Frenzy in Thailand over 'drug' for AIDS

Experts outraged that creators call it a cure

Rafael D. Frankel, Chronicle Foreign Service
San Francisco Chronicle - Monday, August 27, 2001

Chiang Mai, Thailand -- Wearing sunglasses to shield his eyes and a towel draped around his neck to cough into, Uthai Narangasuna sat with 5,000 other HIV-stricken people in a soccer stadium here early this month waiting for his number to be called.

He soon received a one-month free supply of a controversial, locally produced drug advertised as the first-ever clinically tested oral AIDS vaccine, which he hopes will cure the deadly virus that is ravaging his body.

"I heard that people who took it got much better," he said. "I hope it will help me."

Without the financial means to obtain conventional drugs and virtually no government assistance, tens of thousands of AIDS victims like Narangasuna are packing stadiums throughout Thailand to obtain little pink pills -- free, at least for now -- called the V-1 Immunitor. In June, the first two handouts in Bangkok drew more than 20,000 people, including a few so sick that they died at the stadium.

V-1's creators say the drug not only helps AIDS victims but has completely cured four people. Such claims have outraged health experts, who point out that V-1 has undergone no rigorous scientific testing and is registered in Thailand only as a food supplement.

'SENSE OF A SCAM'
"There is a sense of a scam about it," said Dr. Chris Duncombe, senior physician for a program headed by the Thai Red Cross that helps 1,300 AIDS patients. "They give small amounts that are not enough to do anybody any good and charge for blood tests."

Sen. Jon Ungphakorn, a longtime AIDS activist, insists that V-1 is setting back the cause of AIDS treatment in Thailand by distracting from a campaign to obtain generic AIDS drugs for the poor.

"If (V-1's makers) give it out of the kindness of their hearts and call it a food supplement, I wouldn't interfere," said Ungphakorn. "But if they claim it's an oral vaccine that treats and cures AIDS, the Ministry of Public Health should charge them with making false claims."

But an intense media campaign and a sense that someone is finally doing something to alleviate their suffering is prompting the poor to flock to receive the so-called miracle cure, creating a frenzy over its distribution.

Thailand has 755,000 AIDS patients, according to U.N. figures. And with an annual per capita income of $2,000, the majority cannot afford the $125-a- month price tag for conventional anti-retroviral drugs. Neither can the government, which is still feeling the effects of the Asian financial crisis in 1997.

"It's the usual story of what happens when there is an absence of any sort of orthodox treatment," said Prof. David Cooper, director of the National Center in HIV Epidemiology and Clinical Research at the University of New South Wales in Australia. "People start looking for other solutions."

Even though a government condom distribution program has slowed the spread of the disease, relaxed attitudes toward sex and prostitution, and poverty that forces families to sell their children into the sex trade continue to be potent vehicles for transmission of HIV.

About 300,000 Thais have already died and unless the government provides anti-retroviral drugs, 50,000 more will perish each year for the next decade, according to AIDS Access Group in Bangkok.

EX-POLICE CHIEF TOP PROMOTER
The production and distribution of V-1 involves a tangled web of scientists, politicians and government officials. At the center is a retired police chief turned philanthropist.

Salang Bunnag, whose foundation sponsored the V-1 giveaways in Bangkok and Chiang Mai, is best known for directing a high-profile 1996 hostage-rescue operation that freed all captives from a drug gang. He was later accused of ordering the summary executions of the six kidnappers while they were in custody.

Although never indicted, Bunnag was suspended and forced to resign in 1998. Observers say the ex-cop still has strong connections with high government officials and has re-created himself as a fighter for justice in the health field.

In the past three months, the 62-year-old Bunnag has used the media spotlight to trumpet the virtues of V-1 and attack skeptics as tools of foreign pharmaceutical companies.

"International companies, European companies, American companies -- they don't care about life, they care about money," he recently told The Chronicle. Dr. Vichai Jirathitikal, the Bangkok pharmacologist who developed V-1, claims his invention is the solution for poor countries that cannot afford expensive Western remedies.

"We cannot simply sit by and let our people die without help," said Jirathitikal, whose scientific expertise has been with prawns and not people. Jirathitikal, 44, says V-1 pills contain inactivated HIV antigens capable of withstanding digestive degradation in the stomach. He says V-1 fights HIV in the digestive tract rather than in the bloodstream, the focus of other treatments. And, he claims, the pill reverses the decline of CD-8 interceptor cells, which protect the body's immune system.

When a reporter asked Jirathitikal to list the drug's ingredients, he was told that such information couldn't be made public until patents had been granted.

All he has said is that the key components are magnesium, calcium and "nonliving chemical matter."

"People are skeptical of V-1 because it does not take the traditional approach to treating AIDS," said Sen. Samaporn Thepsithar, the vice president of the National Council on Social Welfare of Thailand, a foundation operated under royal patronage. "But there has never been any medicine like this before. It gives patients new life, new hope."

CRITICISM FROM HEALTH OFFICIALS
A recent report by the Ministry of Public Health disagrees. After studying the drug's effect on 50 patients over six months, the ministry said the pills had no effect, either positive or negative.

When ministry officials suggested that the U.S. Center for Communicable Disease Control examine the drug, they were rebuffed by V-1's creators, who argued that an outside study could breach their intellectual property rights.

Some say the government of Prime Minister Thaksin Shinawatra has opted not to halt the V-1 giveaways for fear of losing popularity. Duncombe says the prime minister is looking for a "cost-effective way to manage the epidemic" and believes V-1 "deserves a chance to prove itself."

Paul Cawthorne of Doctors Without Borders fears that V-1 will soon be marketed in other emerging nations that are being overwhelmed by AIDS and have few resources. "If they use this kind of mass hysteria, governments will be under a lot of pressure to let it happen," he said.

Deputy Public Health Minister Dr. Surapong Suebwonglee said he told Bunnag recently at a private dinner to cease calling V-1 an AIDS remedy or face punishment.

"They have no right to tell people it is a cure," Suebwonglee told The Chronicle. "If (Bunnag) does, he will be fined. I don't know how much."

Bunnag, however, remains defiant and says his foundation will continue to distribute the pink pills and estimates that 100,000 will have received the drug by the end of the year.

"If he wants to arrest me, let him arrest me," he said. "I will then tell my patients to go to public health and demand V-1. Then we will see what happens when 30,000 people come" to the public health ministry.

Bunnag says the proof of the drug's effectiveness is in talking to AIDS victims who have taken it.

Rungreng Sripunyawong, a Bangkok transsexual and former prostitute, was near death three months ago. "A doctor told me that I would be dead by the fall," she said.

After listening to a radio report about V-1, Sripunyawong's sister went to the first handout in Bangkok and brought home a month's supply. Soon Sripunyawong, who had been too weak to get out of bed, began to gain weight and now volunteers her time to tout V-1 to anyone who will listen.

There are huge profits to be made if the drug is ever approved for sale. A Salang Foundation member who asked not to be named said annual revenues in Thailand alone could be $36.5 million -- a fortune in a nation where an average lunch costs less than a dollar.

"Our vaccine will expand to other countries," said Dr. Aldar Bourinbaiar, an American AIDS researcher who works with Jirathitikal. "In a couple of months, we will be in Africa, China and Russia. There is nothing that can stop us."

©2001 San Francisco Chronicle Press