Thailand has had "a long and successful history of health development," according to the World Health Organization. Life expectancy is averaged at seventy years. Non-communicable diseases form the major burden of morbidity and mortality, while infectious diseases including malaria and tuberculosis, as well as traffic accidents, are also important public health issues. [1]
The Human Rights Measurement Initiative [2] finds that Thailand is fulfilling 91.0% of what it should be fulfilling for the right to health based on its level of income [3] .
In 2008, 98 percent of the population had access to an improved water source. [4] Ninety-six percent of the population have access to improved sanitation facilities. [4]
Non-communicable diseases form the major burden of mortality in Thailand, while infectious diseases including malaria and tuberculosis, as well as traffic accidents, are also important public health issues. [1] The mortality rate is 205 per 1,000 adults for those aged between 15 and 59 years. [5] The under-five mortality rate is 14 per 1,000 live births. [5] The maternal mortality ratio is 48 per 100,000 live births (2008). [5]
Years of life lost, distributed by cause, was 24 percent from communicable diseases, 55 percent from non-communicable diseases, and 22 percent from injuries (2008). [5]
Life expectancy in Thailand is 71 for males and 78 for females. [5]
Major infectious diseases in Thailand also include bacterial diarrhea, hepatitis, dengue fever, malaria, Japanese encephalitis, rabies, and leptospirosis. [6] The prevalence of tuberculosis is 189 per 100,000 population. [5]
The first case of dengue fever was recorded in Thailand in 1949. Since then, it has been controlled, but not eradicated. Dengue cases soared in 2019. During the first six months of 2019, 28,785 people contracted dengue fever in Thailand. Forty-three died. The 2019 figures are double the five-year average and exceeds 2018's full-year total of 14,900 infections and 19 deaths. There is no treatment for dengue fever. [7] [8]
Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. [9] In 2009 the adult prevalence of HIV was 1.3%. [10] As of 2009, Thailand had the highest prevalence of HIV in Asia. [11]
The government has begun to improve its support to persons with HIV/AIDS and has provided funds to HIV/AIDS support groups. Public programs have begun to alter unsafe behaviour, but discrimination against those infected continues. The government has funded an antiretroviral drug program and, as of September 2006, more than 80,000 HIV/AIDS patients had received such drugs.
The American Centers for Disease Control and Prevention (CDC) conducted a study in partnership with the Thailand Ministry of Public Health to ascertain the effectiveness of providing people who inject drugs illicitly with daily doses of the anti-retroviral drug Tenofovir as a prevention measure. The results of the study were released in mid-June 2013 and revealed a 48.9 percent reduced incidence of the virus among the group of subjects who received the drug, in comparison to the control group who received a placebo. The principal investigator of the study stated in Lancet, "We now know that pre-exposure prophylaxis can be a potentially vital option for HIV prevention in people at very high risk for infection, whether through sexual transmission or injecting drug use." [12]
The prevalence of leprosy (Hansen's disease) in Thailand is declining. Statistics from the Ministry of Public Health's Department of Disease Control indicate that there were 155 new leprosy patients countrywide in 2015, as compared to the 405 new cases found in 2010. Leper colonies are found in Chanthaburi, Nan, Chiang Rai, Maha Sarakham, Surin, Roi Et, Khon Kaen, and Nakhon Si Thammarat. [13] [14]
In 2017 there were 11,440 confirmed cases of malaria in Thailand with 11 reported fatalities. [15] The nation has committed to becoming malaria-free by 2024. In 2017, the Health Ministry declared 35 of Thailand's 76 provinces malaria-free. The persistence of malaria in border regions and the increasing drug resistance of new strains jeopardize the achievement of that goal. [16] [17] The WHO hopes to eliminate malaria by 2025. [18]
Food safety scares are common to Thailand. Besides, common is microbial contamination of street food left out in the hot sun and dusty roads as well as store food contamination by banned or toxic pesticides and fake food products. [19]
In July 2012 consumer action groups demanded four unlisted toxic pesticides found on common vegetables at levels 100 times the EU guidelines (which are banned in developed countries) be banned. Chemical companies are requesting to add them to the Thai Dangerous Substances Act so they can continue to be used, including on exported mangoes to developed countries which have banned their use. [19] In 2014, Khon Kaen University concluded after a study, that Thailand should ban 155 types of pesticides, with 14 listed as urgent: Carbofuran, Methyl Bromide, Dichlorvos, Lambda-cyhalothrin, Methidathion-methyl, Omethoate, Zeta Cypermethrin, Endosulfan sulfate, Aldicarb, Azinphos-methyl, Chlorpyrifos-ethyl, Methoxychlor and Paraquat. [20]
As of 2019 [update] sugar consumption in Thailand is 28 teaspoons (131 grams) per person per day, four times the World Health Organization (WHO) recommendation. [21] Excessive consumption of sugar leads to obesity, a public health issue. Thailand is number two in ASEAN, behind Malaysia, in the prevalence of obesity. In 2017, Thailand levied an excise tax on sugary drinks to pressure manufacturers to reduce the amount of sugar put in their products. A hike in the tax expected in October 2019. [21]
