Challenges of ending AIDS in Thailand.

We read the publication on ‘The challenges of ending AIDS in Asia: outcomes of the Thai National AIDS Universal Coverage Program, 2000–2014’ with great interest [1]. Chaivooth et al. concluded that ‘Rolling out systems for early detection and treatment for all, regardless of CD4 cell count, are essential and under way’. We would like to stress some of the issues about this report. Based on the Universal Coverage Program, there are important considerations regarding cost and quality of medications [2]. The efficacy of local generic drugs must continue to be comparable to the standard original drugs and therefore quality control remains an important issue [3]. In addition, it is important to remember that access to drugs is dependent not only on the cost of medical care, which is freely provided within the framework of the Universal Coverage Program, but also to other indirect costs, such as transportation to medical centres [4]. Finally, we strongly support the suggestion of universal antiretroviral drug treatment regardless of the CD4 cell count. Additional planning for maintaining the continuum of drug supply after early initiation among patients is necessary [5]. It is also important to stress as suggested by Jiamsakul et al. that ‘a greater emphasis on more frequent adherence counselling immediately following ART initiation and through the first six months may be valuable in promoting treatment and programme retention’ [6].