Thailand

4. HEALTH RESOURCES

4.1 Human resources for health

The public health personnel include medical doctors, dentists, pharmacists, nurses, medical technicians and other 50 job titles. In Thailand there are many institutes, both public and private, producing public health personnel. The production of public health personnel in the public institutes is the responsibility of the Ministry of University Affairs and the colleges under the MOPH. Their further education or training are under the responsibility of the Institute of Praboromratchanaka of the MOPH. The data of output of the public health personnel in 2003 show that there are 1,318 medical doctor graduates, 431 dentist graduates, 807 pharmacist graduates and 1,499 professional nurse graduates. In addition, there are 3,284 primary nurses being matriculated for the professional nurse education and training.

Since the MOPH has demands of 18,203 medical doctors, 6,641 dentists, 7,801 pharmacists and 107,028 nurses, it has drafted a master plan of public health training program to reach an output of 54,400 personnel in next 10 years in order cover the demands in the period. It has prepared a budget of 59.6 million baths for supporting this master plan, which is supposed to produce 596 – 1,250 medical doctors per year, an increase of 200 dentists and 1,000 nurses per year. Further, it has also prepared a budget of 9.6 million baths to locate these personnel to different districts where their services are needed.

Table 4.1 The geographical distribution of medical doctors, dentists, pharmacists, professional nurses and technical nurses in different regions of Thailand, with ratios of public health personnel to population, 2002

Source: Report of Health Resources, Bureau of Policy and Strategy, MoPH, 2002

It is also found that more public health personnel, be they medical doctors, dentists, pharmacists, professional nurses or technical nurses, work in public organizations rather than private ones. This could be due to the fact that there are more government hospitals than private ones. There are 977 government hospitals with the facilities for in-door patients. Only 319 private clinics have similar facilities, i.e. a ratio of 3:1 (government to private). The percentages of various health professionals employed in public and private organizations are given in Table 4.2.

Table 4.2 The distribution of medical doctors, dentists, pharmacists, professional nurses and

Source: Report of Health Resources, Bureau of Policy and Strategy, MoPH, 2002

Table 4.3 shows the rural-urban distribution of public health personnel. Since the primary cares are mostly in rural areas, secondary and tertiary cares are located in urban areas. The public health personnel like public community health officers, public health technical officers, and public health administrative officers are in the rural areas, while medical doctors, dentists, pharmacists, professional nurses, technical nurses and dental officers are deployed in urban areas.

About95.8 percent of medical doctors, 86.8 percent of dentists, 96 percent of pharmacists, 93.6 percent of professional nurses and 92.4 percent of technical nurses work in urban areas; while 97.5 percent of the public health administrative officers, 88.9 percent of community health officers and 83.8 percent of public health technical officers work in rural.                     

The ratios show that the number of rural population per one medical doctor is very high according to the standard of the 9^th National Development Plan of Economy and Society, which stipulates that the ratio of medical doctors to rural population must not exceed 1:6000 by the end of the Plan i.e. by the year 2006.

In the BKK Metro, one medical doctor takes care of 952 persons, one dentist per 6,614 persons, one pharmacist per 4,667 persons, one professional nurse per 279 persons and one technical nurse per 1,511 persons.

While in the North Eastern region, there is one medical doctor per 7,251 persons, one dentist per 28,432 persons, one pharmacist per 14,987 persons, one professional nurse per 1,278 persons and one technical nurse per 3,257 persons.

From the distribution of public health professionals at different levels of health care, primary care, secondary care and tertiary care, it is found that most of the health professionals are in the tertiary care level. Other public health professionals like public health technical officer, public health administrative officer, and community health officers are found mostly in the primary and secondary care levels. Dental officers are mostly found in the secondary care level.

Nearly 79 percent of medical doctors work in the tertiary care, while 46.8 percent dentists work in tertiary care and 40 percent work in secondary care level. Similar distribution is found among pharmacists - 50.6 percent in tertiary care and 45.4 percent in secondary care, while most professional nurses (64.4%) and technical nurses (61.4%) work in tertiary care.

Remarks:

1.      Primary cares are Offices of Community Health, Office of Ampur Public Health, Branch hospitals, Nursery stations/service centres, PCU (Primary Care Unit).

2.      Secondary cares are Community hospitals, Somdej Prayuphratch Hospital, Other Technical Regional Centres.

3.      Tertiary cares are regional or general hospitals, hospitals belonging to other government agencies, specialist hospitals.

