2024 was a year marked by both positive and tragic news stories related to health. From extending universal health coverage to all locations to an alarming surge in poor mental health and the school bus tragedy, here are the top six new articles that sparked the most conversation in the Thai public health arena.
1. Extensions of universal health coverage for all
This year saw the National Health Security Office (NHSO) launch the ‘30-baht treatment everywhere’ project which is part of the universal health coverage scheme (UHCS), also known as the gold card, marking a milestone for the Thai public health system. The move is intended to sync and share health data across multiple hospitals and clinics allowing UHCS beneficiaries to receive healthcare services from any places registered under the scheme.
A pilot project for ‘30-baht treatment everywhere’ started in January 2024 with four provinces – Phrae, Roi-Et, Phetchaburi and Narathiwat. It was then expanded to cover 46 provinces, including Bangkok.
In addition to expanding healthcare services to all locations, in 2024, the NHSO approved breast cancer screening tests including mammograms and ultrasounds for Thai women aged 40 and over who have direct relatives with a history of breast cancer. The tests have been incorporated with the existing benefit package of the UHCS.
2. The rising burden of non-communicable diseases (NCDs)
NCDs are one of the major challenges for Thai public health. The diseases not only have a human and health cost but also impose a huge economic burden.
According to the Thai Health Promotion Foundation, NCDs, which include cancers, cardiovascular diseases, diabetes and chronic obstructive pulmonary disease (COPD), are the leading cause of death in Thailand. The diseases kill nearly 400,000 people each year, or equivalent to about 76% of all deaths in the country, of which 14% are considered premature deaths.
NCDs constitute a significant burden for the Thai economy. They cost the Thai economy about 1.6 trillion baht annually, equivalent to 9.7% of its 2019 gross domestic product (GDP), according to a 2019 study by Thai public health authorities and the World Health Organization.
The main risk factors contributing to NCDs among Thais are unhealthy diets, physical inactivity, the harmful use of tobacco, alcohol misuse and stress.
The Thai Public Health Ministry estimates that 14 million Thai people are diagnosed with high blood pressure every year. There are approximately 6.5 million new cases of diabetes and 1 million new cases of kidney disease reported annually. It’s estimated around 140,000 people in the country are diagnosed with cancer each year.
The Thai government is considering expanding the scope of the sodium tax.
The Excise Department was advised to impose a sodium tax on products outside the current controlled lists. It was also recommended to consider a mechanism for a fat tax to curb the increasing rates of fat consumption. Both salt and fat are linked to rising healthcare costs.
The sugar tax, meanwhile, has been approved for the 4th phase, commencing on April 1, 2025, which is a progressive approach that aims to achieve the goal of reducing sugar content in packaged beverages.
3. Alarming rise in poor mental health among Thais
Mental health is an increasingly critical public health issue in Thailand.
The National Economic and Social Development Council (NESDC) says some 10 million people in the country are living with a mental illness. Of this number, only 2.9 million seek treatment.
Mental health disorders among Thai people have soared over the past years.
The Department of Mental Health reported that the number of patients with mental illness who have received treatment increased from 1.3 million in 2015 to 2.9 million in 2023.
The department found that between October 1, 2023, and April 22, 2024, about 15.48% of people with mental health problems experienced high levels of stress, 17.20% were at risk of depression and 10.63% were at risk of suicide.
The rates of adolescents and young Thais experiencing mental health disorders have risen significantly over the past decade.
The Public Health Ministry has worked with psychological colleges and councils in an effort to address the problems. They have set a long-term goal to produce 400 psychiatrists within five years.
4. Advocating for safer roads for children
Thailand was shaken when the news broke about the school bus fire that killed 23 people, 20 of whom were students. The bus carrying 44 passengers, 38 school students from pre-school to middle school years and 6 teachers, crashed and caught fire while travelling on an outbound lane of Vibhavadi Rangsit Road in Pathum Thani province in early October.
This heartbreaking news underlines the need for immediate attention to more rigid road safety measures and a safer environment for children.
Road safety is a serious public health issue and a significant concern in Thailand.
The country has one of the highest traffic fatality rates in the world, attributed to unsafe vehicles and reckless driving. Annual deaths responsible for traffic are approximately 20,000 and about a million injuries.
In 2023, there were about 17,498 deaths due to road injuries, according to a Department of Disease Control report. And one-fifth of those who died in the accidents were children and young adults aged between 0 and 24, with not wearing a helmet, drunk driving and lack of seatbelt use among the top causes of traffic accidents.
The Thai government has taken steps towards addressing road safety but much more needs to be done. People have demanded long-distance field trips involving young school students be halted. Organizations and activists have called for safety measures in the transportation of school children to be reviewed and the safety standards for buses, especially those for school transport, to be improved to ensure that vehicles are well equipped with the necessary safety features.
