CDC in Thailand

Overview

CDC has worked with Thailand's Ministry of Public Health (MOPH) since 1980. CDC, MOPH, and partner organizations work together to address the following public health areas:

• Public health workforce development.
• Public health laboratory readiness.
• Emergency operations centers (EOCs) and rapid response teams.
• Treatment and prevention of HIV and sexually transmitted infections.
• Migration health.
• Influenza surveillance, prevention and migration measures.
• Pandemic preparedness.

Global health security

Strategic focus

CDC supports Thailand in achieving the goals outlined in the Global Health Security Agenda (GHSA) and implementing the International Health Regulations. Thailand is a member country of GHSA, a permanent member of the GHSA Steering Group. Thailand also served as the Chair of the GHSA Steering Group in 2021.

CDC's global health security work focuses on strengthening the country's public health systems across the following core areas:

Surveillance systems

CDC funding helps support various surveillance system strengthening efforts in Thailand, including:

• Wastewater surveillance in quarantine settings to validate the early detection of SARS-CoV-2.
• Surveillance of COVID-19 in patients presenting with febrile illness and post COVID-19 conditions in Nakhon Phanom and Tak Provinces.
• Improving early warning and response for dengue infection.
• Laboratory-based surveillance of antimicrobial resistant organisms in four Thai Regional Medical Science Centers.
• Sentinel surveillance for influenza among those with severe acute respiratory infections and influenza-like illnesses.

Laboratory systems strengthening

CDC funding aims to improve capabilities to detect, confirm, and identify pathogens of public health importance for global health security. This work includes training, surge capacity testing during public health emergencies, and research.

Workforce development

CDC supports training scientists through the Field Epidemiology Training Program (FETP), established in Thailand in 1980. FETP participants gain the skills to collect, analyze, and interpret data and contribute to evidence-based decisions during outbreak responses. The program consists of three levels of training: frontline, intermediate, and advanced.

CDC and the Thai FETP also established the FETP-Emerging Infectious Diseases track. Through this track, residents work with CDC staff to gain experience in emerging infectious diseases. Residents and graduates have played central roles in Thailand’s successful response to numerous infectious disease outbreaks. They have also been integral to staffing Thailand’s Public Health EOC.

CDC also supports a newly established Southeast Asia Regional Global Laboratory Leadership Program. This training program is designed to foster and mentor current and emerging leaders to build, strengthen, and sustain national laboratory systems.

Emergency response

CDC works to strengthen capacity of Thailand's emergency preparedness response operations. This work aims to improve emergency management in Thailand, and across neighboring Cambodia, Laos, and Malaysia. CDC supported activities include:

• Establishment of the Thai public health EOC.
• Strengthening Thailand’s emergency preparedness and response system both at the national and sub-national levels.
• Enhanced surge capacity of the Thai MOPH rapid response teams to support investigation and response to outbreaks, including COVID-19.

Key achievements

• With CDC support, Thailand completed Joint External Evaluations in 2017 and 2022, a National Action Plan for Health Security in 2019, and chaired the GHSA Steering Committee in 2021.
• More than 1,100 public health workers have graduated from the Thai FETP since 1980.
• Development of a national electronic COVID-19 vaccine registry and certificate system that is used to verify vaccination status for international travel.
• From 2020 - 2023, CDC's laboratory in Thailand performed more than 10,000 COVID-19 diagnostic tests in support of Thai government partners, the International Rescue Committee, and the U.S. Embassy community.
• The establishment and strengthening of Thailand’s Coordinating Unit for One Health.

HIV and TB

Strategic focus

Through the U.S. Presidential Emergency Plan for AIDS Relief (PEPFAR), CDC partners with Thailand to build a robust national HIV response. The PEPFAR South and Southeast Region Program includes a diverse group of 5 countries: Burma (Myanmar), Cambodia, Laos, Nepal and Thailand. The PEPFAR regional coordination unit is based in Bangkok. This office provides advice in planning, budgeting, program implementation, results monitoring, and reporting.

CDC's work focuses on 14 Thai provinces with high HIV burden. Activities include efforts to:

• Strengthen disease surveillance systems, laboratory capacity, case-finding strategies, and safe delivery of medicine.
• Promote pre-exposure prophylaxis (PrEP) use.
• Implement programs to reduce HIV-related stigma and discrimination.
• Promote continuous quality improvement along the HIV continuum of care.
• Conduct and support research on injectable long-acting PrEP and new prevention and treatment strategies like non-daily PrEP and antibiotics for sexually transmitted infections.

