Thailand's antiretroviral drug provision program should serve as a model for other poorer countries

Aug 17 2006

Thailand's HIV/AIDS prevention and treatment programs should serve as a model for other countries with limited resources to fight the disease, according to a World Bank report released on Wednesday at the XVI International AIDS Conference in Toronto, Reuters UK reports.

The report examines Thailand's antiretroviral drug provision program, which was launched in October 2005 and provides access to treatment for almost 80,000 HIV-positive people in the country.

Under the program, a person can access treatment for about 80 cents at any hospital or health clinic.

According to the report, widespread condom distribution and other prevention programs launched about 10 years ago -- combined with a network of hospitals and clinics -- enabled Thailand to control its HIV prevalence.

The report also finds that if Thailand had not launched widescale HIV/AIDS prevention programs, the country would have recorded 7.7 million HIV cases and 850,000 AIDS cases in 2005 -- 14 times the number of cases the country currently records.

Thailand also has avoided spending an additional $18.6 billion on treatment from 2002 to 2012 because of its prevention and treatment programs, the report says.

According to Mead Over, a World Bank economist and report co-author, Thailand saved about $43 in treatment for every $1 the country spent on prevention.

The report recommends that countries -- such as India and China -- with HIV/AIDS epidemics in earlier stages model their HIV/AIDS prevention and treatment programs after the ones implemented in Thailand.

"Thailand's past success with prevention is the most important reason the country can afford universal access to (AIDS treatment) today," Over said, adding, "Furthermore, it is an essential condition of its continued ability to afford treatment in the future."

According to the report, costs associated with Thailand's treatment program will rise as increasing numbers of HIV-positive people require access to second-line drugs, which are seven to 28 times more expensive than first-line drugs.

Because many second-line drugs are under patent, Thailand will have to pay full price for the drugs, negotiate prices with the pharmaceutical companies that hold the patents or issue compulsory licenses for drug production under a World Trade Organization agreement provision.

Thailand could save about $3.2 billion in health-related costs through 2015 by issuing compulsory licenses, according to the report (French, Reuters UK, 8/16).

Reuters Examines Thailand's Antiretroviral Treatment Program

Some health experts say the Thai government's commitment to provide access to HIV/AIDS treatment will face "serious challenges" as the lives of HIV-positive people are extended and treatment becomes more costly, Reuters reports.

Paul Cawthorne, Thailand representative for Medecins Sans Frontieres, said, "It's quite impressive how they rolled out this program so quickly, but it has some teething problems."

Cawthorne said those problems include the strain on health workers resulting from an influx of HIV-positive people; the need for second-line drugs when patients become resistance to first-line treatment; and potential gaps in coverage for injection drug users and prison inmates, as well as for migrant workers and ethnic minorities, who have limited access to the country's public health system (Schuettler, Reuters, 8/15).

Kaisernetwork.org is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at http://www.kaisernetwork.org/aids2006.