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Thailand has been successful in minimizing the spread of infectious diseases. Organizations such as WHO, CDC, and AHF have teamed up for prevention and control which has lead to great outcomes for the country. Thailand continues to advance their technology and knowledge to be prepared for future issues with infectious diseases.

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Centers for Disease Control and Prevention (CDC)

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World Health Organization (WHO) Strategies for Infectious Diseases.

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World Health Organization (WHO) Strategies for Infectious Diseases.

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This is the Country Cooperation Strategy that will be implemented by the MOPH of the Royal Thai Government, collaborating with WHO.

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5 Reasons Thailand is Winning the Battle Against COVID-19

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5 Reasons Thailand is Winning the Battle Against COVID-19

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5 Reasons Thailand is Winning the Battle Against COVID-19

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How Thailand's care system and strategies managed the COVID-19 Pandemic

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How Thailand's care system and strategies managed the COVID-19 Pandemic

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This article talks about how Thailand contained COVID-19 with the strategies they've established. Thailand was able to conquer COVID-19 and return back to their normal lives, by taking serious measures to protect their population from the illness.

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WHO's review on Thailand COVID-19 Response

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WHO's review on Thailand COVID-19 Response

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WHO found Thailand to have strong leadership, well resourced medical and public health systems, and early adoption of a "whole of society" approach.

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The Ministry of Public Health and the World Health Organization Review Thailand’s COVID-19 Response

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Thailand has become one of the first countries in the world to review how its health system has so far responded to COVID-19. This process, known as a Joint Intra-Action Review, had two goals - to identify what went well during the first 6 months of the pandemic in Thailand, and to recommend how the…

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Fully eliminating malaria has been difficult for Thailand to achieve, due to the struggle to find a vaccine that works. Cases of malaria have decreased by 72% in recent years, but the chances of ending malaria would be higher with the help of a reliable vaccine.

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Cases of malaria in Thailand have decreased 72% in recent years, but the country's Department of Disease Control is planning to completely eradicate the mosquito-borne disease by 2024. Today, the DDC is observing World Malaria Day 2022 under the theme "Harness innovation to reduce the malaria disease burden and save lives". A malaria vaccine is also under evaluation and is planned to undergo clinical trials in Thailand in the future.

Thailand has made impressive progress in controlling and preventing cases of malaria through the 'National Malaria Elimination Strategy 2017-2026' initiative. From 2017 - 2021, cases of malaria in the kingdom decreased by 72%. Since the beginning of this year, 731 cases of malaria have been recorded in Thailand. However, the Thai government wants to completely eradicate cases of malaria in the next 2 years.

Cases of malaria in Thailand usually occur in mountainous or forested areas, especially along the Thai - Myanmar and Thai - Cambodian borders. There is very little risk of transmission in urban areas such as Bangkok, Chiang Mai, Pattaya, Phuket, etc. Only certain species of mosquitoes can spread malaria, which is spread in Thailand through female Anopheles mosquito bites. Malaria is caused by protozoa and can be fatal.

Symptoms of malaria include fever, chills, headache, muscle pain, loss of appetite, nausea, vomiting, diarrhea and yellowing of the skin.

If you travel to a rural area where there is a risk of malaria, the best prevention is to prevent mosquito bites by using mosquito repellent and sleeping inside a mosquito net. The drug Chemoprophylaxis, which can cause unpleasant side effects, is not recommended in Thailand where malaria is multi-drug resistant.
HERE is an article about avoiding another mosquito-borne disease, Dengue, with some clues about preventing bites.
People who are repeatedly exposed to malaria can acquire immunity to the parasitic disease, opening up the opportunity for a malaria vaccine to be developed. However, the complexity of the malaria parasite has made developing a vaccine a challenge.

Mosquirix is the world's first WHO-approved vaccine against malaria caused by the plasmodium falciparum parasite. The vaccine is based on a protein expressed on the surface of the sporozoite, called the circumsporozoite protein. The vaccine is under evaluation in Ghana, Kenya and Malawi, with ongoing studies suggesting the vaccine is reducing deadly malaria cases by at least 30%.

Scientists in India have completed the first-ever Phase 1 clinical trials using the vaccine, which were considered to be successful. A Phase 2a trial is being planned at Oxford University and another is planned to take place in Thailand.

