Faculty of Public Health Mahidol University Bangkok Thailand

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• Violation of National Health Policy e. g. Environmental health was outside the domain of health authorities • Outdated organization of health ministries and departments e. g. Integration of public health and medical services had disintegrated the public health system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