Key achievements

In 2022, in coordination with CDC and other partners, Thailand developed the Community-Based-Organization (CBO) certification standard. To ensure domestic financing for HIV services, Thailand advocated for CBOs to be reimbursed by the National Health Services Office.

In 2021, CDC and partners in Thailand and other countries researched a novel PrEP drug. They included men and transgender women who have sex with men in the trial. The results from the trial demonstrated that injectable and long-acting drug is safe and effective. This resulted in the registration of the drug by the U.S. Food and Drug Administration (FDA) in 2021. The drug was also approved by Thailand FDA in 2023. This led to the issuance of new treatment recommendations and policies by the CDC and others.

In 2019, CDC supported expansion of the national PrEP and index partner testing programs. This resulted in a three-fold increase in Thai government funding for PrEP. It also increased government PrEP service outlets, and expansion of provinces providing index testing services.

In 2016, with CDC support, Thailand received World Health Organization (WHO) certification for elimination of mother-to-child transmission of HIV and syphilis. Thailand was the first Asian country to receive this certification.

In 2013, MOPH and CDC conducted the world's first trial demonstrating that PrEP reduces HIV spread among people who inject drugs.

Antimicrobial resistance (AMR)

Strategic focus

CDC provides technical assistance to support Thailand's national strategic plan to prevent, detect, and respond to AMR. CDC activities include:

• Assessing the capacity of health facilities in Bangkok to detect and respond to AMR.
• Strengthening national and sub-national AMR laboratory networks.
• Building capacity to identify novel mechanisms of resistance.
• Providing specimens, strengthening quality of collected data, and supporting expansion of WHO's supported Enhanced Gonorrhea Antimicrobial Surveillance Programme.

Key achievements

CDC, MOPH, the Global Antibiotic Research and Development Partnership, and others, completed a groundbreaking, global study of a novel, first-in-class medication. Based on promising results, and awaiting regulatory approval, the drug, zoliflodacin, is poised to become the first antibiotic for treating gonorrhea. This would represent significant advancement in the fight against AMR infections.

Migration health

Strategic focus

CDC’s global migration health experts address public health threats before they cross international borders. CDC experts help prevent the spread of disease among international travelers, immigrants, refugees, and other mobile populations in Southeast Asia. CDC provides technical support to Thai MOPH and Lao MOH on disease surveillance, emergency response and disease prevention at border crossings. Activities include:

• Development of an electronic record system for international Thai travelers that confirms COVID-19 vaccination.
  • This system has been expanded to include influenza and meningococcal vaccination records for Hajj pilgrims.
• Support of disease detection and prevention at international points of entry in Laos and Thailand through training for officers, testing, and reporting systems.
• Development of migrant health volunteer networks in multiple provinces, training hundreds of migrant workers on disease prevention measures and administering surveys to understand perceptions and concerns in migrant communities.
• Partnership with the Thai Red Cross Society to support the development of an innovative biometric system to uniquely identify migrants or other persons without identification documents for access to healthcare services such as vaccinations.
• Development of multisectoral collaboration networks in 6 target border provinces across Thailand, building information exchange and preparation for future incident responses.
• Support for healthy US-bound refugee and immigrant movements via high-quality medical examinations, vaccinations, and treatments. This program detects and treats serious communicable diseases in refugees and immigrants before they relocate to the U.S., preventing further spread.

Influenza

Strategic focus

CDC supports Thailand to sustain robust influenza surveillance and develop effective seasonal influenza vaccination programs with full regulatory and delivery systems. These efforts increase local, regional, and global pandemic preparedness. CDC's primary objectives include:

• Providing epidemiologic and laboratory technical support for influenza detection, response, and prevention activities in Southeast Asia.
• Growing the evidence-base to inform policy decisions for influenza prevention and control programs, including influenza vaccination.
• Supporting pandemic preparedness in Thailand and partner countries.

Key achievements

CDC supports Thailand to sustain sentinel surveillance and sequencing of viruses to monitor circulating influenza and respiratory pathogens. The Thailand National Influenza Center is recognized as a regional leader in surveillance and laboratory training to neighboring countries.

Seasonal influenza viruses first identified in Thailand have been included in the seasonal influenza vaccines since 2015. This contribution helps protect people worldwide.

CDC supported the Thailand Government Pharmaceutical Organization on clinical trials of domestically produced seasonal influenza vaccine and COVID-19 vaccine. This work helps to strengthen Thai health security.

Related links