Sustainable Immunization Financing in Asia Pacific: Thailand Country Brief

Key messages

Context

• Thailand’s economy is slowing down, stalling at 3% annual growth, which could impact social investment. Funds flowing into the health sector are expected to slow as generous annual budget increases prove to be unsustainable.
• The low fertility rate, paired with an increased life expectancy, has engendered a rapidly aging population and increasing burden of NCDs.
• Thailand’s commitment to providing UHC, drives coverage to nearly 100% for all  vaccines in the schedule and new vaccines have recently been added.

Immunization Financing

• Immunization is a centralized program and provided free of charge for the entire population. At present, procurement of vaccines and the immunization program is financed mainly by the National Health Security Office (NHSO) through its capitation payments to primary care facilities.
• Thailand has made significant efficiency gains since housing its program under an independent purchaser. Limited additional fiscal space will be available through other efficiency initiatives.
• The immunization budget in 2015 represented 0.7% of the total public health budget.

Key Findings

• General taxation accounts for the majority of resources for health in Thailand. GDP spent on health is lower than neighboring countries, but is high in terms of percentage of the public budget
• The Department of Disease Control is actively thinking through types of additional revenue streams or cost sharing opportunities.
• Thailand allocates its existing tobacco tax revenue to fund the ThaiHealth Foundation which focuses on preventative healthcare for NCDs.
• The National Vaccine Institute has recently tabled an immunization bill that includes provisions for earmarking alcohol and tobacco taxes for immunization, though it is in the early stages of discussions.
• NHSO’s focus on cost containment results in a very deliberate process of new vaccine adoption.
• Introducing new materials or procedures into the UCS benefits package is an evidence-based process in Thailand using their advanced health technology assessment institution, The Health Intervention and Technology Assessment Program (HITAP). The Advisory Committee on the Immunization Practice relies heavily on these assessments in their recommendations.
• While the purchasing of immunization services is currently housed under the NHSO, there are active discussions on the possibility of bringing that function back to MoPH.
• Despite a push from the parliament to administratively decentralize the country, the health sector has remained centralized.
• Most sub-national government entities do not have the resources to take on additional financing responsibilities for the immunization program, but there are examples of local governments procuring and introducing new vaccines.