1. Development of NAPHA in Thailand
Dr Anupong Chitwarakorn
Department of Disease Control
Thailand

2. NAPHA in Thailand 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

3. 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

4. Key area of development
VCT
Capacity building for physicians
Laboratory networking
Nurse, community and home care
Drug supply

5. Key information for patients monitoring
Adherence
BW., KS OI
Side affects
CD4
Viral load
4 S’s

6. 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.

7. 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%

8. CD4 after 3TC, d4t, NVP at 6 months: study from the northern Thailand
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

9. 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