Chakrabongse Villa in Old Bangkok was the
perfect setting recently for the start of a new chapter in the long friendship
between Japan and Thailand.
Listening
to Health Minister Piyasakol Sakolsatayadorn's opening remarks on a
relationship that "reaches back as far as the 17th century",
distinguished guests may have nodded as they glanced across the darkening Chao
Phraya River at the lit pagoda of the Temple of Dawn, celebrated in Japanese
Nobel Laureate Yukio Mishima's eponymous novel.
The
occasion was the alfresco signing of a joint project on universal health
coverage between Thailand's Public Health Ministry and National Health Security
Office and the Japan International Cooperation Agency (JICA). At the gathering
were key backers of the project, including upper-house lawmaker Keizo Takemi
and JICA adviser Kiyoshi Kodera.
The
project is the latest in a long line of mutual assistance between Japan and
Thailand dating back to the 1950s, JICA vice president Kae Yanagisawa noted.
Initially confined to the fields of electric power, health and agriculture, the
partnership has now expanded to the social and economic sectors. The
donor-recipient nature of old has also been replaced by a collaboration that
allows both sides to use their experience to help other countries.
For this
latest project, a core objective is to help other nations achieve universal
health coverage (UHC), one of the global sustainable development goals (SDGs).
Thailand played a significant role in the push to make UHC a global goal,
advocating for its inclusion in the list of SDGs at the World Health Assembly
and UN General Assembly.
To
achieve UHC, countries must improve all components that make up the health
system - governance, financing, workforce, service, information and medicines -
as well as tackling the non-health sectors that link with those components. The
resulting impact of a well-functioning UHC is far-reaching, going beyond
improvements to individuals' health, to helping solve unequal distribution of
affordable and quality care.
Some
critics dismiss UHC as an unrealistic goal that seeks a utopia of equality.
More acute observers view it as an astute strategy to eradicate inequity one
sector at a time, starting with health.
Thailand
is known worldwide for achieving UHC ahead of other low- and middle-income
countries. Run by the NHSO, our universal (Gold Card) scheme provides health
coverage for almost 75 per cent of citizens who fall outside of other
government-funded safety nets.
Praised
by the UN and the World Health Organisation, Thai UHC has achieved success on a
par with another of our celebrated acronyms, Otop - One Tambon, One Product.
Japan
meanwhile has half a
century
of UHC experience, with valuable lessons to offer on insurance management and
the roles of central and local governments in health provision.
The
combined expertise of Thailand and Japan could now be an invaluable tool for
those middle-income countries currently considering launching their own
universal healthcare.
One point
worth noting is that the involvement of both Thai agencies is vital if this
latest project is to succeed.
Thailand
is facing new challenges such as increasing healthcare costs, different benefit
packages, and purchasing mechanisms among the three main schemes, not to
mention the impact of a rapidly ageing population on the health system.
Sustainability, Adequacy, Fairness and Efficiency - SAFE - are now crucial
goals for sustaining Thai UHC.
Finding a
sweet spot for civil and deep conversations to reach these goals is important.
And finding it will require that both the Health Ministry and the NHSO work
together as true partners with a shared philosophy.
In this
regard, the UHC partnership project could be an ideal platform for both sides
to map out routes to that sweet spot.
As
representatives from both Thai agencies ambled back to the Chakrabongse
pavilion after the signing, conversation was no doubt already turning to this
critical point.
Kanitsorn
Sumriddetchkajorn
Kanitsorn Sumriddetchkajorn is director of the
Bureau of International Affairs on Universal Health Coverage, National Health
Security Office.
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