CDC in Thailand
The Centers for Disease Control and Prevention (CDC) has worked with Thailand’s Ministry of Public Health (MOPH) since 1980 when CDC established the first Field Epidemiology Training Program outside of North America to train the next generation of public health leaders in Thailand and the region. CDC and MOPH have collaborated to prevent and control HIV/AIDS, tuberculosis, influenza, and other infectious diseases; combat emerging infectious diseases through preparation, surveillance, and control; translate local research into global advances; improve the health of mobile populations; reduce the risk of cross-border disease transmission; and share important lessons and knowledge from Thailand’s experiences with other countries. The current COVID-19 response highlights how this collaboration has been key to building a successful response to a global pandemic.
The goals of CDC’s global health response to COVID-19 are to limit person-to-person spread of COVID-19, minimize the impact of COVID-19 in under-resourced countries with limited preparedness capacity, and reduce specific threats to global health security.
Through partnership with key Royal Thai Government and non-governmental partners in Thailand, CDC has:
- Supported COVID-19 testing in Bangkok and in refugee camps at the Thai-Myanmar border
- Strengthened border health activities by meeting with neighboring countries, conducting point-of-entry assessments, and participating in working groups to share information about population movements
- Helped to integrate COVID-19 surveillance into the influenza sentinel surveillance system
- Published findings on clinical management of COVID-19 patients that have led to changes in the national discharge criteria
- Supported the development of a national electronic COVID-19 vaccine registry and certificate system that can be used to verify vaccination status for international travel
- Provided leadership for contact tracing, mitigation and control efforts in Bangkok
- Supported serosurveillance in healthcare workers and the general public to monitor disease spread
- Supported vaccine preparedness efforts which resulted in >95% of over 3,000 Embassy staff and their families receiving two or more COVID-19 vaccine doses
- Supported safe delivery of medications to people living with HIV, including using the postal service, so people continued to receive HIV treatment during the pandemic
CDC developed an enhanced surveillance program that is active in 9 camps on Thai-Myanmar border which has detected 3 COVID-19 outbreaks and helped mitigate widespread epidemics in a high-risk environment
HIV and Tuberculosis
HIV is a leading cause of death and a health threat to millions worldwide. CDC is a key implementer of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and works with ministries of health, local and international partners to help build country capacity for sustainable, country-owned programs. CDC’s activities are focused in 13 high-HIV burden provinces in Thailand.
CDC activities support surveillance and systems strengthening, laboratory capacity, HIV pre-exposure prophylaxis (PrEP) and case finding strategies, adult HIV care and treatment, interventions to reduce stigma and discrimination, and continuous quality improvement activities targeting the HIV continuum of care.
In 2020, an estimated 94% of people with HIV knew their status, 84% of people diagnosed with HIV were on treatment, and 97% of people with HIV who were on treatment had suppressed viral loads, putting Thailand on track to achieve UNAIDS global targets to control the HIV epidemic by 2025. Overall HIV incidence has decreased, but it remains high among at-risk populations.
During 2018-2019, the Office of the Global AIDS Coordinator (OGAC) consolidated 11 PEPFAR countries into the Asia Regional Program Operating Unit (OU). OGAC also established the PEPFAR Asia Region Coordination Unit, based in Bangkok, to help coordinate activities and translate best practices quickly and efficiently for program impact across the region.
By 2020, 97% of people with HIV in Thailand had achieved undetectable viral suppression. This means they cannot transmit HIV to their sexual partners. This percentage is near the top of all PEPFAR countries
Global HIV Research
CDC also conducts high-quality biomedical HIV prevention research aimed at protecting both Thai and American citizens from becoming infected. Current research activities include long-term evaluations of acceptance, efficacy, and safety of injectable long-acting HIV PrEP medicine; identification of new prevention and treatment strategies including non-daily PrEP and new antibiotics for sexually transmitted infections; and initiating the evaluation of home-based oral PrEP and home-based point-of-care urine testing to monitor PrEP adherence in young men who have sex with men.
Thailand and CDC conducted the world’s first clinical trial that showed that PrEP can reduce HIV transmission in people who inject drugs. In 2021 the CDC, in collaboration with research groups in Thailand and other countries, completed a landmark trial that demonstrated the efficacy and safety of the novel injectable long-acting HIV PrEP drug among men and transgender women who have sex with men. The trial results provided evidence to U.S. FDA, CDC, and others to issue new treatment recommendations and policies. This and other groundbreaking research has helped improve HIV prevention and treatment in Thailand and globally.
Global Health Security
CDC’s global health security efforts strengthen countries’ abilities to prevent, detect, and respond to infectious disease outbreaks before they become global threats. CDC works with local, regional, and global organizations to support disease outbreak response, surveillance, laboratory systems, and workforce development. These efforts aim to help Thailand reach the targets outlined in the Global Health Security Agenda (GHSA), a global partnership launched in 2014 to make the world safer and more secure. Thailand is a member country of GHSA, a permanent member of the GHSA Steering Group, and served as the Chair of the GHSA Steering Group in 2021. CDC Thailand supports Thailand in its role as a co-lead of the National Laboratory Systems and Workforce Development Action Packages and the country’s participation in the Antimicrobial Resistance and Biosecurity Action Packages.
In collaboration with WHO and the Ministry of Public Health, CDC helps Thailand strengthen its core global health security requirements to implement the International Health Regulations. Thailand completed a Joint External Evaluation (JEE) in June 2017 and has published its report online. The country completed a National Action Plan for Health Security in 2019. CDC Thailand will help Thailand complete a follow-up JEE in 2022.