Last July, BioNTech, manufacturer of the Pfizer-BioNTech Covid-19 vaccine, announced it wants to develop a malaria vaccine using mRNA technology and aims to start clinical trials by the end of this year.

SOURCE: NNT

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Thailand wants to eradicate malaria 'for good' | Thaiger

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Cases of malaria in Thailand have decreased 72% in recent years, but the country's Department of Disease Control is planning to completely eradicate the mosquito-borne disease by 2024. Today, the DDC is observing World Malaria Day 2022 under the theme "Harness innovation to reduce the malaria disease burden and save lives".

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Thailand's success factors for eliminating Malaria

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Thailand's success factors for eliminating Malaria

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Using a 1-3-7 method, Thailand was able to quickly and efficiently decrease the cases of Malaria. This method has cases reported in 1 day, cases are investigated in 3 days, and the state of the case is investigated and has a response within 7 days. This strategy uses past interventions and is done in a timely manner to successfully end the spread of Malaria.

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In line with the World Health Organization (WHO) Global Technical Strategy for Malaria 2016-2030 (GTS) and the subsequent Framework for Malaria Elimination and Malaria Surveillance, Monitoring and Evaluation reference manual [ 1], the countries in the Greater Mekong Subregion (GMS) have endorsed the goals of eliminating Plasmodium falciparum by 2025 and all forms of malaria by 2030 [ 1]. The GMS comprises Cambodia, Lao People's Democratic Republic, Myanmar, Vietnam, and Thailand, which are all showing notable declines in malaria burden [ 2]. GMS countries are approaching the challenge using several tailored malaria elimination strategies, including distribution of insecticide-treated bed nets (ITNs), expanded networks of village health workers, and case-based surveillance and response [ 3, 4].

Thailand's National Malaria Elimination Strategy 2017-2026 (NMES), which outlines a vision for reaching zero indigenous cases by 2024, was approved by the Cabinet of the Royal Thai government in 2016. A complementary Operational Plan 2017-2021 proposed a national budget of 2.3 billion Thai baht (USD $64.8 million) over the next 5 years to support malaria elimination strategies to interrupt transmission [ 5]. The core focus of these plans is to identify infections rapidly and to use timely and active surveillance and response to prevent them from spreading [ 5]. The NMES introduced the 1-3-7 strategy as a robust surveillance and response approach for elimination that would prioritize timely, evidence-based action. The strategy requires notification of each malaria case within 1 day of diagnosis, investigation and classification of each case within 3 days, and a focus investigation and response within 7 days to deploy needed interventions.

The 1-3-7 strategy builds on Thailand's history since the 1980s of conducting case investigation and classification. The Containment Project, which was implemented from 2008 to 2012, served as precursor to real-time case-based data collection and follow-up and led to the launch of electronic data capture in a national web-based malaria information system (MIS) known as "Malaria Online [ 6]". In 2009, Thailand added foci investigation as a central part of its malaria control strategy [ 7]. With the launch of the NMES in 2017, Thailand's Division of Vector Borne Diseases (DVBD) within the Department of Disease Control (DDC) of the Ministry of Public Health (MOPH) upgraded Malaria Online to aggregate all sources of malaria case data and monitor progress on a near real-time basis [ 8].

The 1-3-7 malaria elimination strategy was initially developed and implemented in China in 2012 [ 9, 10], and Thailand both studied and adapted the strategy for the local epidemiological context. The strategy is considered a key factor in helping China reach zero locally transmitted malaria cases in 2017 and in supporting its efforts to maintain the interruption of transmission. Other countries in Southern Africa and Southeast Asia have also established malaria case reporting and response follow-up systems, complemented by increased monitoring activities [ 11, 12]. However, the hallmark of the 1-3-7 strategy is timeliness, with strict deadlines for reporting and response to enforce a robust elimination programme. This paper outlines Thailand's experience adapting and implementing the 1-3-7 strategy, including lessons learned and success factors, in the hope that this information may be helpful for other countries considering strengthening surveillance for malaria elimination.

From malaria control to malaria elimination

From 2012 to 2015, the DVBD's malaria control efforts were associated with a significantly reduced blood slide positivity rate (SPR) of less than 5% among suspected cases with fever and an annual parasite incidence (API) of < 1 per 1000 population (range 0.38-0.82) [ 5]. The same downward trend was seen in malaria incidence, decreasing from 33,835 cases in 2012 to 24,332 cases in 2015, representing a 28.1% decline in just 3 years [ 8]. The malaria control programme also documented reduced mortality, with just 0.05 deaths per 100,000 population by 2015, representing fewer than 50 malaria-attributed deaths from 2012 to 2015.

