Thailand - Stop TB Partnership

on resources from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The reliance
on outside funding raises concerns about the sustainability of these aspects of the TB
program. 24 Due to budget shortfalls, many planned NTP training activities could not be
implemented at the provincial and district levels in 2004. The emphasis on primary care
has also had a detrimental effect on such core NTP activities as program monitoring and
evaluation, as well as case recording and reporting. 25
While some patients like the new universal coverage scheme, others have expressed
frustration. For instance, one representative from a network of people living with HIV/AIDS
asserted that referring patients to the hospital rather than to a local TB center has reduced
accessibility to TB services.
Political commitment
I don’t think the government views TB as a threat. [T]here’s an inherent
faith that a rising tide of better healthcare in general will lift all boats
— [that] TB will progressively be eliminated along with other developing
country diseases . . . [while] HIV garners such high-profile activism that
it’s hard to shut the door on it. . . .
—Jay Varma, section chief for TB Prevention and Control of the
Thailand–U.S. Collaboration (TUC) 26
The Thai government has demonstrated a high level of political commitment to TB control
activities and implementation of the WHO-recommended DOTS strategy. By joining
other high-burden country governments in adopting the Amsterdam Declaration to Stop TB
in 2000, the government embraced the global TB control targets of 70 percent case detection
and 85 percent treatment success. In 2003, the MoPH declared TB to be one of five
“priority diseases.” (The other priority diseases are HIV/AIDS, malaria, heart diseases,
and diarrhea.) 27
However, some observers assert that there is still insufficient political recognition
of the persistence and severity of TB as a public health threat. According to the leader of one
faith-based group, the general perception among political leaders as well as in Thai society
is that TB has been completely eradicated. 28
Political commitment to TB control is particularly weak at the regional, provincial,
and district levels, where officials often place higher priority on other health issues such
as dengue fever, avian flu, and diarrhea. Budget reallocation has exacerbated this trend.
Resources formerly devoted to specialized TB control activities and staffing are now part of
PUBLIC HEALTH WATCH MONITORING REPORTS 41