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หน้าแรก รอบโลก Thailand takes the lead in building foundation of global universal healthcare coverage.

Thailand takes the lead in building foundation of global universal healthcare coverage.

รอบโลก | 14 ธันวาคม 2561

Bangkok, 12 December 2018—Thailand is taking steps to set up Universal Healthcare Coverage (UHC) as a global agenda, after the country’s achievement in introducing the scheme sixteen years ago. But the challenge of building the scheme’s sustainability remains.

“If Thailand, as a middle-income country, can run UHC successfully, many other countries can do too,” said Kanchana Patarachoke, Director-General of the Department of International Organizations, Ministry of Foreign Affairs.  

Her speech came during a seminar ‘UHC: start from Thailand, progress in the world’ at Centra Convention Centre at the Government Complex in Chaeng Watthana, Bangkok.  

Held on 12 Dec, the event marked the International Universal Health Coverage Day, the anniversary of the first unanimous United Nations (UN) calling for all nations to provide affordable and quality healthcare to their citizens.

Achieving UHC is one of key targets in the UN’s Sustainable Development Goals (SDGs) to be attained by all countries in 2030.

Thailand has taken effort to help the world achieving this target, said Ms Kanchana, adding that the country was one of the major parties supporting the creation of Universal Health Coverage Day to call for access to ‘health for all.’

As parts of global efforts to build stronger equitable healthcare, permanent representative of Thailand to the UN Vitavas Srivihok, with a Hungarian diplomat Katalin Annamária Bogyay, are appointed by the UN as co-facilitators for the preparation of high-level meeting on UHC at the 74th annual UN General Assembly in New York next year. The meeting is likely to discuss about the introduction of UHC declaration to encourage health access for all.  

Sakchai Kanchanawattana, secretary-general of National Health Security Office (NHSO) which oversees the tax-funded UHC, spoke during the seminar on Wednesday that that the scheme had provided healthcare rights and access to over 48 million people.

It has prevented many families from indebtedness and financial collapse caused by unaffordable medical fees. When UHC was introduced to Thailand in 2002, over 660,000 households or four per cent of overall households experienced catastrophic health expenditure. The numbers declined to 440,000, or two per cent of overall households, in 2017.

Amidst the global praises for achievement, however, UHC has faced critics for causing financial burden to the nation by tripling state health expense since its introduction in 2002.

"This is a good investment, not a financial burden,” said Dr Sakchai. “If we invest in people's health, they will give return to economy.”

Kannikar Kijtiwatchakul, a NHSO board member representing civil society groups, said that the UHC’s operation was prominent by its application of democratic principle. 

The NHSO board members represent multi-stakeholders---ranging from civil society groups, patients, health practitioners to government official---that can assure checks and balances. All stakeholders can co-design health packages for the highest advantage of the scheme’s beneficiaries.

“The scheme proves that the democracy can be functioned in improving society as a whole,” said Ms Kannikar.

Life improvement of HIV and AIDS patients is a clear example of UHC’s success. This patients group participated in drafting the UHC law prior its official launch. They could raise voices through their representatives in NHSO board members and achieve in including antiviral drugs into the scheme’s benefit package.

Access to drug allows them to survive, work as ordinary employers and contribute back to national economy. Other patient groups such as cancer and kidney patients could also access channels to participate in designing benefit packages for their survivals.    

“An ongoing challenge for UHC is the government’s priority on budget allocation. If the priority is the well-being of citizens, the government should allocate the funds on building stronger social welfare instead of spending large budget for populism policies and military weapons,” said Ms Kannikar.

Deirdre Boyd, United Nations Resident Coordinator in Thailand, raised some other challenges faced by healthcare system---including influx of migrants, stigma and discrimination toward marginalised groups, aging society, increasing of mental health problems and non-communicable diseases in human. There's also a challenge on how to convert new technology to provide healthcare more efficiently.    

“Not just tracing issues of today, we must also look ahead in future," she said.

As half of the world's populations don't have access to UHC, she said, Thailand shows the possibility that UHC can be achieved in middle-income countries with long-term commitment and constant effort.

In adopting holistic measures for SDGs, the UN is looking for ways to implement UHC to address other relevant issues including poverty.

“We set a goal to eliminate extreme poverty. We can't do that until we address healthcare access with no financial risk,” said Ms Boyd. “The UN keens to learn more from Thailand and helps Thai colleagues share the lessons.”

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