Non-Communicable Diseases (NCDs):
“Non-communicable diseases are a diverse group of chronic diseases that are not communicable, meaning you can't catch them from another person. They are defined as diseases of long duration, generally slow progression and they are the major cause of adult mortality and morbidity worldwide”(WHO, 2005)
NCD's are currently the leading cause of death in Thailand; accounting for 71-74% of deaths in the country (WHO, 2020). The most common NCDs are:
1. cardiovascular disease
2. cancer
3. diabetes
4. chronic respiratory disease
These NCDs are directly affected by obesity, smoking, excessive alcohol consumption (the highest in the South-East Asia Region), high sodium intake (2x over the WHO recommended levels), and high blood pressure (over 25% of population) being so prevalent among the Thai population.
Retrieved from http://origin.searo.who.int/thailand/areas/ncd/en/
Communicable Diseases:
The Dictionary of Epidemiology defines communicable disease as "illness due to a specific infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person, animal, or reservoir to a susceptible host, either directly or indirectly through an intermediate plant or animal host, vector, or the inanimate environment. Pathogens include bacteria, viruses, fungi, parasites and prions.
Common examples in Thailand:
1. Dengue Fever
2. Influenza
3. Melioidosis
4. Leptospirosis
5. HIV/AIDS
*Covid-19: COVID-19 risk is low, and new cases are decreasing or stable (CDC, 2020).
Thailand’s overall response, and ability to curb infections, has shown the world (alongside New Zealand), how to effectively ideal with the pandemic. The economic impact of the pandemic has been serious, though, with predictions of an 8.1 per cent contraction of the economy in 2020. According to a recent survey, 65 per cent of people in Thailand report that their incomes are very inadequate under pandemic conditions (UN, 2020.). Much of this impact is due to the lack of tourism.
(Retrieved from https://www.tatnews.org/2020/09/coronavirus-disease-2019-covid-19-situation-in-thailand-as-of-14-september-2020/)
Of note: Drug resistance, defined as "the extent to which infectious and parasitic agents develop an ability to resist drug treatment", has a significant impact in Thailand (Skolnik, 2020). The burden of antibiotic resistance in Thailand has been estimated result in 3.24 million days of hospitalization and 38 481 deaths per year, and to cost 0.6% of national GDP. 2019 (ReAct, 2019).
Challenges to Prevention and Control:
1. The existing aid was focused more on health services than risk factors and increasing the people’s awareness (WHO, 2020).
2. The activities of the Ministry of Public Health was project-based, resulting in the lack of continuity (WHO, 2020).
(Retrieved from https://ehs.iu.edu/images/virus.jpg)
3. Implementation of aid lacked evaluation (the results and impact). This lead to the lack of lessons learned and clear direction for further development (WHO, 2020).
4. Most of the agencies addressing these issues encountered limitations in terms of budget, management, determination of goals and communication (WHO, 2020).
Measures of prevention, control or improvement:
Thailand is responding to the epidemic of NCDs in multiple, helpful ways. The World Health Organization reports the following current actions that aid in the prevention, control and alleviation of the burden of disease:
(Retrieved from https://media.nationthailand.com/images /news/2020/04/14/30385972/800_ef0d0d11e605854.jpg?v=158685939
"Taxation on cigarettes is in line with WHO recommended levels: tobacco use has decreased from 32% in early 1990s to under 20% in the most recent survey in 2017 and the new tobacco product control act is in line with WHO FCTC.
The Alcohol Beverage Control Act of 2008 and subsequent amendments place a ban on direct advertising and promotions, a minimum legal age of 18 years for drinking, new warning labels, and restriction on hours of sale.
The government has announced a ban on Trans Fat in domestic and imported food products— from 9 January 2019 Thailand will be Trans Fat free.
Government is working with industry and communities to reduce the amount of salt that people are consuming.
A tax on sugar sweetened beverages (SSBs) has been recently introduced in an attempt to reduce consumption of unhealthy drinks.
The Thai cabinet has taken on the role of national champion for improving levels of physical activity across the country in order to increase public awareness on the benefit of active lifestyles.
Treating NCDs is a core element of the primary care system and the country has a strong commitment to universal health coverage. But without stepping up efforts on preventing NCDs, the costs of treatment will threaten the sustainability of UHC"(WHO, 2018).
(Retrieved from https://www.nationthailand.com/news/30378514)
Interesting Fact: Thailand has been ranked sixth among 195 countries providing the strongest health security, according to research by John Hopkins University. “Thailand is the only developing country ranked among the global top ten, as well the first among Asian countries. Thailand can be proud to have a strong system of disease prevention and control that is globally recognized" (The Nation, 2019).