Prevention and Control of NCDs Policy

Economic Impact and Progress Toward Sustainable Development Goals (SDGs)

ภาระ NCDs The burden of NCDs affects labor productivity, healthcare costs, and the country’s economic and social development. In 2019, the estimated economic loss from illness and death due to NCDs was 9.7% of GDP, or about 1.6 trillion baht per year. Losses from reduced productivity in the working-age population accounted for 8.9% of GDP, while healthcare costs accounted for 0.8% of GDP.

Thailand has implemented preventive policies and measures against NCDs, such as the National Action Plan for the Prevention and Control of NCDs (2023–2027), the Tobacco Products Control Act (2017), the National Tobacco Control Action Plan III (2022–2027), the Alcoholic Beverage Control Act (2008), the National Alcohol Control Action Plan II (2022–2027), and the National Food Management Action Plan I (2023–2027). However, risky behaviors and NCD trends remain challenging. It is projected that by 2030, the probability of premature death from NCDs among Thais will be 12%, meaning Thailand will not achieve the Sustainable Development Goal (SDG 3.4.1) of reducing premature deaths from NCDs by one-third by 2030.

Analysis of Health Expenditure and Investment in Disease Prevention

In 2021, current health expenditure (CHE) was 715,325 million baht (excluding COVID-19-related spending), equal to 4.4% of GDP, with per capita health expenditure of 9,990 baht. Most spending was on personal health goods and services, especially outpatient and inpatient care, totaling 497,050 million baht (69.5% of CHE). Preventive care accounted for only 8.8% of CHE, a proportion that has remained relatively unchanged since 1994. Specifically, spending on NCD prevention (health communication, campaigns, community prevention, tobacco/alcohol/substance reduction, self-help groups) accounted for only 1.2% of CHE, or 13.7% of total preventive care spending in 2021. The Ministry of Public Health contributed 40% of preventive spending, followed by the National Health Security Office (21.5%), local governments (19.8%), and other ministries (10.2%).

Financial Sustainability of the Health System and Funding Policies

The financial sustainability of public health spending is a major challenge, as costs continue to rise due to NCDs and chronic diseases requiring long-term care. Thailand is now a fully aging society, and expanded medical benefits using costly new technologies add further pressure. The government has introduced funding measures such as increasing VAT and sugar taxes (since 2017). While such taxes raise revenue and promote health, there are few policies to reduce healthcare costs directly. Some proposals include incentives for individuals to maintain good health as annual bonuses for insured people without NCDs.

Gaps in Disease Prevention and Challenges for Primary Care Units

Thailand’s health spending is heavily treatment-oriented, with limited investment in prevention. Health promotion and NCD prevention services (screening for BMI, smoking, alcohol, substance use, stress/depression, counseling, and community health promotion) remain inadequate. The 7th National Health Survey (2024–2025) found diabetes prevalence increased from 9.5% to 10.6% in five years, while hypertension prevalence rose from 25% to 29%.

Challenges include limited infrastructure and capacity at primary care facilities for effective screening and health promotion, fragmented health data systems, and lack of integration of behavioral risk and health outcomes into service delivery and monitoring.

Current Strategies and Risk Factor Management Policies

Thailand has multiple national policies addressing NCD risk factors (alcohol, tobacco, nutrition, salt reduction, physical activity, air pollution). The National Action Plan for NCDs (2023–2027) is the main plan, with three strategies:

• • Smart NCD Network – integrating all sectors to manage NCDs.
• • NCD Health Literacy – raising awareness, knowledge, and values for prevention.
• • NCD Ecosystem – creating supportive environments for NCD management.

Other national plans include the National Cancer Control Plan (2024–2032) and the Minister of Public Health’s “Thais Free from NCDs” policy (2024–2025). While strong policies exist for tobacco and alcohol, food environment policies remain weak. Unhealthy foods (highly processed, sugary drinks, fast food) are widely accessible and aggressively marketed.

