Photo by Kees Metselaar

1988, fresh out of college and working in northern Thailand, Karyn Kaplan, J88, was surprised to see the country’s open attitude about AIDS prevention—billboards of dancing condoms, health literature distributed even to third graders. It showed that the country took AIDS education and prevention seriously.

Yet today, as Bangkok hosts the 15th annual International AIDS Conference, she says the problem is more serious than ever, exacerbated by neglect of one of Thailand’s most vulnerable populations.

Kaplan brings unrelenting determination to what she calls “the greatest global health emergency of our time.” As international advocacy coordinator for the Thai AIDS Treatment Action Group (TTAG) in Bangkok, she concentrates on protecting the rights of injecting drug users, a group she says is largely overlooked by prevention strategies and the target of repressive—and dangerous—drug policies. “Society enforces the law at the expense of human rights and public health,” says Kaplan, who chaired two sessions and spoke at the July conference. She pointed to the Thai government’s violent crackdown against drug users, including extra-judicial killings. The policy ensures that drug users will not come forward and seek the health care they so desperately need, she says.

According to Kaplan, the consequences are enormous: injecting drug users account for the fastest growth of new HIV infections worldwide. In China, more than 70 percent of the country’s one million HIV/AIDS patients are drug users. In Thailand, around 50 percent of injecting drug users are HIV+.

While much urgent work must be done to avoid an explosive AIDS crisis in Asia, organizations like TTAG are making progress, Kaplan says. She points to a recent $1.3 million grant awarded to TTAG and two other community-based organizations for HIV prevention, care, and support from the Global Fund to Fight HIV/AIDS, TB and Malaria.

“This was a revolutionary proposal because it showed that, in the midst of Thailand’s crackdown, drug users could make the case that their lives are of value and [they deserve] support for their innovative, peer-driven HIV intervention,” says Kaplan, who is also advisor to the Thai Drug Users’ Network.

Growing up in New Jersey, Kaplan learned the value of activism early on. Her mother was a theatrical producer, working largely on radical works. Performers from around the world would often stay at the family home during the summer, inspiring her to speak out for causes she believes in. “I was trained to understand the power of politics and that having a voice was important, that giving voice could bring many groups out into the public view,” she says.

After graduating from Tufts in 1988 with degrees in French and English literature, she traveled to northern Thailand to establish an English curriculum at the International YMCA. Volunteering with a grassroots program, she helped distribute HIV and health-service information in brothels. She saw firsthand how this rural corner of Thailand had become the epicenter of the country’s AIDS crisis.

“Here was a poor area near the border with Burma, with many young girls being drawn unwittingly into the sex trade in the cities,” says Kaplan. “There was little information and support for them, and inadequate political attention, even denial about this reality, and HIV spread rapidly. Then, as now, there is a flourishing and condoned domestic commercial sex industry so prevalent that one of the highest ‘risk factors’ for HIV infection is being married.”

She returned to the United States to hone her language skills and gather experience, working at the Gay Men’s Health Crisis and then with the HIV/AIDS and Human Rights Project at the International Gay and Lesbian Human Rights Commission in New York City. Frustrated by working away from the grass roots, she traveled back to Thailand and helped found the Thai AIDS Treatment Action Group and Thai Drug Users Network. As international advocacy coordinator, she travels widely, including serving as a speaker at the International Harm Reduction Conference in Melbourne, Australia. She also recently traveled to San Francisco, where she joined a coalition of AIDS activists criticizing the pharmaceutical industry for running clinical trials without making the drugs affordable for poor people.

Human rights and ethics, she says, provide the bedrock for her convictions. Her cheerful voice often belies outrage, as when she talks, for instance, about how pressure must be put on the United Nations (UN) to repeal or reform conventions on drugs, established back in the 1970s, that made methadone illegal. Now health workers know that opiate users should have access to methadone to maintain therapy.

“So there is this tension between the outdated thinking of the UN and what the public health community knows is critical,” says Kaplan. “People in positions of power, particularly at UN agencies and heads of government, must be held accountable for their broken promises to effectively address HIV/AIDS. As an AIDS activist, it is my responsibility to point out, by any means necessary, the betrayal by politicians of the public good.”

It is a responsibility that pits her against tremendous odds. Yet when asked if she feels brave, Kaplan simply replies, “Not particularly. But I am inspired by the bravery of others who live under privation and oppression and can channel the power of human dignity into change.”

And it is that inspiration, she says, that will keep her fighting for a cause of tremendous global consequence. She may travel far, but she is always home: “The world’s a big place,” she says, “and the home is in the heart, right?”