title: Thailand's HIV/AIDS program after weaning-off the global fund's support.
abstract: BACKGROUND
  Though 85% of financing HIV/AIDS program was domestic resources, Global Fund (GF) programs played a significant role in prevention interventions and treatment for non-Thai Key Affected Populations (KAP) and migrants. As upper-middle income country, Thailand is not eligible for GF support. This study identified the remaining challenges and funding for prevention interventions for Thai and non-Thai KAP and migrants if GF supports were to curtail.
  
  
  METHODS
  Qualitative method was applied including document review and in-depth interviews of 21 key informants who were Principal Recipients, Sub-recipients, provincial level program implementers and policy makers in health financing agencies. A multi-stakeholder consultation workshop was convened to discuss recommendations.
  
  
  RESULTS
  The "public financed public services model" where Principal and Agents were the same entities resulted in less accountability than the "contractual agreement" in GF programs where the Principal Recipients, as the Agents were more accountable to the GF as Principal through results based financing. If GF supports were to curtail, impacts on the current programs would be varied from low to high degree of negative consequences. Scale down the scope and targets, while keeping the most critical components were common coping mechanisms. All three, except one, Principal Recipients had difficulties in fund mobilization. Prevention among non-Thai KAP and migrants were identified as the remaining challenge.
  
  
  CONCLUSIONS
  A pooled funding mechanism from multiple domestic sources was proposed. Replacing the conventional public-financed-public-service by a contractual model was preferable. The GF should continue funding the non-Thai KAP and migrant as transition mechanism. Multi-countries or regional programs especially at the border areas were priorities.
authors.affiliation: International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand. walaiporn@ihpp.thaigov.net.
authors.forename: Walaiporn
authors.initials: W
authors.lastname: Patcharanarumol
authors.forename: Noppakun
authors.initials: N
authors.lastname: Thammatacharee
authors.forename: Suwat
authors.initials: S
authors.lastname: Kittidilokkul
authors.forename: Thitikorn
authors.initials: T
authors.lastname: Topothai
authors.forename: Chompoonut
authors.initials: C
authors.lastname: Thaichinda
authors.forename: Rapeepong
authors.initials: R
authors.lastname: Suphanchaimat
authors.forename: Nakorn
authors.initials: N
authors.lastname: Premsri
authors.forename: Viroj
authors.initials: V
authors.lastname: Tangcharoensathien
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000191:economics / Q000517:prevention & control / Q000628:therapy; D005376:Financial Management / Q000592:standards*; D005380:Financing, Government; D015658:HIV Infections / Q000191:economics* / Q000517:prevention & control / Q000628:therapy; D061889:Healthcare Financing; D006801:Humans; D007391:International Cooperation; D036301:Qualitative Research; D012941:Social Responsibility; D013785:Thailand