Challenge and co-operation: civil society activism for access to HIV treatment in Thailand.

Challenge and co-operation: civil society activism for access to HIV treatment in Thailand. .

Civil society has been a driving force behind efforts to increase access to treatment in Thailand. A focus on HIV medicines brought civil society and non-governmental and government actors together to fight for a single cause, creating a platform for joint action on practical issues to improve care for people with HIV within the public health system. The Thai Network of People with HIV/AIDS, in partnership with other actors, has provided concrete support for patients and for the health system as a whole; its efforts have contributed significantly to the availability of affordable generic medicines, early treatment for opportunistic infections, and an informed and responsible approach towards antiretroviral treatment that is critical to good adherence and treatment success. This change in perception of people living with HIV from ‘passive receiver’ to ‘co-provider’ of health care has led to improved acceptance and support within the healthcare system. Today, most people living with HIV in Thailand can access treatment, and efforts have shifted to supporting care for excluded populations.

This ‘participant-observers’ perspective, written by representatives of AIDS ACCESS Foundation, the Thai Network of People living with HIV (TNP+) and Médecins Sans Frontières, describes how civil society activism in Thailand pushed the government to increase availability of affordable antiretroviral drugs and then provided practical support to implementation of treatment programmes. Civil society groups played a pivotal role in Thailand’s decision to establish universal health care coverage for its citizens and used legal and other strategies to fight intellectual property restrictions to medicines, including non-HIV medicines. The groups represented by the co-authors developed a strategy for central involvement of trained people living with HIV in the scale up of treatment programmes through providing systematic peer support in ‘Comprehensive and Continuous Care Centres’ in hospitals. This rich historical analysis of policy change in Thailand is well worth the read.