By Rafael D. Frankel, Globe Correspondent, 12/8/2002
BANGPAKONG, Thailand - Like many Thais with AIDS, Thares Sangsakul could not afford the antiretroviral drugs that might keep the disease in check. So after suffering from severe wasting and skin lesions, among other symptoms, he put his faith in a pill touted by its inventor as a possible cure.
Since he started taking the V-1 Immunitor three years ago, Sangsakul said, his life has turned around: He has regained 45 pounds, his lesions are mostly gone, and he has returned to work full time.
''I could not really explain about V-1,'' said Sangsakul, 33. ''But I know people should try it because it helps.''
While Sangsakul and thousands of others believe the pill is a lifesaver, health officials insist that there is no scientific evidence to prove it. They say inventors and distributors of the pill, which is officially registered as a food supplement, are taking advantage of the most hopeless of people in a quest for fame and wealth.
Despite the warnings, word of the pill's reported benefits is spreading, including to other countries. Perhaps most perplexing to skeptics of claims made for the substance is the new type of patient taking it: those who can afford antiretroviral treatment.
''It's all a charlatan exercise,'' said Dr. Chris Duncombe, the senior physician for a program headed by the Thai Red Cross that cares for 1,300 AIDS patients. ''The scientific evidence presented by the investigators is not at all sound. It's just anecdotal, single-case examples of many possible things - placebo, emotional, anything.''
A pharmacist named Vichai Jirathitikal invented V-1 and began distributing it to a few dozen AIDS patients three years ago. Users now number more than 60,000 in Thailand and more than 4,000 in 50 other countries, according to Dr. Aldar Bourinbaiar, a Mongolian-born former California resident who has worked closely with Jirathitikal for the past two years.
Every day, Jirathitikal says, 10 to 20 people find their way to his clinic, tucked away in an inconspicuous industrial park an hour east of Bangkok.
''They don't have a choice because they are going to die,'' he said in a recent interview. The standard drug cocktail used throughout the world is too expensive for them, he said.
He insists that toxicology tests on animals prove V-1 is safe, and asserted that 95 percent of those who take V-1 show some improvement.
''The problem is the big [pharmaceutical] companies and health institutes don't understand the HIV virus so well, and they refuse to look at our documented studies, which show our patients, including children, getting much better.''
Jirathitikal frames his program as a people-against-the-establishment drama, but the reality is that many AIDS patients in Thailand do have a choice now that the price of antiretroviral therapy in the country has fallen dramatically in the last year - to around $28 per month. The Bangkapong clinic charges $21 a month for V-1.
The scrutiny of the drug comes at a pivotal time in Thailand's battle against AIDS. Condom-distribution programs have slowed the of HIV growth, but the virus is still proliferating because of casual attitudes about prostitution and increasing intravenous drug use, health officials say.
According to a Nov. 26 United Nations report, an estimated 675,000 Thais have HIV or AIDS - significantly fewer than the estimated peak of 800,000 in 1997. A disproportionate number of Thailand's AIDS patients are poor, even when compared with the annual per capita income of $2,000.
It is with the poor that V-1 has its roots. The pill gained popularity last year, with five high-profile giveaways to anyone with an HIV-positive blood test. The largest of the giveaways, at a stadium in Bangkok, drew upwards of 20,000 people and helped fuel the near-hysteria about the supposed merits of the pill.
As a result, the government stepped in and halted the giveaways and has tried to discredit V-1, saying tests by Thailand's Food and Drug Administration show no conclusive evidence it helps those with HIV and AIDS.
V-1 has become a political hot potato, so much so that the head of Thailand's FDA recently ordered government employees not to speak about the pill to the news media. Officials from the FDA, Ministry of Health, and Medical Sciences Department all refused to comment for this story.
Further alarming health officials, V-1 has shown up in China, parts of Africa, and even in small numbers in Europe and the United States. How is not clear, although Bourinbaiar said HIV-positive tourists buy it in Thailand and take it home.
The secrecy in which the ingredients of V-1 are cloaked also breeds skepticism, since secrecy is a characteristic of quack remedies, exempting them from scientific study. Jirathitikal said it contains ''inactivated HIV antigens,'' but will give no further description.
He said that unlike the majority of experimental AIDS medicines, which seek to boost antibodies, V-1 attempts to reverse the decline in CD4 blood cells, which protect the body against infection.
A recent AIDS Day celebration at his clinic in Bangpakong showed what the government is up against: Three dozen people turned out to sing the praises of V-1, including the Thai television actress Yoko Takano, whose brother developed AIDS three years ago.
After going on antiretroviral medication, he became very ill and ''was close to death,'' Takano said.
''He switched to V-1, and now he is healthy. Why should he go back'' to antiretrovirals, she asked.
© 2002 Globe Newspaper Company
Rafael D. Frankel was a foreign correspondent based in the Middle East from 2005-2007 and in Southeast Asia from 2000-2005. He wrote mainly for The Christian Science Monitor, The Boston Globe & The Chicago Tribune. Mr. Frankel holds an M.S. in Foreign Service from Georgetown University (2009) and a B.A. in Economics from UC Santa Cruz (1999). He was the 2009 Edward Weintal Fellow at the Institute for the Study of Diplomacy at Georgetown University and is currently a Ph.D. candidate.
