UHC and AMR: The Thai Experience

2019-09-22

Thailand is among the few countries in the South East Asia region or among middle income countries worldwide, that boasts of a Universal Health Care (UHC) system, which allows access to publicly-funded healthcare without any co-payments and covers 98% of the population. UHC costs are financed through general taxation.

Thailand achieved Universal Health Coverage in 2002 and since then out-of-pocket expenditure for Thai citizens was reduced from 27.2% to 12.4%. Since the introduction of Universal Health Coverage, Thailand has also seen a reduction in infant and child mortality, HIV infections, the effects of diabetes, and workers’ sick days, as well as many other health benefits.

Thailand also has an excellent record in tackling the drivers of contagion over the decades. Starting in the seventies, it successfully tackled the problem of malnutrition, ensured provision of clean drinking water and access to sanitation facilities while creating a strong primary health care network in the rural areas.

All these efforts have had considerable impact on lowering burden of infectious diseases in the country, which are a major driver of Antimicrobial Resistance (AMR). For more explicit integration of AMR concerns, Thailand has already instituted a broad rational use of medicine policy within the Universal Health Coverage system in recent years and carried out awareness programs amidst both health professionals and the patient community groups.

AMR is likely to become a priority issue within the Thai Universal Health Coverage system as the focus shifts from access to quality of care and  to cater to needs of specific disease groups or sections of the population, such as the elderly or those requiring surgery and longer-term hospitalization. Also, with Antimicrobial Resistance gaining a higher profile globally and also within Thailand there is likely to be greater coordination of AMR-related work that overlaps with or is complementary to functioning of the Universal Health Coverage system.

References

The Kingdom of Thailand Health System Review. 2015. Asia Pacific Observatory on Health Systems and Policies.  http://apps.searo.who.int/PDS_DOCS/B5410.pdf (accessed on 7 April 2019)

Tangcharoensathien V, Limwattananon S, Patcharanarumol W, Thammatacharee J. Monitoring and evaluating progress towards Universal Health Coverage in Thailand. PLoS Med. 2014; 11: e1001726