Thailand/ART: Close monitoring to ensure success
At the end of 2001, there were 670,000 HIV-positive people in Thailand, including 21,000 children under five (source: UNAIDS figures). Since the start of the epidemic, one million Thais have been infected, of which one third have died (Thailand has 60 million inhabitants).
Thailand is the first South-East Asian country to have documented the AIDS epidemic and set up a national AIDS policy. The country also produces generic antiretrovirals: the Generic Pharmaceutical Organisation (GPO),which is linked to the government, produces a triple therapy (stavudine, lamivudine and nevirapine) for less than US$1 a day.
MSF has been working in Surin hospital since 1997. Triple therapy was introduced in December 2000 - first for home-based care patients, and later for those in hospital. Patients are included in the programme when their CD4 count falls below 200/mm3.
Patients are given plenty of information about the treatment and the importance of compliance. They are monitored closely to check for medical problems, and to find out if there are any other problems - psychological, social or financial.
As of October 2002, 369 people had started triple therapy in the MSF Surin programme, including 58 children. An estimated 1,200 people need ARVs in Surin - MSF hopes to be treating 500 patients by the start of 2003. MSF treats a further 350 patients in other parts of Thailand.
Since over 60% of people treated at the Surin hospital live outside Surin Muang, MSF decided to offer care for patients in other health centres in the region. In October 2001, MSF opened an HIV clinic in Thatum hospital; in December 2001, one in Sikhorapum hospital; and in May 2002, one in Sangka.