Mechai Viravaidya: Thailand's “Condom King”

Published: 12 January 2008

Mechai Viravaidya's enthusiasm for his newest project is evident. His eyes light up as he describes innovative ways to educate the latest population most at risk of HIV infection in his native Thailand: adolescents and young people. “Kids from 12 to 18 are going to be advising us”, he says. Mechai expects them to say, “Look, this is the way to tell us, this is the way to talk to us, these are the sounds and these are the colours.” Mechai is a master social marketer. His Population and Community Development Association (PDA) has already designed a shirt he thinks will get the message across. Over the words, “Safety First!” it shows male and female stick figures intimating 21 different sex acts. The drawings are accompanied by explicit safe sex messages. “OK” several acts are decreed, whereas others carry the warning “Condom please!” or “Don't swallow.”

It is Mechai's willingness to take on the subject of sex candidly but with humour that has led to substantial reductions both in population growth and HIV infection in Thailand. His remarkable methods and success over the past 30 years were recognised by a US$1 million 2007 Gates Award for Global Health. “He understood the essence of the problem and dealt with it directly”, says Tadataka Yamada, President of the Gates Foundation Global Health Program, adding that Mechai took a “truly creative approach to solving what might seem at the outset an unsolvable problem”.

An economist schooled in Australia, Mechai first helped to tackle Thailand's unsustainable 3·2% growth rate in the early 1970s. He explains how, “We would never catch up on any of the needs of society, of families, of education, of health, of everything” with such a “horrendous” birth rate. So he devised ways to make contraceptives accessible and acceptable to the population, including staging condom-blowing contests and making oral contraceptives available in communities without physician involvement. His relentless and high-profile advocacy earned him the name the “Condom King” and condoms became known in the country as “mechais”. The growth rate in Thailand had dropped to less than 1% by 2005.

When HIV emerged in the 1980s and 1990s, PDA turned its attention there, concentrating first on Thailand's booming commercial sex industry. The group prodded a reluctant government to take on the issue aggressively. The approach led to an 87% decrease in new HIV infections in the 1990s. Underlying all of Mechai's efforts is a passionate commitment to community development. Always, he says, “thinking out of the box”, he has helped devise programmes to empower Thailand's poor to improve their own lives. Many of his recent efforts involve forms of microcredit. His “privatization of poverty eradication” programme links companies with villages to provide credit and work opportunities. “The poor are in fact business people—the poor are doing business on a daily basis”, he says. “But they lack two things—they lack business skills and they lack credit, therefore they stay poor.”

Born to a Thai father and a Scottish mother, both physicians, Mechai was an excellent athlete but an uneven student, according to a biography by Thomas D'Agnes. He graduated from the University of Melbourne in 1964. Upon returning to Thailand, he found his calling in development through visits to the Thai countryside where he came to appreciate the integrity and generosity of his poorer compatriots. During a remarkably varied career, Mechai has served as a newspaper columnist, radio personality, actor, refugee camp manager, high-ranking government official, banker, and senator. He founded PDA as a non-governmental organisation in 1974. It now has 600 employees and more than 12 000 volunteers. The association has trained more than 2900 people from 50 countries in HIV prevention, family planning, and development activities.

Mechai emits a quiet warmth and generosity combined with the wit and delivery of a stand-up comedian. “He is a force of nature himself, but he is very rigorous and systematic in the way he goes about things”, says Global Health Council President and CEO Nils Daulaire. “It's not just a matter of him being unique, it's a matter of him having taught the whole world a new way of approaching people through humour, through engagement, through very frank discussion in a very conservative society.”

With characteristic directness, Mechai, who is also the Chairman of Thailand's National HIV/AIDS Education Commission, criticises the Thai government for the recent upsurge in youth HIV rates, a trend heralded by a spike in new infections among teenagers from 11% to reach 17% during 2002. “The younger generation is having sex earlier with no regard to STDs [sexually transmitted diseases], because they've not seen it advertised at all so they think it's gone away”, he explains. Teenagers need to know that sex is natural, but “to master it rather than to let it master you”, he says. After proper education if “you still want to fly before your time, have a parachute”, he says of condoms. Some of the Gates Award money will go to the new campaign, he says. As Mechai begins spinning off safe sex slogans aimed at the next generation at risk of infection—“Stop global warming use a condom” and “A condom a day keeps the doctor away”—he seems to be relishing his latest challenge.