The Role of Local Governments and the Design of Healthy Spaces

Local governments play a key role in creating healthy environments, such as public parks and exercise facilities. However, urban planning and infrastructure design that integrates health considerations remain limited.

Policy Recommendations : Development of NCD Prevention and Control Policies

1. Develop and implement public policies and legal instruments to address gaps in environmental risk factors for NCDs, in line with WHO NCD Best Buy Interventions. This should especially focus on food environments and marketing of unhealthy products through online and new platforms, applying the principle of Health in All Policies with an inside-out approach, ensuring that non-health sectors also consider health protection and quality of life in policy development.

2. Develop targeted measures for high-risk population groups, such as managing risky health behaviors and promoting tobacco and alcohol cessation among men, particularly in occupations such as mechanics, laborers, and construction workers. Workplace and enterprise-level policies should also be developed.

3. Create environments that reduce NCDs, such as “NCD-free homes,” supported by incentive mechanisms and effective food labeling that provides nutritional information and risk warnings.

4. Expand local innovations to create environments that reduce NCDs, such as reformulated local food products, and healthier provincial souvenirs.

Policy Recommendations : Governance Systems for NCD Prevention and Control Policies

1. Strengthen governance mechanisms for NCD prevention and control policies, including management, monitoring, and decision-making systems at all levels, linking all agencies together. Emphasis should be placed on citizens’ rights to access ecosystems that support healthy lifestyles and protect them from risk factors.

2. Support the role of local governments in collaboration with health agencies to create healthy environments and wellness spaces at the community level.

Policy Recommendations : Data Systems and Data Governance Mechanisms

1. Develop databases and monitoring frameworks to track progress, covering intermediate outcomes such as behaviors and environmental factors, health outcomes, process indicators, and NCD-related health expenditure data.

2. Develop personal health databases to identify at-risk and vulnerable populations and determine where they are located. Return health information to patients so they can continuously manage their own health—for example, “know your number” (blood sugar, blood pressure, cholesterol, body weight). Support simple self-assessment through easy-to-use self-test kits and encourage daily self-care practices, to reduce duplication of health services.

3. Support the use of provincial, district, sub-district, and village-level data to plan and identify key issues or agendas in managing risk factors or non-communicable diseases according to local contexts.

4. Establish mechanisms for data and situation coordination among agencies and working groups across the country.

Policy Recommendations : Health Financing Policies for Health Promotion

1. Develop innovative fiscal and financial health policies, such as introducing new excise taxes on health-damaging products (e.g., high-fat foods, high-sodium foods), subsidizing sports equipment to increase accessibility and promote physical activity, offering tax deductions for businesses with healthy employees, and reducing rental fees in markets or shopping centers for businesses selling healthy products.

2. Develop and implement fiscal mechanisms to incentivize entrepreneurs and service providers to create products or services that promote desirable health behaviors and reduce long-term healthcare costs, for example through corporate social responsibility initiatives.

3. Develop benefit packages for health promotion and disease prevention services that are effective, cost-efficient, and high-impact, aligned with modern lifestyles and behaviors. These should include benefits that empower individuals to manage their own health, such as pedometers and salt meters, along with reimbursement systems designed to reflect desired health outcomes. Examples include bundled payments based on diseases and conditions (before onset and during chronic illness) or value-based payments tied to positive health outcomes. For instance, higher payments could be made for diabetic patients in remission or those maintaining normal blood sugar levels, or for populations with improved health who did not require medical visits for NCDs within a year.

Summary of NCD Management Approaches

การจัดการปัญหา Managing NCDs in Thailand requires policies that effectively address environmental risk factors using economically cost-effective measures at the population level. Public policies should prioritize current challenges while also apply targeted measures for specific high-risk groups. Strong governance systems and integrated data frameworks across all sectors are essential for success and sustainability. Additionally, health investments should increasingly focus on health promotion and prevention, in ways that are practical and aligned with Thailand’s evolving social and economic context.