Home visit performed by MSF nurses and PHA workers allows follow up of some difficult patients more closely, such as paediatric HIV patients who usually have difficulties in understanding and adhering their treatment. Surin province, Thailand Photograph by Joanne Wong
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Case study: Involvement of People Living with HIV/AIDS in Treatment Preparedness in Thailand

Photograph by Joanne Wong

In 2001 the Thai Ministry of Public Health (MOPH) launched an antiretroviral therapy (ART) programme. A decentralized approach was adopted and treatment was initially provided to 1500 people living with HIV/AIDS (PLHA) in 112 government hospitals (1). Previously, health care for PLHA had been provided from specialist centres. By February 2004, 23 000 PLHA were being treated in 860 hospitals. 

In 2003 the Ministry undertook to provide 50 000 people with ART by 2005 and it is intended that 20 000 more will receive ART through a social insurance scheme. This amounts to close to complete coverage and exceeds the WHO “3 by 5” target. 

In parallel with these efforts, patient groups and nongovernmental organizations (NGOs) have been working to provide PLHA with enough knowledge to make informed decisions on treatment and to play a central role as partners in the provision of care. This began in November 2000 as a nationwide community response to inadequate access to the prevention and treatment of opportunistic infections (OIs), and has prepared the ground for PLHA to provide practical support for the rapidly increasing access to antiretroviral drugs provided by the government.

The change in the role of PLHA from being passive consumers of health care to becoming partners in care provision has helped to build their confidence and pride as well as gaining them greater respect from public health service staff. The present case study outlines the work of PLHA and their NGO partners over the last four years.