Related Links

Ministry of Public Health

Human Resources – WHO/HQ

4.2 Financial resources for health care

The government’s financial source has been the biggest funding source of the MOPH, yet during the years 1980 – 1989, the allocated budget decreased from 29.9 percent in 1980 to 19.7 percent in 1989. However, after 1989 the government’s allocated budget for the MOPH started to rise again and reached 37.1 percent in 1997 and 63.4 percent in 2003. It is due to the fact that during the said period, Thai economy started to recover, the economic growth was steady and rapid plus the government’s policy of human-cantered development. Efforts were put into the health insurance to cover all people and promote good health for all. Budget allocation for public health increased from 4.2 percent in 1989 to 7.7 percent in 1998. However, after the Financial Crisis, the government had to lower the budget allocation in order to comply with the IMF agreements. In 2001, the budget allocation was 6.7 percent of the country’s total budget.

It is seen that the budget for MOPH were quite high in the past decade. Budget data shows that during 1969-01, the allocation was about 2.7 – 7.7 percent of the total country budget, or about 0.4 to 1.0 percent of the GDP. This is because the foreign debt burden and the budget for security have decreased, until the outbreak of the Financial Crisis in 1997, which has hiked the foreign debt from 5 percent in 1997 to 10.9 percent in 2001. The MOPH, consequently, has been allocated lower budget, in the fiscal year 2001 - 58,692.2 million baths plus another 2,400 million baths from the Health Insurance Funds, totalling 61,097.2 million baths, or about 6.7 percent of the total country budget. In the fiscal year 2003, MOPH received 69,133.94 million baths or 6.915 percent of the total country budget. However, in term of real value of the budget, it is found that the 2001 budget was lower than the 1996 budget. It is note-worthy that during 1997 to 2001, there was a lot of foreign loan. In 1997 the loan was 1,360 million baths, 1998 =1,360 million baths, 1999 = 3,560 million baths, 2000=2,360 million baths, and 2001 = 446 million baths.

From the perspective of expenditures, it can be seen that about 31-53 percent of budget was for the salary, 28-50 percent for the operation, while a portion of investment was dependent on the economic situation i.e. about 11-39 percent.

The Private Financial Sources: initially, private sector was the largest financial source for the public health financing. Since the coverage of the health insurance has not been 100 percent, 30 percent of the population is without health insurance. This suggests that these people are to pay for their healthcare. Also, Thai people are used to taking care of their own health, like buying one’s own medicine, when sick. This suggests that the household financial source for the healthcares is very important in the MOPH’s determining the provision of public health services. In fact, the households provided 60 percent of the total healthcare expenditure in 1980.

In Thailand, total health expenditure was around 3.5 percent of GDP in 2003. Public health expenditure of total expenditure on health was 63.4 percent in 2003, whereas private health expenditure of total expenditure on health was 36.6 percent during same period.

The financial sources from the households in healthcare account for 73.9 percent of the total health care expenditure. In the year 1989, the households’ contribution to the health care increased to 80.1 percent due to the fact that the government had reduced public health budget, resulting in increased financial burden on the households in taking care of their health. After 1989 until the 1997’s Financial Crisis, the household’s financing health has a decreasing trend i.e. 62.9 percent, but it increased to 66.8 percent in 2000.In the future, the economy is expected to be better and thus the government will be able to provide more financial support for the public health plus the policy of public health reformation, which aims to increase the health insurance to cover every one and improving the quality of the public healthcare establishments and services. More people are expected to use public health services, instead of buying their own medication. This also contributes to the decreasing trend of household’s healthcare spending.

The financial aids from abroad: it is found that the foreign health financial aids tend to decrease, from 1.44 percent in 1980 to 0.15 percent in 1990, and the decrease propensity is continuing to be 0.14 in 2000. On the contrary, Thailand is now becoming a financial aids provider rather than a receiver.

