Developments of Policy on Providing Access to Antiretroviral Therapy and the Impacts of Policy Change: from Limited Access to an Era of Free Treatment in Thailand

Abstract

Thailand had the highest HIV prevalence in Southeast Asia. As time went by, the country was able to fix the problems of HIV/Aids infection which was praised by the World Health Organization (WHO) and United Nations (UN). With the ability to contain Aids epidemic, Thailand had become a role model to fight against HIV/Aids infections for many countries around the world. One of the Ending Aids policy was providing access to antiretroviral therapy. This research was an academic article utilizing historical documents published during 1992 – 2018. Its purposes were to explain the developments of policy on providing access to antiretroviral therapy in Thailand during 1992 – 2018 and present the impacts caused by policy change. Thailand’s developments of policy on providing access to antiretroviral therapy could be divided into five stages: 1) moving to the national agenda, 2) reducing dependence on foreign organizations, 3) targeting specific groups, 4) allowing access to HIV/Aids medicine during pre-exposure prophylaxis, and 5) role of the member of the Thai royal family in policy formulation. The public policy process was concerned with the following components: policy formulation, policy adoption, policy implementation, policy evaluation, and policy improvement or policy change. However, theoretical gap was found to be the impacts of policy change. The article presented such impacts caused by policy change. The empirical results revealed that when each policy on providing access to antiretroviral therapy was changed, the number of HIV/Aids infected people getting access to the antiretroviral therapy increased significantly. Therefore, it was recommended that “impacts of policy change” be added as another component of public policy process.