Faculty of Public Health Mahidol University Bangkok, Thailand

2. Faculty of Public Health Mahidol University Bangkok, Thailand

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

4. 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

5. 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

6. 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• Violation of National Health Policy e.g. Environmental health was outside the domain of health authorities • Outdated organization of health ministries and departments e.g. Integration of public health and medical services had disintegrated the public health system

7. 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

8. 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

9. 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

10. 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

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

12. Universal coverage(30 Baht policy)Hospital AccreditationTobacco banned policy Drunk don’t drive Healthy Thailandetc.

13. Thank you