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On World Diabetes Day, 14th November 2023, the Danish Embassy in Thailand collaborated with the Diabetes Association of Thailand, the Thai NCD Network, and Novo Nordisk Pharma (Thailand) to host discussions on ‘Public-Private Partnership – Key to Tackling the Burdens of Diabetes and Obesity in Thailand’. The event brought together stakeholders from the public and private sectors, as well as medical experts, to provide accurate knowledge about diabetes, obesity and NCDs. It also aimed to support the government and partners in jointly addressing the challenges of reducing diabetes prevalence and increasing access to medication and medical benefits. The event was honored by the participation of Dr. Opart Karnkawinpong, Permanent Secretary of the Ministry of Public Health, and Dr. Jadej Thammatacharee, Secretary General of the National Health Security Office (NHSO), who participate in the seminar to provide an overview of healthcare policy and drive Thailand’s public healthcare system at the Embassy of Denmark in Thailand.
H.E. Mr Jon Thorgaard, Ambassador of Denmark to Thailand, explained the event’s objective was to emphasise the importance of public-private partnerships in addressing complex healthcare issues, especially diabetes, obesity and other NCDs. It also aimed to promote global partnerships and information sharing to jointly improve people’s quality of life. Key focuses were the need for innovation, collaboration, and a continued commitment to balancing healthcare quality with sustainability, as “sustainable healthcare” is an investment in our collective future.
The Danish government has successfully built public-private partnerships through the Steno Diabetes Center in Copenhagen where has worked with the Novo Nordisk Foundation to implement innovative programs that have improved the quality and efficiency of healthcare services for patients with chronic diseases. These programs have included initiatives to provide personalized treatment plans, increase patient education and self-management, and ensure timely access to medications. As a result of these efforts, the Steno Diabetes Center has been recognized by the World Economic Forum’s Global Coalition for Value in Healthcare as a world-leading example of Human-Centered Healthcare.
In his opening remarks, Dr. Opart Karnkawinpong, Permanent Secretary of the Ministry of Public Health, emphasised the importance of building partnerships between the public and private sectors (Public-Private Partnerships or PPPs), with the addition of “people” as a key component. He stressed sharing knowledge, as this is a major factor in achieving long-term health sustainability. Since diabetes and obesity are behavioural diseases, change must come from individuals themselves, along with creating an environment that encourages more physical activity in daily life. Society and communities should also help stimulate positive behaviours collectively. The Ministry of Public Health has initiated a ‘Diabetes School’ project to educate diabetes patients in communities on self-care, as well as promote the use of digital technology in public health to increase the efficiency of treatment.
Mr. Enrico Cañal Bruland, Vice President and General Manager of Novo Nordisk Pharma (Thailand) Ltd, revealed that as Novo Nordisk turns 100 years, reflecting on the global healthcare challenges, our commitment to drive change for sustainable healthcare in the generations to come. Novo Nordisk is extending its innovative approaches to treatment by developing solutions for a wider range of therapy areas than ever before. These solutions are designed not only for diabetes but also for other chronic diseases, including obesity. In Thailand, Novo Nordisk has been operating for 40 years, collaborating with the Department of Medical Services, Ministry of Public Health, on the Affordability Project to enhance accessibility to efficient screening, diagnosis and treatment of diabetes in rural areas. It also provides knowledge to medical personnel on diabetes care and treatment for further efficiency. This helps reduce the public healthcare expenditure burden in Thailand. This 3-year project runs from 2022-2025, with shared targets set in 3 areas: (1) Screening a total of 53,000 people, covering 21 provinces; (2) Training 7,000 medical personnel and care providers; and (3) Providing intensive blood sugar management for 7,000 diabetic patients. After year one, it was found that more awareness on screening is still needed, and it was proposed to improve data management for monitoring and checks to reduce duplication across involved agencies. It was also suggested to increase budgets to support more volunteer screeners in local areas.
The Steno Diabetes Center in Copenhagen, Denmark is a successful model example resulting from public-private partnerships between the Danish government and the Novo Nordisk Foundation. This center was thoughtfully designed with various dimensions of holistic health in mind, aiming to advance diabetes care and research to improve overall quality of life for diabetes patients.
According to the BMJ (2021), it was revealed that by 2060, with no significant changes to the status quo, the economic impacts from obesity are projected to grow to 4.9% of GDP in Thailand. These costs include both direct costs (healthcare expenses) and indirect costs like lost productivity. Reducing obesity prevalence by 5% from projected levels in 2019 will translate into an average annual reduction of 13.2% in economic costs between 2020 and 2060.
Prof. Emeritus Dr. Wannee Nitiyanant, President of the Diabetes Association of Thailand, said the prevalence of type 2 diabetes resulting from obesity and lifestyle behaviours is increasing steadily, with around 100,000 new cases annually. Currently around 5.2 million Thais have diabetes, or 1 in 11 people over the age of 15Of those, 40% are undiagnosed, while only 54.1% or 2.8 million are diagnosed and treated. Of those, only 1 in 3 achieve treatment targets, resulting in 200 diabetes-related deaths daily in Thailand. She believes a collaborative effort across sectors is the best solution to reduce diabetes, obesity and other NCDs to sustainably improve the quality of life of patients and Thai society in line with the 9 operational goals of the World Health Organization (WHO) to prevent and control the global non-communicable disease situation by 2025.
Assoc. Prof. Dr. Petch Rawdaree, President, Association of Thai NCD Alliance, addressed the rising obesity rates in Thailand, with over 30% or more than 20 million patients now obese, leading to risks of non-communicable chronic diseases (NCDs) including diabetes, hypertension, dyslipidaemia, cardiovascular disease, and cancer. NCDs also threaten the sustainability of Thailand’s universal health coverage system, with over half the budget now spent on treating NCDs, greatly impacting businesses. The current solutions are reactive, with most patients unaware that “obesity is a disease requiring treatment.” Thai public health should acknowledge and collaboratively identify preventative approaches before disease onset. There is an urgent need to implement policies to seriously crack down on obesity and NCDs, including clear measures or policy frameworks regarding sugar tax, sodium, proper nutritional intake, and actionably promoting exercise, knowledge-sharing for citizens, and healthy environmental management with public health as the fundamental priority.
In closing, Dr. Jadej Thammatacharee, Secretary General of the National Health Security Office (NHSO), emphasised the organisation’s role in working with government and private sectors to build a sustainable healthcare system, which will help reduce budget burdens. Additionally, if new, highly effective treatments at reasonable prices become available, it enables more cost-effective budget allocation. The NHSO also requires financial support, as it aims to provide quality medicines and new technologies at appropriate prices to increase public access to treatment more inclusively. He sees raising public awareness and understanding of self-care as key to addressing diabetes and obesity, so blood sugar control can improve from the current 22% reaching target to 40%, requiring collaboration across all parties.
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