According to WHO in 2017, Thais consume an average of 10.8 grams of salt per day (over 4,000 milligrams of sodium), a rate more than double the recommended daily intake of salt. The main sources of salt are salt added during cooking, packaged food, and street food. [22] Researchers claim that more than 22 million Thais suffer from salt-related ailments. Each year 20,000 of them die from related diseases, costing the country losses estimated at 98.9 billion baht a year. Thai health officials are calling for a tax on high-sodium food products to reduce demand. [23]
A study by the health ministry and Britain's Wellcome Trust released in September 2016 found that an average of two people die every hour from multi-drug resistant bacterial infections in Thailand. [24] That death rate is much higher than in Europe. The improper use of antibiotics for humans and livestock has led to the proliferation of drug-resistant microorganisms, creating new strains of "superbugs" that can be defeated only by "last resort" medicines with toxic side effects. In Thailand, antibiotics are freely available in pharmacies without a prescription and even in convenience stores. Unregulated use of antibiotics on livestock is also problematic. Drug-resistant bacteria spreads through direct contact between humans and farm animals, ingested meat, or the environment. Antibiotics are often used on healthy animals to prevent, rather than treat, illnesses. [24]
In November 2016, Thailand announced its intent to halve antimicrobial-resistant (AMR) infections by 2021, joining the global battle against "superbugs". It aims to reduce the use of antibiotics in humans by 20 percent and in animals by 30 percent. The health minister said that about 88,000 patients develop AMR infections a year. The infections claim at least 38,000 lives in Thailand each year, causing 42 billion baht in economic damage. Without measures to address the issue, he said that the world would enter a "post-antibiotic era" with at least 10 million people around the world dying from AMR by 2050, 4.7 million of them in Asia. [25]
Thailand had 35 cases of teen pregnancies for every 1,000 girls from the ages of 15 to 19 in 2018. Health officials have set a target of 25 cases per 1,000 by 2026. [26] In 2014, some 334 babies were born daily in Thailand to mothers aged between 15 and 19. [27]
The World Bank estimates that deaths in Thailand attributable to air pollution has risen from 31,000 in 1990 to roughly 49,000 in 2013. [28] [29]
Antimicrobial resistance (AMR) occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. All classes of microbes can evolve resistance where the drugs are no longer effective. Fungi evolve antifungal resistance. Viruses evolve antiviral resistance. Protozoa evolve antiprotozoal resistance, and bacteria evolve antibiotic resistance. Together all of these come under the umbrella of antimicrobial resistance. Microbes resistant to multiple antimicrobials are called multidrug resistant (MDR) and are sometimes referred to as a superbugs. Although antimicrobial resistance is a naturally occurring process, it is often the result of improper usage of the drugs and management of the infections.
Tropical medicine is an interdisciplinary branch of medicine that deals with health issues that occur uniquely, are more widespread, or are more difficult to control in tropical and subtropical regions.
Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.
India's population in 2021 as per World Bank is 1.39 billion. Being the world's second-most-populous country and one of its fastest-growing economies, India experiences both challenges and opportunities in context of public health. India is a hub for pharmaceutical and biotechnology industries; world-class scientists, clinical trials and hospitals yet country faces daunting public health challenges like child undernutrition, high rates of neonatal and maternal mortality, growth in noncommunicable diseases, high rates of road traffic accidents and other health related issues.
Neglected tropical diseases (NTDs) are a diverse group of tropical infections that are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens, such as viruses, bacteria, protozoa, and parasitic worms (helminths). These diseases are contrasted with the "big three" infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of neglected tropical diseases as a group is comparable to that of malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.
Pakistan as a developing country is struggling in many domains due to which the health system has suffered a lot. As a result of that, Pakistan is ranked 122nd out of 190 countries in the World Health Organization performance report. Pakistan ranks 154th among 195 countries in terms of quality and accessibility of healthcare, according to a Lancet study. According to the study Pakistan has seen improvement in healthcare access and quality since 1990, with its HAQ index increasing from 26.8 in 1990 to 37.6 in 2016. Pakistan per capita income is 4,920 and the total expenditure on health per capita is $129, which is only 2.6% of GDP (2014). The gender inequality in Pakistan is 0.536 and ranks the country 147 out of 188 countries (2004). The total adult literacy rate in Pakistan is 55% (2014) and primary school enrolment is 73%. Life expectancy at birth is 68 years, Pakistan's population is around 185 million out of which more than 70 million people are living below the poverty line. The proportion of population which has access to improved drinking water and sanitation is 91% (2015) and 64% (15) respectively.
