Voices from the Bangkok AIDS Conference: sex workers and the developing countries

July 13, 2004

EMPOWER, an organisation of sex workers in Thailand and a Christian Aid partner, invited sex workers from 12 countries in the surrounding region to attend the Bangkok AIDS conference. This was an opportunity for them to share their experiences and to unite in their call for an end to discrimination against them.

They say their concerns are not being met and are calling for the decriminalisation of the sex trade in Thailand. They say the sex workers themselves should run the sex trade so that they can protect themselves properly against violence and the danger of infectious diseases such as HIV.

One sex worker, who asked to be called 'Porn,' said: 'This conference is an opportunity for us to speak out and to highlight the plight of migrant sex workers, who are even more marginalised than we are.

'The theme of the conference - 'Access for All' - is a good one. But it does not go far enough. We not only want access to condoms but we want the right to insist on the use of condoms.'

Commercial sex between men and women is one of the major factors behind the rise of the HIV epidemic in Asia. Most of the new infections in Asia are contracted during paid, unprotected sex.

'It is extremely important that Christian Aid supports organisations such as EMPOWER,' says Ray Hasan, Christian Aid's Asia programme manager, 'if we are to halt the rise of the epidemic in this part of the world, sex workers must be able to protect themselves with condoms.'

One of the livelier sessions of the conference so far pitted donors against recipient countries.

In a session called 'Why are donors not working together?' Dr Bizwich Mwale, the director of the National AIDS Commission in Malawi, complained that, in spite of a significant increase in money for HIV, bilateral donors did not reflect the needs and requests of the countries.

The US government was singled out for particular criticism, as it favours programmes which promote abstinence rather than comprehensive prevention strategies.

Many counties which have been successful in reducing HIV transmission, such as Uganda, Zambia and Thailand, have included information about and provision of condoms as part of their comprehensive approach.

Mwale said that 'donors are too prescriptive and impose too much'. He also criticised donors for not investing enough in health systems and the training of health workers.

The US failure to endorse generic combination drugs already approved by the World Health Organisation, insisting instead on a parallel system of approval by the US Federal Drugs Authority, was also heavily criticised as it was delaying and confusing HIV treatment.

The World Bank was also the target of much disapproval, as massive debt burden is hampering the efforts of many of the most heavily HIV-affected countries. The World Bank's limits on public health spending were cited as another example of obstacles imposed by the rich countries on the developing world.

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