Presented by Dr. Sorakij Bhakeecheep, Fund Management of HIV and AIDS and TB, National Health Security Office, Thailand

The country’s PPTCT programme has a budget of about $5 million and covers three target groups: mothers, husbands and children. The most important activities are counselling and systems strengthening. In examining the costs associated solely with PPTCT and the various medication regimens, therapy using single-dose nevirapine is the cheapest, while lopinavir-based (lpvr) combination therapy is the most expensive. However, when  indirect and overall costs including the cost of care and treatment for mother and child were calculated, it was found that single-dose nevirapine actually yields very high cost. The transmission rate under the HAART regimen is lower, and so the cost of care is also lower. By looking at the whole picture, the highest cost regimen is actually single-dose nevirapine. Lpvr adds $2 million in costs to the budget, but in the longer run $15,000 per child is saved because of lower transmission rates. Efirenz is cheaper but there have been reports of damage to the foetus and so it is not used. It is preferable to have one regimen for the whole country.