Thailand is an active member of the Global Health Security Agenda, having completed a Joint External Evaluation in 2017, a National Action Plan for Health Security in 2019, and chairing the GHSA Steering Committee in 2021
Field Epidemiology Training Program
CDC helps strengthen workforce capacity to investigate and respond to disease outbreaks through Thailand’s Field Epidemiology Training Programs (FETP). FETP provides field epidemiologists with the skills to identify and contain outbreaks before they become epidemics. CDC established the first FETP outside of North America in Thailand in 1980. Graduates of Thailand’s FETP have the skills to collect, analyze and interpret data and contribute to evidence-based decisions during outbreak responses. In 2020, the Thai FETP and CDC Thailand established the FETP-Emerging Infectious Diseases (FETP-EID) track so that each year, selected residents can work with CDC staff for 10 months to gain experience in the area of emerging infectious diseases. Thai FETP graduates have been integral to staffing Thailand’s Emergency Operations Center, particularly since the onset of the COVID-19 pandemic. They provided invaluable support to provincial efforts to control and prevent COVID-19 infection. While working with CDC Thailand, residents in the FETP-EID track have had on-the-job training in laboratory methods, epidemiologic analyses and field research, and emerging and re-emerging infectious diseases.
Thailand is home to the first FETP outside of North America and since 1980 the Thai FETP has graduated 237 epidemiologists – including 56 non-Thai epidemiologists from nine Asian countries
CDC’s International Influenza Program is a global network, designed to guard against, monitor, and reduce the devastating impacts of a pandemic. CDC and its global partners closely monitor and respond to influenza and other respiratory viruses with pandemic potential, including SARS-CoV-2. CDC’s international influenza program also makes critical contributions to U.S. and global prevention and control of seasonal influenza epidemics through global surveillance, applied science to support vaccine and prevention policies, and to inform the best selection of seasonal influenza vaccine components. The influenza program supports countries to develop effective seasonal influenza vaccination programs with well-established regulatory and delivery systems, enhancing global pandemic preparedness. As countries build capacity to deliver seasonal influenza vaccines each year, they develop the infrastructure to deliver life-saving vaccines early and efficiently during the current and future pandemics.
Understanding the risk of continued and unprecedented pandemic threats, the primary objectives of the CDC-Thailand Influenza Program are to:
- Support influenza detection, response, and prevention activities in Southeast Asia through epidemiologic and laboratory-based technical assistance
- Grow the evidence-base for sound policy decisions for influenza vaccination programs and other prevention and control programs
- Provide support to pandemic preparedness and the ongoing COVID-19 pandemic in partner countries
The CDC Thailand Influenza Program provides sub-regional support and coordination not only to Thailand, but also to Bangladesh, Indonesia, Lao People’s Democratic Republic, and WHO.
CDC’s regional influenza program in Thailand worked with Thailand’s ministry of public health to deliver emergency supplies of the influenza antiviral drug oseltamivir to Laos in less than 24 hours to address a devastating outbreak of seasonal influenza in 2019
Antimicrobial Resistance (AR)
Thailand’s National Strategic Plan on AR (2017-2021) aimed to reduce AR-related morbidity by 50%. The CDC office in Thailand has provided technical assistance to assess and strengthen the capacity of health facilities in Bangkok to detect and respond to AR, establish and strengthen national and sub-national AR laboratory networks, build capacity to identify novel mechanisms of resistance, and provide specimens to WHO’s supported Enhanced Gonorrhea Antimicrobial Surveillance Programme.
Immigrant, Refugee, and Migrant Health
With the aim of preventing the spread of infectious diseases among international travelers, immigrants, refugees, and other mobile populations, CDC’s Division of Global Migration and Quarantine addresses public health threats before they cross international borders. The CDC Thailand program serves the Southeast Asia region, with special attention to mobile populations such as immigrants, refugees, and migrants. The program provides technical assistance to the Thai MOPH and Laos MOH to stop the spread of infectious diseases among travelers and mobile populations, including supporting COVID-19 testing and vaccination, surveillance to detect outbreaks, and strengthening the emergency response and disease prevention capacities at international border crossings. The program ensures that health examinations of U.S.-bound immigrants and refugees throughout the region follow CDC’s regulations for detecting and preventing important communicable diseases like tuberculosis and COVID-19, and that refugees receive vital treatments and vaccinations to support healthy resettlement. The program also supports disease surveillance and outbreak response in refugee camps along the Thai-Myanmar border.
CDC Thailand has assisted Thailand on several critical noncommunicable disease (NCD) initiatives. CDC Thailand worked with Thai partners to implement aspects of WHO’s Global Hearts Initiative to reduce the burden of uncontrolled hypertension and decrease morbidity and mortality associated with cardiovascular disease. CDC Thailand also supported the Thai FETP to conduct a cardiovascular surveillance system evaluation in Saraburi province and has worked with the Thai National Cancer Institute on screening programs for colorectal and cervical cancer. In addition, CDC Thailand has supported Thai FETP-NCD residents and staff to conduct a series of situational analyses and research projects, focusing on cardiovascular health. CDC Thailand’s work in the country is informing the development of cardiovascular interventions to reduce premature deaths.
Hunting for COVID-19 Answers in Thailand’s Wastewater
– September 1, 2022
Celebrating 15 Years of a Successful Partnership
– June 30, 2020
CDC’s Global Response to COVID-19
– June 24, 2020
International network explores the economics of noncommunicable diseases
– January 29, 2019
Thai Global Hearts Project Keeps Communities Heart-Healthy
– September 26, 2018
- 16 U.S. Assignees
- 141 Locally Employed
- Population: >69.7 million
- Per capita income: >$17,650
- Life expectancy at birth: F 80/M 73 years
- Infant mortality rate: 7/1,000 live births
Source: World Bank 2020, Thailand
Population Reference Bureau 2020, Thailand