However, the free antiretroviral program had to be halted in early 1997 due to the financial burden and the need for program revision. It is felt that it might be more efficient and realistic to have each hospital integrate the cost of care of HIV patients with the cost of routine hospital operations and have the government pour more resources into the hospitals. There are several other unsolved questions regarding antiretroviral use in countries with moderate resources. In general, internationally based pharmaceutical companies are reluctant to invest in clinical trials in developing countries due to uncertainty about the quality of the data being generated. HIV-NAT is conducting clinical trials that serve the local interest but at the same time have scientific merit.
Examples are trials of full dose vs half-dose double nucloesides or double vs triple nucleosides.
Patient recruitment was fast, drop-out rate was low, and the quality of data was high. Since over 90 percent of HIV infection in Asia and the Pacific islands is heterosexually acquired and almost equal numbers of women and men are being infected, vertical transmission of HIV poses a real threat in the region. The prevalence of HIV infection in the antenatal care clinics in several towns in Thailand and India is already over 10 percent. For example, there are 20,000 HIV-infected pregnant women each year in Thailand. Although ZDV costs less in Thailand than in the US, the overall cost is still tremendous.