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Thai activist against AIDS gets $1m prize

Gates Foundation honors creativity of his message

Mechai Viravaidya with a lampshade made from condoms in Bangkok in March. The AIDS activist stresses family planning. (PORNCHAI KITTIWONGSAKUL/AFP/Getty Images)

WASHINGTON -- In Thailand, he persuaded Santas and toll booth operators to hand out condoms. Traffic police gave them away, too, which he called "Cops and Rubbers." And Buddhist monks blessed packets of the latex sheaths in ceremonies.

Such creative HIV prevention tactics helped Mechai Viravaidya -- known as "Mr. Condom" -- and his Population and Community Development Association win the Gates Award for Global Health , a $1 million prize to be announced today by the Bill & Melinda Gates Foundation .

"Everyone has to fight this," Viravaidya said in a telephone interview from Japan, referring to the battle against AIDS. "So you get people like policemen to help you. And you tell them, 'You could be saving lives on the road as well as in the back seat.' "

Dr. Tachi Yamada , president of the Gates Foundation's Global Health Program, said Viravaidya and his organization have been at the forefront of public health innovations for more than three decades -- first in advocating for birth control and later in battling AIDS. His organization has grown from a handful of workers to a staff of 600 along with 12,000 volunteers.

"He's been in the game for a long time," Yamada said. "Without a lot of money, without a lot of technology or science, he and his organization have had a big impact."

The award, to be presented Thursday at the Global Health Council's conference in Washington, D.C., is the world's largest prize in international health. A jury selected Viravaidya's organization from 90 nominees.

Viravaidya, a 66-year-old Thai, who spent a year as a visiting scholar at Harvard University nearly two decades ago, started working in Thailand in 1974 to spread education about family planning.

"We had a severe population growth. Each woman in Thailand had seven kids," he said. "It was out of the world. We would never catch up with development needs. So we provided alternatives.

"And instead of seven children per woman," he said, "Thailand now has [an average of] 1.2 children per woman."

As he would do later in the AIDS fight, Viravaidya won support for his work from the Thai government in promoting birth control, and often joined it, holding several health-related Cabinet posts over the years. In his family planning campaigns, shopkeepers nationwide began to sell birth-control pills, and teachers in primary schools nationwide gave lessons on the importance of planning for children.

In the AIDS fight, Viravaidya's goal has been to get people to talk openly about sex.

Many international health organizations, including the Bush administration's AIDS program, follow what they call the "ABC" model of HIV prevention: abstinence, being faithful to one partner, and using condoms correctly and consistently. But Viravaidya takes a different approach.

"You've got to start off not with A or B, but start off with S -- sex," he said. "You've got to understand what drives human beings regarding sex, and how to control it if you can. Sex is not bad, but when and with whom is important."

For young people, he said, his message is to abstain from sex for as long as possible. "I say, 'Try to hang on, don't fly yet, wait until you have enough feathers on you.' And if you're going to fly, make sure you have a safety belt -- condoms."

Yamada of the Gates Foundation said some of Viravaidya's strategies, especially those that have helped empower women and communities, could be applied in other countries.

The programs have "allowed women to make choices, or a sex worker to feel strong enough to demand her customers use condoms," Yamada said. "In reproductive health, the exchange of information was done in communities, often led by people in those communities."

During the year he spent at the Harvard Institute for International Development in the late 1980s, Viravaidya became frustrated by the tendency in academia to talk about problems, but not act on them. "It was like sleep walking," he said.

But during that year, he thought of new ways to get businesses involved in helping poor people, and he developed close relationships with three Harvard Business School students, who traveled with him to Thailand in 1989. One of the three was Curtis Clawson , now president and CEO of Hayes Lemmerz International , one of the world's leading makers of wheel rims for trucks and cars.

The three students helped him enlist businesses to put aside money for teaching skills for the poor, including prostitutes, to help them get out of Thailand's booming sex-trade industry.

"It was one of the greatest experiences I've had," Clawson said from Germany. "He's such a great ideas man."

Viravaidya told the Harvard students that it was vitally important to stop the AIDS crisis as soon as possible, believing that it could overwhelm Thailand and many other countries in Africa and Asia.

A recent World Bank analysis estimated that an additional 7.7 million Thais would have been HIV-positive if the country had not launched an aggressive AIDS fight in the early 1990s. John Donnelly can be reached at donnelly@globe.com

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