1In the 1990s, researchers in Thailand initiated clinical research on pregnant women suffering from HIV. With more than one million people infected at the time (2% of the population), Thailand was the Asian country most affected by the epidemic. Inspired by the results of a Franco-American study published in 1994, they devised a simplified method to prevent the perinatal transmission of HIV for the benefit of women in developing countries. This study began in 1997 with the financial support of the US National Institutes of Health (NIH) and the logistical support of the Thai government. The simplified protocol proved to be as effective as the original, relatively heavy Franco-American protocol, which included zidovudine infusions during childbirth and five oral doses per day for five months. Thailand and other countries immediately began to use the results of the new protocol.

Caring for a baby infected with HIV, Thailand.

••• A medical protocol to prevent mother-to-child transmission of HIV •••

2That was when a joint South African and US team showed that administering nevirapine to the mother during delivery and to the newborn child helped reduce transmission by 50%. IRD researchers and Thailand’s Ministry of Public Health decided to combine zidovudine with nevirapine in the treatment. This new protocol, which helped reduce the transmission rate to 2%, was recommended from 2004 by the WHO until triple therapy drugs became available in resource-constrained countries to treat the mother and prevent the transmission of HIV to the child.

Generic antiretroviral drugs distributed in Thailand.

“Collaboration between Chiang Mai University and IRD was instrumental in accelerating access to the prevention of the perinatal transmission of HIV in Thailand and all resource-constrained countries. It also contributed to a better understanding of underlying mechanisms.”
Wasna Sirirungsi, virologist, Dean of the Faculty of Associated Medical Sciences at Chiang Mai University