In the efforts to heighten the public health insurance, the MOPH, as the principal responsible agency, has pushed forwards many programs to respond to the government’s policy. One of them is the program of 30 baths for Every Disease, which started in the April of 2001. It has begun with the participation of the MOPH healthcare establishments by launching a pilot program in 6 provinces covering 1.3 million eligible people. During October of the same year, the program was expanded to the 75 provinces and some districts of the BKK Metro with participation of 1,017 government healthcare establishments and 103 private establishments covering 38.8 million rightful people. In April of 2002, the program of 30 baths for Every Disease has successfully covered all the districts of Thailand with 45 million eligible people under its coverage and participation of healthcare establishments in all the covered districts. As a result, the rightful people now have easier and cheaper healthcare access. Further, the MOPH also encourages people to have their own families’ dedicated healthcare establishments, which are near their homes by allowing people to register their choices of their dedicated healthcare establishments at their nearby Community Health Centres. Regarding payments for the “Health Insurance for All” project, the Office of the Permanent Secretary of MOPHwill be responsible for allocating the fund to each Provincial Public Health Office according to its population size. The Provincial Public Health Office will in turn allocate the fund to each of its healthcare establishments, according to its population size.

Related Links

Ministry of Public Health

WHO/HQ

4.3 Physical infrastructure for health

The total numbers of healthcare establishments, which have in-patient beds, were 1,293 with 1,34,453 beds in 2002. Of them, 94.7 percent are generic healthcare services and 5.3 percent are for specialized healthcare services.

There are 973 healthcare establishments belonging to the government, while 320 to private, with a private to government ratio of 1:3.6, and are classified as generic healthcare services and specialized healthcare services as the followings:

      For the government establishments, there are 915 generic healthcare services (74.7%) and 93,268 beds

      For private establishments, there are 309 generic healthcare services (25.3%) and  28,511 beds

      For the specialized healthcare services establishments, the government has 58 (84%), 12,271 beds and the private has 11 (16%), 403 beds.

The dispersion of the public healthcare establishments concentrates in certain areas. The government’s healthcare establishments of different scales have been expanded to cater to all the needs quite well, especially those establishments under the MOPH, which is the principal government agency for the public health affairs. In 2002, the MOPH had 94 Regional/General Hospitals, 722 Community Hospitals, which cover about 82.4 percent of the total Ampurs; 9,804 PCUs  for catering the tambols, and 69,331 Primary Public Health Centres in the communities catering 94.4 percent of the villages. Regarding the dispersion of the public health facility in terms of the bed to population ratio, it is found that the ratio is increasing in all regions and the whole country. Nevertheless, there is high concentration of beds in the BKK Metro, with the ratio of one bed to 213 people; while in the Central region it is 1:391; in the N. Eastern region, it is 1:759; in the Northern and Southern region, and they are 1:496 and 1:465, respectively.

The overall bed occupancy in the healthcare establishments is 72.26 percent. The bed occupancy in the government establishments (81.74%) is more than that in the private one (37.66%).  The bed occupancy of the MOPH’s establishments is 86.15 percent. The expansion of the private healthcare services depends much on the economic conditions and the market demand. In the year 2000, there were 13,099 drug stores and 10,875 clinics.

Related Link

Ministry of Public Health

4.4 Essential drugs and other supplies

The National Drug Policy: According to the 9^th plan of the MOPH under the guideline of the National Development Plan of Economy and Society, Issue 9 (2002-06), it is stipulated in the 3^rd strategy, which regards the development of basic health factors and health enhancement in the aspects of drug supply.

Regarding the drug uses, there are the following policies:

      The drugs must be efficient, safe, with good quality, with reasonable prices, evenly distributed by both public and private agencies.

      To mandate that the drugs consumed must be efficient and effective in healing, to reduce unnecessary drug consumption.

      To encourage the domestic pharmaceutical industry, so as to be self-sufficient in drug production and consumption; the related R&D must be emphasised and promoted; drug exports are to be promoted, too.

      To encourage the use of the domestic materials and resources in producing drugs.

      To encourage the R&D of herbal medicines in order to understand and evaluate their healing capacity, efficiency and safety, and also to promote the safe and efficient uses of herbal medicines and traditional methods in healthcares and therapies.

      To encourage the uses of drugs, according to the National Accounts of Major Drugs in both public and private sectors.

      To improve the efficiency in administration of drug affairs, and to amend to the related laws and regulations so as to ensure maximum protection to the consumers.

Drug-related laws: The regulating regime is through The Pharmacy Act 1967, the Ministerial Regulations, Ministerial Announcements, the Ministerial Orders, and their amendments. Besides, there are other laws and regulations which have been issued according to the stipulation of the Pharmacy Act 1967.These laws and regulations are being amended and notified from time to time.

