Thailand is one of the few LMICs to have successfully implemented UHC and has developed and sustained institutional capacities for the various aspects of UHC implementation. However, specific challenges remain, particularly in addressing the increased financial costs, partly as a result of the shifts in the country's health profile associated with the rising burden of noncommunicable diseases.
As with the ADP approach in India, Thailand has been engaged primarily as a resource country, with the objective of facilitating a process of mutual exchange and learning towards multi-disciplinary policy- and decision-making to address challenges to UHC. Through ADP collaboration with HITAP, the aim is to foster partnerships between technical institutions in other LMICs and those in Thailand, in order to leverage the health policy and technical expertise in the latter.
Three areas of collaboration have been identified by country stakeholders, namely: priority setting and policy coherence; procurement; and access to new TB regimens. Through HITAP, the Ministry of Public Health in Thailand supports the use of HTA for multi-sectoral research that examines the cost, clinical effectiveness and other implications (e.g. sociocultural and ethical issues) to inform selection of health technologies for the National Essential Medicines List, and hence, coverage under the UHC scheme. ADP has partnered with HITAP to meet requests from the government stakeholders in Bhutan, Indonesia, Kenya and Lao People's Democratic Republic in support of the technical aspects and institutionalization of HTA in these countries.
Through the ADP Platform for South–South Exchange and Learning, representatives from the national medicines regulatory authority (FDA), national health insurance scheme (NHSO), national TB control programme, the HTA agency (HITAP) and a health policy research institution (IHPP) contributed to greater understanding and learning among other LMICs on policy, programmatic and technical solutions to address major challenges across the value chain. In addition, officials from HITAP, NHSO and IHPP participated in a training workshop on strategic pricing to share the experience of Thailand in establishing benchmark pricing for new medicines and health technologies that are part of the national formulary, in conjunction with Indonesia, Malaysia and the Philippines, to share pricing information for an ADP-commissioned study on regional pharmaceutical price comparisons.
ADP also supported capacity assessment of the Thailand FDA through the use of the WHO GBT. The resulting IDP identified the specific capacity needs of the national regulatory authority. In this connection, ADP supported the training of Thailand FDA personnel on best practices for inspection of clinical trials, to ensure data quality and safety of human subjects. ADP will continue its support for the implementation of the IDP to address the identified capacity gaps.
|Country profile a|
|Human Development Index ranking||83|
|Population total (millions)||69|
|Gross national income per capita (USD)||15,516|
|Working poor at PPP $3.10 a day (% of total employment)||1|
|Public health expenditure (% of GDP)||4|
|Life expectancy at birth (years)||76|
|<5 mortality rate (per 1000 live births)||11|
|TB epidemiology b|
|TB incidence (per 100,000)||156|
|Deaths due to TB (per 100,000)||17|
|TB treatment coverage (%)||74|
|MDR-TB incidence (per 100,000)||6|
|Malaria epidemiology c|
|Cases of malaria (per 1000)||0.2|
|Deaths due to malaria (per 100,000)||0.1|
|NTDs epidemiology d|
|Population in need of PC / coverage of PC||73,495 / 93%|
All data from 2017 unless stated. PC: preventive chemotherapy.