and there is no medication, it’s better not to know at all. I wouldn’t go for testing.
If things continue, what will happen to the people in these countries?
Well, the average life span in these countries is reducing all the time. The average life span in Botswana is only 35 years old. In Mozambique they say that if AIDS patients continue to be untreated the average life span will drop to 27 years old. Can you imagine?
What has been your experience in the five years you’ve been there? Has anything changed or improved?
The problem is huge and the population on that continent is 785 million. People are dying every minute and I am alone. But, if you think that the situation is useless, hopeless, you won’t be able to help anything. So, I always believe that in your lifetime if you can save one life it’s worth living.