The idea of classifying the drugs which are essential to the well being of the public has been initiated since 1972 by the MOPH. It then framed the policy and appointed the Department of Medicine to prepare and maintain a National Account of Essential Drugs. However, after the restructuring of the Ministry in 1972, the maintenance of the National Account of Essential Drugs has been transferred to the Division of the Regional Hospitals. The major objective of the National Account of Essential Drugs, which has been adopted since 1970, is to be a template for the MOPH’s hospitals to assort their drug inventories. Later on, it has been revised and ameliorated by incorporating the factors of budget frugality and the convenience of drug inventory management. It has been published as “The MOPH Account of Essential Drugs” in 1979.

Since the idea of the above National Account of Essential Drugs agrees with the recommendation of the WHO, Thailand has started to have its own national Account of Essential Drugs, for which the MOPH has designated a committee, the National Account of Essential Drugs Committee in 1981. The committee is to identify and classify the essential drugs in health establishments of each level, to provide advice and recommendation on how to make uses of the National Account of Essential Drugs and follow up and evaluate the results there from.

After the Panel of the Ministers has approved to designate the National Drugs Policy, and has installed a committee, the National Committee of Drugs in 1982, the preparing and maintenance of the National Account of Essential Drugs has been transferred to the Subcommittee of the Development of the National Account of Essential Drugs, which is the subcommittee under the National Committee of Drugs. The subcommittee has reviewed and improved the National Account of Essential Drugs from time to time as necessary until 1996. The maintenance of the National Account of Essential Drugs is under the WHO’s principle regarding drugs, which define “principal drugs” in the National Account of Essential Drugs as that they are important drugs that cannot be left out, and they are necessary for the public health of the population and for solving the public health problems of a country.

The National Account of Essential Drugs, 1999, is divided into two parts:

1.      Account of Essential Drugs for hospitals and public health establishments

2.      Account of Essential Drugs for primary public health affairs

Account of Essential Drugs for hospitals and public health establishments consist of drug items assorted, according to the pharmacologic and therapeutic classification, into 23 groups, totalling 932 items. The drugs that can be produced within the hospitals by their Pharmacy sections and have been approved by the Subcommittee of the Development of the Hospital Account of Essential Drugs, are also added to the drug list of the hospitals or the public health establishments’ National Account of Essential Drugs.

Drug Procurements:The Office of Permanent Secretary of the MOPH and the Food and Drug Administration, together with the Mixed Committee of Public and Private for the Resolutions of the Medical and Public Health Issues are the working agencies that respond to the preparation of the qualification of drug requirements of the country, which are used as the guideline for both private and public to plan the sourcing of the essential drugs.

The National Pharmaceutical Organization is one of the working agencies for (i) mobilization of resources from private and public (ii) to enhance and expand the capability of the productions of the essential drugs which are primary for the prevention and curing of diseases and for the public health purposes so that the drug supply meets the nation’s demand. The Organization also monitors the quality of drugs, efficient sourcing of the essential drugs and strategic drugs which are required to be imported. The procurement of the strategic drugs is usually by price biddings in order to acquire the drugs with reasonable prices and with stipulated quality. The organization also monitors the stocks of drugs to maintain a suitable reserve level of each essential drug. It is also responsible for preparing the necessary drug ingredient chemicals, proper procurement and storages of them for meeting any crisis to control the supply and demand of drugs, and to control the quality of drug ingredient substances.

MOPH is the government agency, which is to provide support and provide aid to the domestic production of drugs by procuring and reserving necessary drug ingredient substances. Besides, it is to facilitate by eliminating various obstacles so as to promote the private productions of the essential and primary drugs for the public health. It is also to encourage and educate people to use the proper primary health drugs in their own self-medications.

In the year 1986, the Office of Prime Minister has announced the 7^th issue of the Regulations of the government inventories, which stipulate that the public health establishments under the MOPH are to deploy no less than 80 percent of the allocated drug budget to procure the drugs according to the National Formulary, while the public health establishments under other government agencies are to spend no less than 60 percent of the drug budget to procure the drugs according to the National Account of Essential Drugs.

MOPH is responsible for promoting and restoring health and updating the drug usage standard. Moreover, the MOPH is to improve the present measures and laws regarding the diagnosis, the suitability and updating of the National Formulary by considering the needs of the public health. Therefore, the MOPH has taken measures to improve the drug administration systems in different government agencies, both at the national and regional level so that the government public health establishments, drug foundations and PCUs can manage their drug resource efficiently and economically. Besides, it also provides the required knowledge, technology and suitable personnel for the above public health establishments.