These results led to a comprehensive malaria programme review in 2015 to identify strengths, gaps, and challenges across disciplines and to recommend key actions [ 5, 13]. Recommendations for surveillance included updating and reorienting surveillance as a core intervention to detect and trigger an appropriate, focused, and timely response for every confirmed malaria case. Also in 2015, malaria became a notifiable disease in Thailand with the passage of the Infectious Disease Act, which expanded surveillance potential. To improve performance, the DDC decided to transition the malaria programme to one focused on elimination (Fig. 1) per the Global Technical Strategy for Malaria 2016-2030, with a goal to achieve national malaria elimination by 2024 [ 1]. The MOPH created a Malaria Elimination Strategic Plan for Thailand 2017-2026, and the DDC contributed the complementary Thailand Malaria Elimination Operational Plan 2017-2021 to pave the way forward [ 5]. These plans outlined incremental targets to support zero malaria by 2024.

Source: Malaria Elimination Strategic Plan for Thailand 2017-2026 [ 5]. API annual parasite incident, SPR slide positive rate

Milestones from malaria control to malaria elimination. (Asterisk)

The DVBD developed a new district-level stratification of malaria endemicity based on guidance from the WHO Malaria Elimination framework [ 14], which is detailed in the NMES [ 5]. The stratification is the basis for subsequent tailored case and vector management activities for elimination based on evidence from surveillance data. The DVBD also coordinated adoption of existing systems and infrastructure to prepare for adoption of the 1-3-7 strategy, including strengthening and sustaining epidemiological and entomological surveillance as recommended by the malaria programme review committee.

Protocols of the 1-3-7 strategy

Case reporting within 24 h

All individuals who test positive for malaria using microscopy or a rapid diagnosis test (RDT) receive malaria treatment according to the national treatment guidelines and trigger the start of the 1-3-7 surveillance process. All malaria species are included in 1-3-7 surveillance efforts, with P. falciparum and Plasmodium vivax being most common in Thailand [ 8]. Health care providers were already required to report confirmed cases and laboratory results under Thailand's malaria control strategy [ 8]; this was adjusted for the elimination programme to include a requirement to complete the notification within 24 h (1 day) of diagnosis [ 15]. An optional cellphone-based short message service alert system immediately informs district-level staff of a case, ensuring timely follow-up. Providers may also choose to report cases using the traditional paper form.

Case investigation and classification within 3 days

Thailand has long conducted malaria case investigations to identify risk behaviour and to classify cases as imported or indigenous. Under the NMES, the MOPH adopted an enhanced case classification to allow a more precise understanding of where the patient contracted the disease and identify a source of transmission from remaining hotspots. Thailand's case investigation form (EP3) includes minimal essential data (e.g., demographics, illness history, diagnostic results, treatment, travel history) and likely location of infection. Cases are investigated by malaria clinic workers, district officers, or provincial officers and are classified per the criteria in Table 1 [ 4].

Case investigation data are recorded on a paper form that is then uploaded to a national repository in the MIS. If the conclusive case classification is "A," a focus investigation is warranted, and the surveillance rapid response teams (SRRT) deploys the focus investigation and response.

Foci investigation and response within 7 days

Thailand's foci investigation compiles epidemiological, entomological, and sociological information and the results of past interventions. This allows local health authorities to identify causes and characteristics of indigenous transmission to deploy appropriate interventions. With the NMES, Thailand adopted a new foci stratification with four categories according to level of transmission, as outlined in Table 2 [ 16]. Thailand's adoption of the NMES also reoriented foci investigation in two ways. Firstly, a strict timeline to conduct the investigation within 7 days of case investigation was required. Secondly, in active foci (A1 and A2 areas) where all interventions are applied, but malaria cases persist for over 4 consecutive weeks, reactive case detection (RACD) is conducted (Table 3). RACD is a surveillance response initiated when an indigenous index case is found in a village (foci) with transmission (A1 or A2) or without transmission but with the presence of a suitable vector (B1). Blood is taken for microscopy from all members living in the index patient's house and all neighbors living around the index patient's house, aiming for at least 50 blood samples or 10 households within a 1-km radius. Additional foci response activities include vector control (distributing ITNs to reach 90% coverage at 1 bed net per 2 persons or indoor residual spraying [IRS] of at least 90% of households) and health education [ 4]. These data are stored in the MIS in a designated foci registry.