Health in Ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively. A central feature of the sector is the priority given to the Health Extension Programme, which delivers cost-effective basic services that enhance equity and provide care to millions of women, men and children. The development and delivery of the Health Extension Program, and its lasting success, is an example of how a low-income country can still improve access to health services with creativity and dedication.
Health in Indonesia is affected by a number of factors. Indonesia has over 26,000 health care facilities; 2,000 hospitals, 9,000 community health centres and private clinics, 1,100 dentist clinics and 1,000 opticians. The country lacks doctors with only 0.4 doctors per 1,000 population. In 2018, Indonesia's healthcare spending was US$38.3 billion, 4.18% of their GDP, and is expected to rise to US$51 billion in 2020.
The Tajikistan health system is influenced by the former Soviet legacy. It is ranked as the poorest country within the WHO European region, including the lowest total health expenditure per capita. Tajikistan is ranked 129th as Human Development Index of 188 countries, with an Index of 0.627 in 2016. In 2016, the SDG Index value was 56. In Tajikistan health indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease.
Healthcare in Laos is provided by both the private and public sector. It is limited in comparison with other countries. Western medical care is available in some locations, but remote areas and ethnic groups are underserved. Public spending on healthcare is low compared with neighbouring countries. Still, progress has been made since Laos joined the World Health Organization in 1950: life expectancy at birth rose to 66 years by 2015; malaria deaths and tuberculosis prevalence have plunged; and the maternal mortality ratio (MMR) has declined by 75 percent.
Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.
The quality of health in Cambodia is rising along with its growing economy. The public health care system has a high priority from the Cambodian government and with international help and assistance, Cambodia has seen some major and continuous improvements in the health profile of its population since the 1980s, with a steadily rising life expectancy.
The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.
A landlocked sub-Saharan country, Burkina Faso is among the poorest countries in the world—44 percent of its population lives below the international poverty line of US$1.90 per day —and it ranks 185th out of 188 countries on UNDP's 2016 Human Development Index .Rapid population growth, gender inequality, and low levels of educational attainment contribute to food insecurity and poverty in Burkina Faso. The total population is just over 20 million with the estimated population growth rate is 3.1 percent per year and seven out of 10 Burkinabe are younger than 30. Total health care expenditures were an estimated 5% of GDP. Total expenditure on health per capita is 82 in 2014.
Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.
Zambia is a landlocked country in Sub Saharan Africa which experiences a burden of both communicable and non-communicable diseases. In line with WHO agenda for equity in health, it has adopted the Universal Health Coverage agenda to mitigate the challenges faced within the health sector. The Ministry of Health (MOH) provides information pertaining to Zambian health. The main focus of the Ministry of Health has been provision of uninterrupted care with emphasis on health systems strengthening and services via the primary health care approach.
Even though Panama has one of the fastest growing economies in the western hemisphere, this prosperity has still left behind an estimated 500,000 people who remain trapped in extreme poverty. The country have major socioeconomic and health inequalities between the country’s urban and rural populations, further, the indigenous population lives in more disadvantaged conditions and experiences greater vulnerability in health. In general, the population living in more marginalized areas has less service coverage and less access to health care.
The United States Intelligence Community (IC) has a long history of producing assessments on infectious diseases. Most of these papers are distributed to government administrators and inform the choices of policymakers. Three of these assessments stand out as analytical products that have had important impact on the awareness, funding and treatment of infectious diseases around the world. The first paper is the National Intelligence Estimate on the Global Infectious Disease Threat, the second paper is the assessment on the Next Wave of HIV/AIDS, and the third paper was the assessment on SARS. This page summarizes the findings of these three papers and provides information about their impact.
The Health in Eswatini is poor and four years into the United Nations sustainable development goals, Eswatini seems unlikely to achieve goal on health. As a result of 63% poverty prevalence, 27% HIV prevalence, and poor health systems, maternal mortality rate is a high 389/100,000 live births, and under 5 mortality rate is 70.4/1000 live births resulting in a life expectancy that remains amongst the lowest in the world. Despite significant international aid, the government fails to adequately fund the health sector. Nurses are now and again engaged in demonstrations over poor working conditions, drug stock outs, all of which impairs quality health delivery. Despite tuberculosis and AIDS being major causes of death, diabetes and other non-communicable diseases are on the rise. Primary health care is relatively free in Eswatini save for its poor quality to meet the needs of the people. Road traffic accidents have increased over the years and they form a significant share of deaths in the country.
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