Apart from the above responsibilities, MOPH and the Ministry of University Affairs have collaborated in providing courses of clinical pharmacology, the exchanges and dissipation correct and current information and knowledge of prudent drug usages. They also provide measure and methodology to help in improving general people’s capability of prudent and economical drug purchases and consumptions. This includes the necessary knowledge about the deadly drugs and the potential danger of improper uses of some common drugs so people can lower their consumptions.

Thailand has enacted the protection of intellectual property rights since 1979. The Drug Patent Act then protected only the right of the drug production processes. However, on 21^st of August, 1985, the Association of Pharmaceutical Products and the American Chamber of Commerce in Thailand have appealed to the government to have the Drug Patent Act amended to also protect the right of drug products and the patent age to be extended from 15 years to 20 years. For this appeal, Thailand has then amended the Act accordingly in 1986.

Later on, on 30^th September, 1992, the Drug Patent Act 1979 has been amended again to extend the Drug Product Patent age from 15 years to 20 years, and also appointed the Committee of Drug Patents to look after the prices of drug to prevent them from hiking too much since the drug products which had the protecting patents, monopolized the market.

In the year 1993, the “Temporary Measure” was amended to become the Safety Monitoring Program (SMP). On 31^st May, 1994, it was mandated that the drug products which had received their first Drug Patents between 1^st January, 1986 and 30^th September, 1991, were to be monitored under the SMP.

The SMP was for the original drug products, and the Measures of Bioequivalence was for the generic drug products which had the same ingredients as the original drug products. These measures had been effective since 22^nd August 1989.

After the MOPH had incorporated the SMP into the procedure of new drug registration, it received complaints and opinions from consumers, specialists, intellectuals from government and private agencies, both from within and without the country, that the above measures had created market monopoly for the original drug products, which were usually too expensive to be affordable by the majority of the patients, like most AIDS patients and HIV carriers. As a result, in 2001, Thailand made an amendment to separate the SMP from the new drug registration and thus, from the drug monopoly and allowed the generic drug products to have the bioequivalence during the SMP period of the original drugs (Bolar Provision). The principle of this amendment is to protect the safety of the consumers and the highest possible benefits to the country.

Compliance with the international practices and the Patent Laws of Thailand: The Pipeline drug products are still governed by the Food and Drug Administration’s “Temporary Measures” of 1994, which regulates the related SMP and bioequivalence studies of new drugs dated 31^st May, 1994 so as to comply with the obligation that Thailand has to the USA. However, the FDA mandated the pipeline product distributors to report their drug items within 180 days.

During 9^th – 13^th May, 2001, the 4^th WTO Ministerial Conference held in Doha, Qatar, the Thailand’s standpoint was that we supported the inclusion of the meeting agenda of TRIPS and that of the public health in this 4^th conference hoping that the problem of patient’s accessibility to the necessary drugs would be resolved.

In this 4^th WTO Ministerial Conference, Thailand had its financial minister as the head of Thailand representative team of which one was from the MOPH. The MOPH representative tried his best to persuade the Ministry of Commerce to understand the importance of the public health problems, which were the consequences of the agreements regarding the intellectual property right that were covered in the trade agreements under the WTO, especially the problem of patient’s accessibility to the necessary drugs like AIDS patients and HIV carriers’ due to the fact that most AIDS drugs were new and patented. Thus, the prices are too high to be affordable due to monopoly created by the drug patents. The issue of solving this problem of expensive drugs and inaccessibility of necessary drugs was an important issue being attended by many developing countries and the international organizations like WHO and UNAIDS. There was need to balance the TRIPS agreements of the WTO and the impacts they have on the public health of the people. It is the rights of the patients to receive proper medical treatment and the society too as a whole. Instead of looking forward to the one sided commercial benefits from the agreements one should see the society as a whole in the present world, which can survive under the principle of the free trade of the WTO.

Related Links

Ministry of Public Health

EDM – WHO/SEARO

WHO/HQ 

4.5 International partnership for health

Thailand has already evolved a mechanism of international health co-operations in the form of an aids receiving country, bilateral co-operation or multilateral co-operation. In the year 1998, Thailand had established a committee for the international health co-operation affairs, which has the responsibilities of forming policies regarding the international health co-operation with other countries, international agencies, private organizations and other co-operation groups. The committee is to support the government policy in solving the economic and social problems of the country and of the region and also to monitor and control these international co-operations to ensure that they are programming towards the pre-decided goals. Furthermore, an operation committee for co-operations with the neighbouring countries and developing countries has been set up to take care of planning, implementation and following up and reporting the progress of related co-operations with those countries.

