Thailand's HIV/AIDS program after weaning-off the global fund's support

Area of Science:

• Public Health
• Health Economics
• HIV/AIDS Research

Background:

• Global Fund (GF) financing is crucial for HIV/AIDS prevention and treatment for non-Thai key affected populations (KAP) and migrants in Thailand.
• Thailand's upper-middle-income status limits eligibility for GF support, necessitating an evaluation of future funding challenges.
• This study examines remaining challenges and funding needs for HIV/AIDS prevention interventions for both Thai and non-Thai KAP and migrants.

Purpose of the Study:

• To identify challenges in HIV/AIDS prevention interventions for Thai and non-Thai KAP and migrants.
• To assess funding needs and potential impacts of reduced Global Fund support.
• To propose sustainable funding mechanisms and program models for HIV/AIDS prevention in Thailand.

Main Methods:

• Qualitative research methodology.
• Document review and in-depth interviews with 21 key informants (Principal Recipients, Sub-recipients, program implementers, policymakers).
• Multi-stakeholder consultation workshop to discuss recommendations.

Main Results:

• Contractual agreements in GF programs demonstrated higher accountability than the 'public financed public services' model.
• Reduced GF support could lead to varied negative consequences, including program scale-downs.
• Difficulties in fund mobilization were reported by most Principal Recipients; prevention among non-Thai KAP and migrants remains a key challenge.

Conclusions:

• A pooled funding mechanism from diverse domestic sources is recommended.
• Transitioning to a contractual model is preferable over the conventional public-service model.
• Continued GF funding for non-Thai KAP and migrants is advised as a transitional strategy, with a focus on regional and border programs.