Thailand achieved most MDG targets early in the 2000s through sustainable health system development and investments in infrastructure, health workforce, and financial risk protection. This success was due to political and financial commitments to health, continuity of pro-poor policies across governments, rapid economic growth, and effective generation and use of evidence to guide policies and implementation. Thailand then introduced a national "MDG Plus" agenda to move beyond global targets and ensure more equitable progress, focusing on poorer areas. Maintaining these achievements and embracing emerging issues like non-communicable diseases will be important beyond 2015.

1. Achieving the MDGs and beyond: the importance of national ownership and capacities Viroj Tangcharoensathien International Health Policy Program, Ministry of Public Health, Thailand

2. Thailand MDG achievement Early 2000s, almost all MDG targets were achieved In 2004 MDG review, engaging multi-stakeholders, a concept of MDG Plus was introduced, Move beyond--making global MDG target as “point of departure” instead of “end point”; Plans, strategies and targets of line ministries form national MDG Plus targets, and approved by Cabinet Bottom up and engagement creates ownership and commitments Equity concerns Beyond national average: ensure equitable achievement, focusing poorer geographical areas, Muslim communities

3. Why health MDG were achieved? Sustainable health-system development. Wide geographical coverage of functioning primary health care Heavy investment in health delivery infrastructure Production and deployment of health workforce Improve financial risk protection, ensuring better access to care Synergistic contributions from other sectors Universal education move from 1 ry to 2 nd free education High level of female literacy rate and decreasing gender gap, Poverty reduction and improved living standards Better access to information and social services: transportation and communications

4. Why sustainable HSD? Political and financial commitments to health Policy formulation influenced by pro-poor, pro-rural and universality ideologies Continuity of policies by successive governments Rapid economic growth though slow progress in Gini Improved institutional capacities Generating evidence to guide upstream decision, downstream implementation and reprogramming, Effective interface between evidence and policy decisions Implementation capacities Pragmatism, pilot and scale up of innovations Street level bureaucrats’ capacity and effectiveness in translating health policy to implementation, M&E

5. Sample of Thailand MDG Plus

6. Why MDG Plus agenda? Sub-national evidences Political concerns: equity, national security Infrastructure favourable to move beyond global MDG Economic, health, education, agriculture Intersectoral engagement and actions

7. What’s beyond 2015? Sustaining MDG Plus achievements Maintain multisectoral actions of human development Embracing holistic, equity, national ownership, community participation, financial and programmatic sustainability Emerging national agenda Chronic non-communicable diseases: a national agenda Social determinant of ill health International trade and impact on health