Health Transitions and the Double Disease Burden in Asia and the Pacific by Lewis Milton J.;MacPherson Kerrie L.; & Kerrie L. MacPherson

Author:Lewis, Milton J.;MacPherson, Kerrie L.; & Kerrie L. MacPherson [Milton J. Lewis]
Language: eng
Format: epub
ISBN: 1097836
Publisher: Taylor & Francis Group

Health promotion and non-communicable diseases

One of the major components of post-crisis health reform was the promulgation of the Thai Health Promotion Act in 2001 and the establishment of the Thai Health Promotion Foundation (THPF ), a quasi-public agency and autonomous organisation funded by 2 per cent of the excise tax on tobacco and alcohol. The Foundation was a direct response to the growing public concern with the increased mortality from chronic non-communicable diseases and road traffic accidents. The priority programmes of the THPF are the introduction of health promotion, creating awareness about unhealthy behaviour, support campaigns against tobacco and alcohol consumption, and supporting research on health promotion. The THPF ’s mission is to complement existing MoPH health promotion activities (mostly clinical preventive services) and to network with and support civil society and community-based health organisations (for example, the 144 partner organisation of the Stop Drinking Network and the No Alcohol Campaign) (Phusit et al. 2007:17). In 2005 the THPF supported more than 700 projects, with more than one-third of the projects related to tobacco, alcohol and prevention of road traffic injuries (34 per cent), health promotion among specific groups (17 per cent) and community capacity strengthening (16 per cent) (ibid.: 18). The THPF has demonstrated some success in tobacco and alcohol supply control, road safety campaigns and the regulation of alcohol advertisements. With regards to alcohol control one notable achievement has been the passing of the 2008 Alcohol Act that prohibits various forms of alcohol advertising.

However, despite these important health promotion initiatives it is doubtful whether they will have a significant effect on the reduction of chronic non-communicable diseases. In 2005 78 per cent of health expenditure was spent on curative services and rehabilitative care (activities dominated by clinical prevention and personal health services and minimally related to primary prevention), while only 4.8 per cent of total health expenditure was used for public health services and disease prevention, compared to 7.1 per cent in 1994 (ibid.: 13). The policy report by Phusit and others (2007) concludes that the 2 per cent ‘sin tax’ that funds the Thai Health Foundation ‘cannot serve as an adequate financial leverage to halt and reverse the trend of chronic NCD’ (ibid.: 15). Revenue collected from the tax was equivalent to US$57.9 million in 2005 – only $1 dollar per capita. The report recommends that the ‘sin tax’ be increased to 5 per cent of the tax on tobacco and alcohol (ibid.: 29). Another obstacle to health promotion and the reduction of non-communicable diseases, highlighted in this report, is that major health funds, such as the Civil Service Medical Benefit Scheme and Social Health Insurance scheme, ‘deliberately exclude prevention and health promotion from their benefit packages, on the ground that these two insurance funds are for curative purposes’ (ibid.: 27).

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