The Child Welfare Policy Working Group, backed by 450 organizations including the Thai Health Promotion Foundation (THPF) and the Thailand Consumers Council (TCC), in particular, has called on
the government to implement pro-active measures to strengthen road safety, particularly in home-to-school travel by public transport.
The THPF has demanded an effective transport management system for school buses and coaches for field trips to be developed and that mandatory regulations and technologies be used to monitor safety. The foundation has also advocated the wearing of safety helmets for kids and youth while using the roads and making the protective gear part of the social welfare program.
The TCC, meanwhile, has proposed the creation of curricula for effective school bus management to the Ministry of Education and that particular requirements for people who wish to apply for a school bus driver’s license be put in place.
5. Low birth rates and a rapidly aging population pose significant economic challenges for Thailand
According to recent global statistics based on data derived from United Nations Population Division collected between 1950-2024, Thailand ranks third in the world in terms of declining birth rates.
The Thai national birth rate has declined by 81% over the past 74 years, after only South Korea (88%) and China (83%).
If the trend continues, the country’s population could reduce by half, from about 66 million people to about 33 million, in just 60 years according to a study by Chulalongkorn University’s Sasin School of Management.
The dramatic demographic shift would also impact the country’s economy and society down the road. It could lead to a lower number of working-age adults, resulting in Thailand facing a labour shortage crisis in the future that would then affect the country’s economic development.
In addition, a rapidly aging population will put a strain on the Thai healthcare system, be detrimental to the economy, and impede Thailand’s competitiveness in the international arena.
Thailand has already become a full-scale ageing society as the number of older population continues to rise while the birth rate declines. According to the United Nations’ data, 13.06 million people in Thailand were aged over 60 in 2023, making up about 20% of the total population.
The Thai government has made the declining fertility a national agenda. In 2023, the Ministry of Public Health rolled out a campaign in a bid to encourage married couples to have children and boost the nation’s falling birth rate. It has also added primary fertility treatment to its 30-baht universal healthcare coverage program.
Last October, Labour Minister Phiphat Ratchakitprakarn floated the idea of increasing the amount of financial support to parents from 1,000 baht to 3,000 baht per month per child for a period of seven years as an incentive for workers who have more children.
However, there is a shortage of plans to help people find love and encourage marriage and births.
A 2023 household socio-economic survey by the National Economic and Social Development Council showed that 23.9% of Thais are single. In particular, the share of singles in the reproductive age group (15-49 years old) reached 40.5% in 2023, a rise from 35.7% in 2017.
The state should formulate comprehensive measures and policies to deal with the demographic timebomb. Most of the measures it has launched are short-term, while others are populist policies that help treat the symptoms but not the disease.
6. Immediate action needed to reduce air pollution
Air pollution is increasingly serious in Thailand and threatens Thai public health.
The main causes of the problem, especially in the northern region, are seasonal crop burning that often creates toxic smog at the beginning of the year, traffic emissions in cities and industrial processes.
In 2023, authorities said more than 10 million Thais sought treatment for illnesses related to air pollution.
There has been a surge in cases of pollution-related diseases since the beginning of 2024. According to news reports, the number of people seeking treatment for pollution-related illness increased from 1.3 million in the first nine weeks of 2023 to 1.6 million at the start of 2024.
Indeed, air pollution in northern Thailand is now a crisis, not least because it often fall into the ‘hazardous’ category.
The dangerous levels caused by PM 2.5 in the region have led to a surge in patients with lung cancer and lung diseases.
A comparative analysis of data from 2010-2021 shows that people living in northern Thailand, particularly in Chiang Mai, which was among the world’s worst cities for air pollution, and Lampang have the highest death rates from lung cancer. The hazardous levels of air pollution in the region are blamed for being one of the main causes of the deadly disease.
A study by Chiang Mai University’s Faculty of Medicine involving emphysema patients living in Chiang Dao, which is infamous for its smog and elevated PM2.5 levels, found significant cellular changes during periods of high PM 2.5 compared to low PM 2.5 periods.
A professor from Chiang Mai University said the changes indicate genetic abnormalities that could lead to cancer cells in the future.
In March, when the PM 2.5 levels were high, it was reported that there was an increasing number of people with respiratory problems ranging from nose-bleeds, runny noses, sore throats and persistent coughs.
Severe and life-threatening conditions such as emphysema flare-ups, coronary heart disease, and strokes are notably prevalent during elevated PM 2.5 levels.
These are not the first reports showing how dangerous air pollution threatens human health and it’s evident that the situation is unacceptable.
Air pollution is a public health emergency. The Thai government should stop dragging its heels on the issues and instead intensify its efforts and take immediate, bold action to avoid putting more lives at risk.
