Anti-retroviral medication for all HIV+ Thais - fact or fiction

[CM4Me]

A year or so ago a Thai friend came to us in a rather depressed state. He had been

diagnosed with having HIV.

Since then we have continually provided moral support and advice, though our advice

is rather limited on this matter.

In early October he was all excited as he had heard, via Thai media, about the

government policy in relation to HIV. The following I selectively quote from

The Nation:

The Sunday Nation on October 5, 2014 reported that . the Deputy Public Health

Minister Somsak Chunharas said that one of the government's policies was to

prescribe.. free prescriptions for anti-retroviral drugs ..regardless of the CD4

level, through both the universal healthcare scheme and the social security

scheme. See

http://www.nationmultimedia.com/national/Free-anti-retrovirals-for-all-with-HIV-30244777.html

The Nation on October 27, 2014 also reported that the Prime Minister Gen Prayut

Chan-o-cha . expressed his intention for Aids patients at all levels to have access to appropriate drugs. See

http://www.nationmultimedia.com/national/PM-wants-all-Aids-patients-to-have-access-to-drugs-30246328.html

Last week our friend went for his periodic blood test, and asked the hospital doctor could he receive the medication, as announced by the government.

To his horror he was told that Anti-retroviral medication is only available once the CD 4 level falls below 300, and not for those above this level.

Unfortunately the poor guy is now rather depressed, again. In a typical Thai way he

doesnt know who to believe and/or who to turn to (for advice).

So, is the government policy on Anti-retroviral medication, as announced in October, fact or fiction? Would appreciate some clarification, if possible. Tks

[hhgz]

Apparently, his doctor explained the situation to him.

[Sheryl]

The policy is as the government announced but implementation is lagging, specifically, getting sufficient stocks of ART into all the hospitals.

But it is also possible the doctor he spoke to is not up to date....

Even under the old policy, the cut off was 350, not 300. So if he is sure the doctor said 300 and not 350, the doctor is not even following the prior policy and something is wrong.

Is he under Soc Security or the Universal Scheme (gold card/30 baht)?

There are HIV patient advocacy organizations he can contact for help. He can also contact either the NHSO or SS office depending on which one he is under.

BTW what is his current CD4?

[CM4Me]

Sheryl,

Tks for your reply.

I'm not sure what scheme (SS or Universal)he is under, but he has worked full time

for a rather large organization for quite some time now, but I'll find out the next

time we see him.

Do you know of any HIV patient advocacy organizations specifically in Chiang Mai that he can speak to, and or go and see?

I'm not sure of his current CD4 count, but again I'll ask him the next time we see

him, & will advise.

Again, tks for your advice

[Tywais]

Here is a paper on ART facilities in Chiang Mai though it doesn't specifically identify the hospitals - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3754485/

Currently, there are a total of 27 hospitals in 25 districts of Chiang Mai province providing ART free of charge for those HIV/AIDS patients whose health benefits are covered under the three national health insurance schemes: ie, the Civil Servant Medical Benefit Scheme (CSMBS), the Social Security Scheme (SSS), and the Universal Coverage Scheme (UCS). Additional to those services to Thai patients, the hospitals also provide free ART to migrant workers and ethnic groups (who are not granted Thai citizenship and therefore are not covered in any national healthcare insurance schemes) through the National Access to Antiretroviral Programs for People living with HIV/AIDS (NAPHA) Extension Program.

[Sheryl]

Sheryl,

Tks for your reply.

I'm not sure what scheme (SS or Universal)he is under, but he has worked full time

for a rather large organization for quite some time now, but I'll find out the next

time we see him.

Do you know of any HIV patient advocacy organizations specifically in Chiang Mai that he can speak to, and or go and see?

I'm not sure of his current CD4 count, but again I'll ask him the next time we see

him, & will advise.

Again, tks for your advice

If he is employed he should be under SS in which case he can and should (1) change doctors and (2) if still denied treatment complain to the SS : call center 1506 or CM office

Chiang Mai Provincial Social Security Office

City Hall 1th floor, Chotana Road,

Muang District, Chiang Mai 50300

Tel. 0 5311 2629-30

Yes, there are HIV patient advocacy groups & very helpful at that. Have him try here http://www.thaiplus.net/ (sorry website only in Thai) local contact is

TPN+

Tel: 053-304-045

Email: [email protected]

If they can't help get back to me as there are other groups but I would try TPN first.

While he should certainly fight to get ART now, he can take comfort in the fact that even starting at a CD4 below 350, survival is ?90% (and that figure encompasses people who wait until they have full blown AIDs and start only when their CD4 is almost nil......among people who take care and start at 300-350 survival is almost 100%).

[CM4Me]

Tywais & Sheryl (once again)

Tks for the info, will pass it on to our friend. Will advise the outcome