Health networks are raising concerns about a possible shortage of drugs for patients with HIV/Aids following a dispute over who should handle the procurement of medical supplies for the universal healthcare scheme.
The National Health Security Office (NHSO) has long procured key medical supplies, including anti-viral drugs, for state-run hospitals but its ability to do so is being challenged by the Office of Auditor-General (OAG) which insists it is outside the NHSO's jurisdiction.
A proposal has been floated that the state-run Rajavithi Hospital should handle procurement instead of the NHSO.
A joint committee from the Public Health Ministry, the NHSO and the Government Pharmaceutical Organisation will be set up to look into the matter.
But with authorities preoccupied by the wrangling, health advocate groups say the issue has started taking its toll on particular groups of patients, including those with HIV/Aids.
Anan Muangmoonchai, president of the People Living with HIV/Aids Network, said a shortage of anti-viral drugs is imminent with the 2018 fiscal year approaching.
He said people infected with HIV and medical personnel in the central and northeastern regions had told him that some hospitals are running out of the anti-viral drug Teevir and are prescribing Teno-m+EFV instead.
According to Mr Anan, several patients reported only receiving one-month's supply of anti-viral drugs, instead of the usual three month supply. In some hospitals, patients are asked to pick up their supply of TDF each week.
He said some hospitals also report they have yet to receive new supplies of Teevir, Rilpivirine and Abacavir and have no idea what has delayed the delivery.
"Hospitals are concerned about a shortage of antiviral drugs. Patients are being advised to prepare for a possible shortage," he said, warning that if patients do not receive a regular dosage of medicine, the Aids virus may develop resistance to the drug.
Sureerat Trimakkha, coordinator for the People's Health System Movement, said the move to make Rajavithi Hospital responsible for procurement is likely to cause legal problems and cannot be implemented.
According to Ms Sureerat, the law does not allow Rajavithi Hospital to procure for other facilities and there are rules about disbursement of funds.
"The proposal faces several obstacles and its highly likely it won't be implemented. But it is the patients at risk. We disagree with this proposal. And if a drug shortage does occur, Rajavithi Hospital will be blamed. Should it take responsibility for that?" she said.
Yupadee Sirisinsuk, a member of the NHSO board, said the board will hold a special meeting today to finalise the procurement of key medical supplies for 2018.
She said board members who represent the civic sector will propose that the NHSO continue handling procurement to avoid medical supplies running short.
This seems to be the only option and the NHSO has been responsible for procurement since 2010, she said.
"Why did the OAG protest against this? Even the cabinet gave the NHSO the green light to buy [medical supplies]. The OAG still tries to get in the way and now we have a problem," she said.
The NHSO oversees the spending of the annual 170 billion baht budget for state-run hospitals.