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AIDS in Singapore

BMJ 2002; 325 doi: https://doi.org/10.1136/sbmj.0212468 (Published 01 December 2002) Cite this as: BMJ 2002;325:0212468
  1. Richard Bellamy, specialist registrar in infectious diseases and general internal medicine1
  1. 1Singleton Hospital, Swansea

Richard Bellamy reflects on the 16 months he spent in Singapore working as a registrar in infectious diseases and HIV medicine

On World AIDS Day, in particular, we should think about the difficulties faced by people living with HIV and AIDS. Although advances in antiretroviral treatment have made AIDS a manageable chronic disease, people with HIV and AIDS still live with a potentially fatal condition, numerous drug side effects, and society's prejudice. In Singapore, people with HIV and AIDS face an additional challenge--finding the money to pay for their extremely expensive drugs, at least £400 ($624; a634) every month for triple therapy.

The Singapore health service has a limited list of drugs which patients can be prescribed at subsidised rates. Antiretrovirals are not included, so patients must meet the full costs. Initially, I thought this burden was a sign of a cruel and insensitive government. After a few months in Singapore, however, I realised that local people place greater value on support from their families than from the State. It was wrong to judge the system with my Western values; Singaporeans would be just as shocked by many aspects of British society, such as our system of caring for elderly people. People with HIV and AIDS in …

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