2. Thailand Well-developed health care system 200,000 need ARV Target 50,000 on ARV 50% in Northern Thailand 50% rest of Thailand, including Bangkok

3. Thailand Min of Public Health and BMA responsible for scaling up ARV Major target: district hospital (DH) 800 DHs, of which 500 deliver ARV now ARV free/cheap

4. General remarks M&E info comes from different sources: Continuous monitoring Surveillance Surveys Unified M&E system is possible in Thailand, while the following issues are important to keep in mind : patient referral between hospitals patient migration stigma on ARV (no smartcards)

5. Needs, resources,access Available: national level guidelines for doctors, nurses, counselors Needed: training in comprehensive treatment, including OIs and pediatrics Lab infrastructure + QA system Better pediatric formulation Policies to ensure equal access Better access for children

6. Program Monitoring (1) KEEP IT SIMPLE

7. Program Monitoring (2) Start of treatment Body weight CD4 Side-effects Regimen + regimen change + reason Termination + reason Electronic, 1 page, once a month

8. Program Monitoring (3) Data can be used at all levels Feedback of results important Drug resistance: now going from research to surveillance (1000 patients) Cost/Cost-effectiveness: important to measure, monitor

9. Research Issues Evaluations of the ongoing program Research on program improvement, additions to program Step-by-step-improvement model Adherence very important issue Effects of training? Effects of peer support? Relation quality of program and adherence?