Transcript Anupong Chitwarakorn (MoH Thailand)

Development of NAPHA in
Thailand
Dr Anupong Chitwarakorn
Department of Disease Control
Thailand
NAPHA in Thailand
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Start in 2001
Shift from research based to service based
Target 3,000 patients, ARV budget 6 m$
Service provider sites increased from 55 to
110 hospitals
NAPHA in Thailand
• Scaling up in 2003
• Target 10,000 patients, ARV budget increased to 9
m$, service sites increased to 400 hospitals
• In 2004, target 50,000 patients, ARV budget
increased to 20 m$, all 800+ public hospitals
involved
• In 2005, target 80,000 patients, ARV budget will
increase to 30 m$
• Additional budget from GFATM 1st, 2nd
Key area of development
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VCT
Capacity building for physicians
Laboratory networking
Nurse, community and home care
Drug supply
Key information for patients
monitoring
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Adherence
BW., KS
OI
Side affects
CD4
Viral load
4 S’s
Program M/E
• Monthly report, indicate which projects.
• Service sites to provincial coordinators (75 plus
BMA) to regional coordinators and to national
level
• 4 S’s:
• Numbers of pt. still on drugs as of last month,
number of new enrollment this month, number of
pt stopping and why, number of patients died and
why, number of pt. still on drugs as of this month.
Latest status of NAPHA
as of 31st January 2004
• No. of pts. enrolled as of 31st December
2003 was 23,158
• No. of new pts. Enrolled in January was
2,503
• No. of pts. still on ARV as of 29th February
2004 was 20,896
• Lowest achieved was region 1 (central),
20%
• Highest achieved was region 10 (northern),
75%
CD4 after 3TC, d4t, NVP at 6 months:
study from the northern Thailand
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Mean CD4 at starting: 58 cell/cu.mm
Mean CD4 increase at 2 months: 61
Mean CD4 increase at 6 months: 118
95.5% of pts. had CD4 increase
Computerized information
• Start to develop in 2003
• All level: laboratory, facility, provincial,
regional and national
• Now in training process
• Monthly report with diskette from hospitals
to provincial coordinators to regional and to
national level