In 2001, the International AIDS Society (IAS) awarded the 2004international AIDS conference to Bangkok, Thailand, whose HIVprevention progress has long stood out against Asia’s loomingcatastrophe. But today, as an estimated 15,000 conference-goers plantheir July stay in the continent’s colorful commercial-sex capital,they face a more serious dilemma than what to pack: Are they rewardinga newly savage Thailand, whose prevention policies now include massmurder? In February, the government literally took aim at its severalmillion drug users, many of whom have HIV. So far, more than 2,000Thais—traffickers, junkies and petty criminals—have been shot dead inthe streets.

The brutal crackdown is intended to cleanse the nation of itsdrug users by December 5, the king’s 76th birthday. At its launch,Interior Minister Wan Muhamad Nor Matha announced that users anddealers would be “put behind bars or may even vanish without a trace.Who cares? They are destroying our country.” These terror tactics arehaving a cruel side effect: Fear of murder, arrest or cold-turkeylockdown has sent 37 percent of Thai drug users into hiding—and awayfrom prevention and treatment, according to a study co-sponsored by thegovernment’s own health ministry. Half of Thai injection drug usersalready have HIV—and represent a third of all new cases in the country.Indeed, while the immediate crisis is the bodies on Bangkok’s sootycurbs, rising infections will likely be the policy’s lasting legacy.

That Thailand is touted as a condom success story for all butevicting HIV from its $20 billion sex industry is only one of thisstory’s ugly ironies. Another, local advocates say, is that themassacre began just as the health ministry was showing a glimmer ofsupport for needle exchange. “We’re slipping back in time,” said KarynKaplan of the Thai Drug Users Network (TDN), a peer-ed and lobby group.TDN’s Paisan Tan-Ud added, “If the government doesn’t kill us all, AIDSwill.” 

The scandal has hardly been headline news, and internationaloutrage, such as it is, has not focused mostly on HIVers. Thehuman-rights lobby—the United Nations, Amnesty International, HumanRights Watch—has issued condemnations or sent observers. A U.S. embassyofficial anonymously said the Bush administration “has made it veryclear we have serious concerns.” But the HIV bloc has beenuncharacteristically quiet, although IAS, the world’s professionalsociety for HIV scientists, health-care and public-health workers, hasdutifully “expressed its concern,” said the group’s director, JoepLange, MD.

Still, the irony of the international AIDS elite descending onthe killing fields of Thailand is not entirely lost on conferenceorganizers and delegates. What they must decide is whether a Bangkokgathering would endorse the slaughter or slow it—a murky matter oftactics, perception and conscience. Human Rights Watch’s Brad Adamssaid, “The question is how to get at the government — whether with ablunt instrument, like moving the conference — and whether the wrongpeople will be affected.”

Moving the conference has its backers. ACT UP/New York’s JamesWentzy believes that unless the killings stop, “it would beunconscionable to hold an international AIDS conference in Thailand—andthere would be hell to pay.” TDN’s Kaplan added, “What’s unconscionableis that the country will be in the IAS spotlight for its preventionsuccesses.”

But other advocates such as Adams argue that it is preciselythe spotlight that will focus global attention on the exterminationpolicy. At presstime, IAS’ Lange was on the fence. “Threatening to movethe conference at this stage is not the most productive way forward,”Lange told POZ. What else might work? He wouldn’t say.

Not surprisingly, Sombat Thanprasertsuk, MD, Thailand’s AIDShead, opposes a boycott. He said the conference “is for people to shareexperience and innovations. It is not just important to Thailand, butthe whole world.” To groups mulling a stayaway, he protested: “Theconference has nothing to do with the drug action.”

The hard-pressed HIV community apparently agrees. So expect the show to go on—and the killings, too.