Faculty of Public Health Mahidol University Bangkok, Thailand

Health Challenges of South-East Asia by Assoc. Prof. Dr. Nawarat Suwannapong Deputy Dean, Faculty of Public Health, Mahidol University, Thailand

I. Health challenges related to Health Management Urbanization: Pollution, crime, drug abuse, commercial sex worker, etc. Ecological imbalance: Landslide, flood, ecological and environmental issues are neglected, low priority, etc. Changing social structures: Increased elderly population, increased stress,etc. Globalization: Trans-boundary diseases, SARS, Free Trade Area (FTA) Quality Health Care

I. Health challenges related to Health Management ( contd ) Healthy public policies and decentralization Equity in health care Lack of emphasis on health promotion/prevention Lack of coordinated information for basing policy decisions Confusion about the control of communicable diseases Poor capacity of health authorities to evaluate the outcome Professional ethics and human right

II. Public Health System Lack of popular support to public health e.g. India, political support and technical commitment were lacking Leadership crisis e.g. Most of health administrators are clinician Violation of National Health Policy e.g. Environmental health was outside the domain of health authorities Outdated organization of health ministries and departments e.g. Integration of public health and medical services had disintegrated the public health system

II. Public Health System (contd) Professional inadequacy and apathy e.g. Health authorities took away ad hoc actions with inadequate technical insight and competence, India -- one doctor: 20,000 population Conservative bureaucratic administration: there was a tendency to maintain the status quo Financial constraints e.g. The limited financial resources available were spent wrongly, misconduct

III. Infectious Diseases Malaria: –Mapping of Malaria risk –Monitoring of drug resistance –Development of combination therapies and new methods of administering medications –Use of Insecticide-treated materials for personal protection –Improvement of responses to malaria epidemics –Gender issues in diagnosis, treatment and prevention –Home and community-based action to reduce malaria burden

III. Infectious Diseases (contd) Emergence of new diseases and new epidemics e.g. Avian Flu Measles: a re-emerging disease, exhibited a new strain virus that attacks kidney TB: Indonesia, Bangladesh, Myanmar, India, HIV/AIDS: India, Myanmar, Thailand DHF: e.g.Thailand, Indonesia

Health Challenges of Thailand Changes of lifestyle – pattern of morbidity and mortality changed Non-Communicable Diseases –Cerebrovascular Diseases –Carcinoma: all forms –Accidents –Diabetes –Overweight and Obesity

Health Challenges of Thailand (contd) Infectious Diseases –DHF –AIDS –TB (re-emerging) –Severe diarrhea –Malaria (re-emerging)

Universal coverage(30 Baht policy) Hospital Accreditation Tobacco banned policy Drunk don’t drive Healthy Thailand etc.

Thank you