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Sym 14a_IUHPE_HP and NCD Prevention in Thailand_9 Apr 2019
- 1. Dr. Sirikiat Liangkobkit Assistant Chief Executive Officer Thai Health Promotion Foundation Bangkok, Thailand Health promotion and NCD prevention in Thailand 1
- 2. W o r l d H e a l t h O r g a n i z a t i o n – N o n C o m m u n i c a b l e D i s e a s e s ( N C D ) C o u n t r y P r o f i l e s , 2 0 1 4 Proportional mortality in Thailand by cause of death, 2014 Health and Economic Burden of NCDs in Thailand • Around 400,000 deaths/year ( >70% of total deaths) • Societal cost of 2.2% of GDP C a r d i o v a s c u l a r d i e a s e 2 9 % C a n c e r s 1 7 %C h r o n i c r e s p i r a t o r y d i e a s e s 9 % D i a b e t e s 4 % O t h e r N C D s 1 2 % C o m m u n i c a b l e m a t e r n a l , p e r i n a t a l a n d n u t r i t i o n a l c o n d i t i o n s 1 8 % I n j u r i e s 1 1 % NCD is #1 Killer 2
- 3. Thailand Health System Reform (in Response to NCD Epidemic) 3 2001 20021992 2008 Thai Health Promotion Foundation Act(2001) → 2% ‘Sin-tax’ for health promotion National Health Security Act (2002) → National Health Security Office, reforming financing system for universal health coverage Tobacco Product Control Act + others → Total ad. Ban → Smoke free area → Increase tax 2015 Begins SDGs Era 2011 1st UN HLM on NCDs 2018 IUHPE 10 System Requirements Alcohol beverage Control Act : Control… → Sale point → Drinking area → Advertisement
- 4. Thailand Health System Reform (in Response to NCD Epidemic) 4 2001 20021992 2008 Thai Health Promotion Foundation Act(2001) → 2% ‘Sin-tax’ for health promotion National Health Security Act (2002) → National Health Security Office, reforming financing system for universal health coverage Tobacco Product Control Act + others → Total ad. Ban → Smoke free area → Increase tax 2015 Begins SDGs Era 2011 1st UN HLM on NCDs 2018 IUHPE 10 System Requirements Alcohol beverage Control Act : Control… → Sale point → Drinking area → Advertisement 2017 Recent policies : → Excise tax on Sugary Beverages → New Tobacco Control act 2017 → Ban on Trans fat 2018
- 5. Lancet Commentary by Thailand Prime Minister: “Thailand's commitment to global cooperation on NCDs : acting together now”(Jan. 2019) 1. To make NCD a top national agenda and lead national multi-sectoral effort 2. To monitor the progress 3. To invest more in health promotion Leaders’ Healthy Behaviors UN Inter Agency Task Force (UNIATF) on NCDs, 2018 Requirement #1 : POLITICAL COMMITMENT 5
- 6. 6 Requirement #2 : Transparent and Robust National Action Plans National Alcohol Control Plan/Committee National Tobacco Control Plan/Committee National Physical Activity Plan/Committee MOPH
- 7. • Set up by a parliamentarian act in 2001 • 2% Surcharge Excise Tax (on Tobacco & Alcohol) approx. 140 million USD (2018) Thai Health Promotion Foundation (“ThaiHealth”) Requirement #3 : Sustainable Financing for Health Promotion 7 • Set up by a parliamentarian act in 2002 • National budgeting by per capita: include budget for prevention & promotion(10 USD/person in 2019) National Health Security Office (NHSO) To Support Health Promotion Movement to address NCDs risk factors
- 8. Knowledge Management Social Movement Policy Endorsement - Ministry of Public Health - Other Ministries/National Assembly - Tobacco consumption control committee - The Office of Alcohol Control Committee - The National Physical Activity Committee - The National Food Committee - Tobacco control research & knowledge mgt center (TRC) - Center for Alcohol Studies (CAS) - Food Healthy Policy Program (FHP) - Thailand Physical Activity Research Center (TPARC) - Thai & Inter. Universities - Advocacy network (Tobacco,Alcohol) - Media ,Mass sports - Health professional orgs - Local Networks/NGOs: ASH, Stop drink network, Thailand NCD Alliance - Inter Networks/NGOs: GAPA, SEATCA, IOGT International, ISPAH, IUHPE, INHPF, NCD Alliance Service Support - Quitline 1600 (tobacco) - Call 1413 (alcohol) Key Partners in ThaiHealth’s “Tri-Power Strategy” on NCDs - World Health Organization - FCTC Secretariat - UNIATF for NCDs Requirement #4 : Strengthen health promotion institutions 8
- 9. 9 Requirement # 9 Engage with NGOs & communities Requirement # 8 robust policies Requirement #... 5 cross-sect. collaboration 6 leadership 7 workforce competency Requirement # 10 evidence generation Source: Lessons from the Thai Health Promotion Foundation. Bulletin of the World Health Organization, March 2019
- 10. 10 Requirement #7 (case): Robust policies and environment changes Smoke-Free Areas Alcohol-Free Festivals Healthy Spaces
- 11. 11 3rd in World along with Finland and Norway 1st in ASEAN Fully achieved 12 out of 19 targets World “NCD” Progression Monitoring Report (2017)
- 12. Source : National Statistic Office 12 Source: National Statistical Office of Thailand 12.26 12.52 11.98 11.35 10.86 10.9 11.5 10.77 10.9 10.7 32.00 28.81 25.47 22.98 21.22 20.7 21.4 19.94 19.9 19.1 0 5 10 15 20 25 30 35 1991 1996 2001 2004 2007 2009 2011 2013 2015 2017 current smokers smoking prevalence Thailand: Total Number of Smokers and Smoking Prevalence
- 13. Thailand : % Alcohol Consumption at Harmful Level 13
- 14. 2555 2556 2557 2558 2559 2560 72.9% 71.7% 68.3% 66.3% 68.1% 70.9% 80.0% 71.1% 74.1% 75.2% ref : 2013-2017 survey “surveillance & monitoring on Physical Activities of Thai population” 2012 2014 2016 2018 2019 2021 National TargetRecently 14 Projection The Situation of “Physical Activity” in Thailand
- 15. Way Forward : Recommendations by UNIATF on NCDs (2018) 1. Scale-up high level leadership and accountability (a new body led by the head of government) 2. Promote whole-of-government and whole-of-society coordinated actions 3. Strengthen fiscal policies further (eg. Sodium Tax) 4. Intensify regulations and enforcement ALL of these points are being followed up closely in 2019 15