Thailand shares lessons learned from the COVID-19 pandemic with WHO

By Thaweeporn Amy Kummetha

Representatives from WHO Headquarters, the WHO South-East Asia Regional Office and the WHO Thailand Country Office recently met with a wide range of pandemic response stakeholders to learn about Thailand’s response to the COVID-19 pandemic. A report is expected to follow, which will include recommendations for Thailand, as well as documenting lessons learned to share with other countries. The objective of this, and similar country-led reviews, is to better prepare the world for the next health emergency. 

Dr Stella Chungong (5th left), Director, Health Security Preparedness Department, WHO, Dr Samira Asma (6th left), Assistant Director-General, WHO, Mr Anutin Charnvirakul (7th left), Deputy Prime Minister and Minister of Public Health, Dr Jos Vandelaer (8th left), WHO Thailand Representative, attend the formal opening session of the Universal Health Preparedness Review at the Royal Orchid Sheraton Hotel, Bangkok - 25 April 2022, © WHO/Ploy Phutpheng 2022 

“The Universal Health Preparedness Review is a new mechanism led by the Member States to prioritise health with a focus on preparedness, Universal Health Coverage, and healthier populations — and how these contribute to health security. This will require sustained political commitment, bold leadership, financing, and better availability and use of data, research and innovations,” said Dr Asma at the formal opening session in on 25 April 2022, which was presided over by Deputy Prime Minister and Minister of Public Health Anutin Charnvirakul.

Thailand is the third country to pilot the UHPR process after the Central African Republic and Iraq. 

The WHO delegates and MOPH officials undertook 13 site visits, six high-level meetings, 29 interviews and two simulation exercises. The people they met included high-level officials from different government and UN agencies, deans of medical schools, provincial public health authorities, factory workers, representatives of civil society, and migrant workers. 

Meeting with a wide range of stakeholders outside the health domain is an underlying theme of UHPR. “We use the whole-of-society approach to look at how the country handled the pandemic because COVID-19 taught us that an event like this is not only a health crisis; it’s a crisis that we can only tackle by involving all sectors: we need to look much broader,” said Dr Jos Vandelaer, WHO Thailand Representative, during the closing session on 29 April 2022. 

Dr Samira Asma, WHO Assistant Director-General, discusses COVID-19 response with Mr Suchat Chomklin, Minister of Labour, at the Ministry of Labour, Bangkok on 26 April 2022, © WHO/Ploy Phutpheng 2022 

During the meetings with high-level officials, the team discussed how ministries – and the larger society - responded to the pandemic, including from the perspective of social security, the economy and technology. Meanwhile, the field visits showed how at provincial level, support, resources, or legal structures that were introduced might need to be continued or reinforced to enhance disaster resilience. 

Samut Sakhon Province was one of the locations visited. Home to over 300,000 migrant workers, and several seafood factories, the province was hit hard when the COVID-19 outbreak started among migrant workers in a seafood market in late 2020. The team learned that the key to a quick recovery is a whole-of-society approach. The response was led by the governor and local public health authorities and was widely supported by seafood entrepreneurs as well as both Thai and migrant worker communities. Civil society organizations also donated supplies to migrants who needed to be isolated or quarantined.  The team learned that limited provincial capacity was a constraint in handling such a big outbreak. Therefore, consideration can be given to enhancing provincial public health and relevant non-health capacities for future health emergencies.

WHO delegates and MOPH officials discusses the COVID-19 response with provincial MOPH officials and migrant workers at the Central Shrimp Market, Samut Sakhon, on 27 May 2022 -- © WHO/Ploy Phutpheng 2022  

After several days of consultation, it was concluded that Thailand has many strengths that contributed to the success of the pandemic response. Some highlights: 

• A high level of political commitment was essential and was exemplified by the Prime Minister leading the response. 
• A robust health system established for decades provided the best platform for an effective response
• The covid-response involved many sectors and people from all walks of life. Adoption of the ‘whole of society’ approach and good collaboration between all sectors were essential.
• Strong community networks, in addition to the presence of more than one million Village Health Volunteers ensured bottom-up support. 
• Innovative solutions to problems encountered were developed quickly, such as cardboard beds in field hospitals. The ‘Bubble and Seal’ approach ensured Thai and migrant workers were kept safe while allowing factories to stay in business.  

Areas that could be improved include: 

• Better aligning population databases generated by different government agencies to record health and vaccination status 
• Addressing barriers in access to health care that were sometimes faced by some vulnerable populations, such as migrants. 
• Enhancing Universal Health Coverage through primary healthcare in urban areas 
• Strengthening measures to address pandemic fatigue and complacency 
• Developing strategies to sustain and share innovations
• Improving arrangements for medical waste management
• The following recommendations were jointly proposed: 
• Continue to invest in innovation and digital technology
• Sustain the gains made during the pandemic response 
• Make healthcare more inclusive, especially for vulnerable populations.  
• Strengthen domestic capacities for self-reliance to produce vaccines, reagents, diagnostics, and drugs
• Further integrate databases 
• Continue to collaborate across sectors, including the management of medical waste
• Share best practices and lessons learned from the pandemic response amoung different stakeholders in Thailand and with other countries 

Dr Jos Vandelaer (left), WHO Thailand Representative, joins a press conference with Mr Anutin Charnvirakul (middle), Deputy Prime Minister and Minister of Public Health, and Dr Kiatiphum Wongrajit (right), MOPH Permanent Secretary, on the outcomes of UHPR in Thailand at MOPH on 5 May 2022 -- © MOPH 2022  

“Three keywords to capture Thailand’s COVID-19 response are flexibility, adaptability and pragmatism,” said the WHO Thailand Representative. 

DPM Anutin highlighted that the UHPR process was very meaningful for Thailand in moving forward. “We stand ready to share lessons learned at the upcoming World Health Assembly that I will personally attend. We’ll make every effort to fill the remaining gaps and take all of the recommendations to strengthen our health system in preparation for the reopening of the country,” said Mr Anutin at a press conference on 5 May 2022.