Symposium 8C: The Best Investment in Health: What have HPFs learned after decades?

1. 1
Speaker: Dr.Sirikiat Liangkobkit
Assistant to CEO, ThaiHealth
Thai Health Promotion Foundation
Why and How?

2. 1. New Specific Act by the Parliament
2. New Autonomous State Agency
3. New Source of Sustainable Funding
4. New (Non-overlapping) Mission Mandate
5. New Way of Working
2
5’s New Features
Thai Health Promotion Foundation

3. • Set up as a state agency under a specific
parliamentarian act called “Health
Promotion Foundation Act 2001”
• reinforce in November 2001 (but process
started since mid 90’s by tobacco control
advocates)
1. New Specific Act by the Parliament
3

4. Board Of GovernancePrime Minister (Chair)
Minister of Public Health
(1st Vice-chair)
Independent Expert
(2nd Vice-chair)
• N a t i o n a l E c o n o m i c a n d S o c i a l
D e v e l o p m e n t B o a r d
• P e r m a n e n t S e c r e t a r y, P M O f f i c e
• M i n i s t r y o f F i n a n c e
• M i n i s t r y o f Tr a n s p o r t a t i o n
• M i n i s t r y o f I n t e r i o r
• M i n i s t r y o f L a b o u r
• M i n i s t r y o f E d u c a t i o n
• M i n i s t r y o f P u b l i c H e a l t h
• O f f i c e o f H i g h e r E d u c a t i o n
Community
development
Mass communication Education Sports
Health promotion Administration
Arts &
culture
Law
8 Independent experts
TH CEO
9 Re p re s e n ta t i v e s f ro m Re l a te d M i n i st r i e s
ThaiHealth Office
2. New Autonomous Agency
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5. • Revenue: S140 million USD (2018)
• 2% Surcharge Excise Tax from Tobacco &
Alcohol
3. New Source of Sustainable Funding
producers/importers
Ministry
Of
Finance
5

6. Rationale
• This extra 2% will be paid out of the harmful industry (→
reduce consumption)
• The Ministry of Finance will get the full amount of the
excise tax as they always did
• Health promotion will lessen the universal health care
(UHC) budget in the long term
• Public opinion supports using surcharge sin tax to fund
health promotion
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7. role as a multiplier or a catalyst
Still only a few drops in a cup …
3.5% of MoPH expenses
0.8% of National health expenses
0.1% of Government
expenses
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8. Social Determinants of
HealthOttawa Charter for Health Promotion
4. New Mission Mandate
To inspire, motivate, coordinate, and empower all
sectors for Tobacco Control, Alcohol Control and other
Health Promotion in Thailand
Through population-based health promotion projects
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9. ThaiHealth’s 15 Master Plans
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10. 10
Multi-Sectoral Partners
Health
&
Non-Health
2,000+ projects/year
22,000 Partners in 17 years

11. Tri-power Strategy
(Triangle that moves the mountain)
Emotional base for policy decision
making
Rationale base for policy options
consideration
Public education
5. New Way of Working
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12. • Excise tax on Sugary Beverages (Sugar Tax) (2017)
• Band on Trans-fat in Thailand (2018)
• New Tobacco Product Control Acts (2017)
• Integrated Excise tax Act (2017)
• Alcohol Control Act (2008) and subsequent related new ministerial regulations
• Control of Marketing of breast-milk substitutes (2017)
• National NCD Strategic Plan 2017-2021 (2017)
• National Strategy on lowering Salt Consumption (2017)
• National Strategy on Physical Activity (2018)
• Etc.
Recent Public Policies for Health in Thailand
- Tens of national and subnational policies & plans enacted
- ThaiHealth and partners help to 1) encourage research and advocacy to support good
policymaking 2) ready social climate
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13. Total number of current smokers and smoking prevalence
(Population aged 15 and above)
Source : National Statistic Office 13
R e s o u r c e : N a t i o n a l S t a t i s t i c a l O f f i c e
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
c u r r e n t s m o k e r s s m o k i n g p r e v a l e n c e

14. Health Promotion Situations: Alcohol
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15. 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”
The Situation of “Physical Activity” in Thailand
2012 2014 2016 2018 2019 2021
National
TargetRecently
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Projection

16. How to achieve sustainable funding
1. Burden of diseases from NCDs
2. Rising health care cost
3. Existing healthcare system “caring for the sick”
4. Morality : pay back from tobacco & alcohol industries to solve & prevent
the problems
5. Need to strengthen health promotion hand in hand with UHC
Rationale
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17. Conclusion
• ThaiHealth’s model is relatively effective for developing country context, born
through the lack of tobacco control funding in 90’s.
• Effective through a combination of new features (not any single one).
• We address:
– Fill funding gap for population-based HP interventions (with no -COI)
– Encourage research and advocacy to support result oriented policy making
– readies societal climate towards good policy, and
– effective platform for working across all stakeholders.
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