For the time being, Thailand has made certain achievements as desired in the policy. Thailand  has  been  able  to  build  up  certain  bilateral  public  health   co-operations with its neighbouring countries like the People’s Republic of Lao, the Republic of Burma (Myanmar), the Kingdom of Cambodia, the Socialist’s Republic of Vietnam, Timor-Laste and other Asia Pacific Countries like Maldives. In addition, multilateral co-operations are also established like the Mekong Basin Disease Monitoring Project, which is the multilateral co-operation of 6 countries which include China, the Kingdom of Cambodia, and the People’s Republic of Lao, the Republic of Burma, the Socialist’s Republic of Vietnam and Thailand.

Besides, Thailand also has long-term co-operation with other countries such as Thai-US public health co-operation which commenced since 2001 and also co-operations with other countries in the form of issue-specific projects such as with Australia, Japan, and Germany. It also has co-operations with international organizations, like WHO, UNICEF, UN agencies, Global Fund to Fight AIDS, Tuberculosis and Malaria.

Allocation and Use of Resource

The resources that are deployed in developing the co-operations of public health are from two major sources - the budget from each of the participating countries and the budget from the international organizations or other organizations. In case of Thailand, most of the allocated budget is under the control of the Ministry of Foreign Affairs and some part is received from the budget allocated for normal programs of the MOPH.

In developing the international health co-operation, there are many obstacles and constraints. The important ones are to be studied and solved for successful development of the international co-operation. They are given below:

1.      There is a lack of continuity in development at the national level, of the outlook and strategy of future development of international health collaboration.

2.      Each responsible agency’s follow-up system of the international health co-operation program at the national level is not efficient enough to meet the standards. Various co-operation projects still scatter around in different responsible agencies.

3.      The involvement of the private organizations and general people’s organizations is rather minimal.

4.      There is a need to reconsider the concerning government policies and international trade agreements under the WTO.

5.      The new public health issues such as the safety in food, drug, and pharmaceutical products.

Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) is an independent fund for the purpose of providing financial support. It has been registered with Risstre du Commerce at Geneva Switzerland. The Fund provides support to the projects which are proved to be pragmatic in controlling AIDS, Tuberculosis and Malaria. It is stipulated that the donor (recipient) countries must build up partnership mechanisms among the government agencies, private organizations, the private developing organizations and other international organizations within their respective countries, by setting up Country Coordinating Mechanism – CCM. Further they must prepare precise and efficient action plan called Country Coordinating Plan – CCP, and the projects proposed must pass the Technical Review Panel – TRP.

Thailand has an important role within this Fund since Thailand has its representative in the Transitional Working Group – WTG, which is responsible in shaping the structure, policy, orienting direction and determining the future operative measures of the Fund. Also, Thailand has actively participated in many important sub-committees like that of Governance, Eligibility Criteria, Result-based Disbursement and Technical Review Panel. Moreover, Thailand has sent specialists to work full-time in the Technical Supporting Secretariat (TSS).

Thailand has jointly organized workshops, on the principle and methodology of managing the fund, with India, China and Japan in order to provide intellectual and technical support to the countries within the South East Asian region and the West Pacific region so that the countries in these regions are able to meet the criteria of the Fund and receive more funds. Besides, Thailand is also one donor country of this Fund contributing annual fund of 1 million dollars for 5 years (2003-2007).

On the part of Thailand, the Department of Disease Control has been appointed as the Principal Recipient which acts as the principal liaison body to coordinate in applying for the fund. The Health System Research Institute (HSRI) has been appointed as the Local Fund Agent who is responsible for following up the progress of the projects, receiving the fund, financial management of those projects. HSRI is also to report to the Principal Recipient about the progress of the fund-receiving projects, appraise the effectiveness of the Country Coordinating Mechanism (CCM) and report to the Fund.

At present there are 4 projects in Thailand that have received fund support from the GFATM Thailand has received a total of 209.65 million US dollars, or about 9,200 million baths of funds during the 5-year term (2003-2007), ranking first in term of the amount received among the Asian countries and ranking third in the world. As a result, Thailand will have enough resource deployed in the efforts to successfully solve the problems of AIDS, Tuberculosis and Malaria.

Related Links

Ministry of Public Health

WHO/SEARO