Enhancing surveillance infrastructure for elimination

Malaria Online was introduced in 2012 to facilitate case-based surveillance data tracking through online and offline reporting. The MIS comprises real-time malaria case data, geospatial foci and vector mapping, and drug efficacy data. It also serves as a resource portal for policies and strategic documents related to malaria. The MIS collates two main sources of malaria case recording and reporting (Fig. 2):

1. 1.
The vertical malaria programme, starting from subdistrict malaria clinics (MCs) through provincial Vector Borne Disease Centres (VBDCs). These health facilities record data on paper forms for case notification and case investigation; district health teams then input the data into the MIS.

2. 2.
The general health services (GHS) programme, starting from community-level malaria posts (MPs) and hospitals (all types) through Provincial Health Offices (PHOs) to the Bureau of Epidemiology (BOE) [ 8]. These health facilities record data in a separate system maintained by the BOE.

Source: DVBD [ 8], MOPH [ 17]

Flowchart of malaria reporting.

Thailand is currently in a semi-vertical approach for malaria elimination as these two reporting lines are being integrated. Regardless of data type, 1-3-7 guidelines for timeliness of reporting are enforced.

In 2016, new features were added to enable real-time monitoring at every level of the health system and to encourage local staff to take ownership of their data and use the results to improve intervention targeting. The DVBD installed dashboards and visualizations in the MIS to show geospatial mapping of the 1-3-7 metrics, RACD targets and achievements, and a summary of the 1-3-7 malaria elimination strategy (Fig. 3). A new 1-3-7 dataset, representing information from the weekly and monthly reports generated by provinces, includes the number of malaria cases reported and the proportion reported within 1 day, the number of cases investigated and the proportion investigated within 3 days, and the number of foci investigations (with RACD) and the proportion investigated within 7 days. From the first year of implementation through fiscal year 2020, on-time case notification improved from 24.4% to 87.8%, case investigations from 58.0% to 94.7%, and foci investigations from 37.9% to 84.1%. Detailed results on these key performance indicators will be reported separately. To encourage local staff to adopt 1-3-7 protocols and use the resulting data, the DVBD also created a weekly report that collates data highlights.

Source: MIS database [ 8], DVBD, MOPH

1-3-7 dashboard in the MIS.

By allowing for timely analysis of malaria surveillance and case investigation data, Malaria Online supports Thailand's goal to use surveillance to develop strategic information that leads to appropriate action. A Business Intelligence add-on to the MIS facilitates comparisons of weekly incidence across years. If case numbers are higher than expected, the DVBD or provincial authorities alert the relevant subdistricts to consider appropriate investigation and control activities. In the example below, Prachuab Khiri Khan Province received notice during the 27th week of the year that there were 20 more cases reported than in the same week the previous year (Fig. 4). The notice included a dropdown list of villages; the action required to find out which areas were affected; and instructions for prompt case re-investigation, focus investigation with RACD of the whole village, and renewed vector control measures in line with the 1-3-7 strategy. Subnational officers took prompt action during the 27th week, with new cases triggering additional case investigations and a wider response until the next week witnessed a decreasing number of malaria cases.

Source: MIS database [ 8], DVBD, MOPH

Weekly data report for Prachuab Khiri Khan in the MIS.

For data to inform more granular operational decision-making as malaria burden decreases, data must be timely and accessible to subnational officers, health workers, and community focal persons. However, in the remaining hotspot locations in Thailand internet access may be unreliable and, therefore, prevents access to submitting and obtaining data in real time. To address these disadvantages, at the provincial and district levels the MIS can access and store back-up data in the Malaria Offline database in a central server [ 8]. Malaria Offline complements Malaria Online to ensure that work can continue during internet outages and that key staff can access their data.

Human resources for strong surveillance

Malaria surveillance for elimination in Thailand relies on human resources in both the malaria vertical programme and the GHS system (Table 4). The surveillance system also engages village health volunteers (VHVs) for community reporting on 1-3-7 metrics. Some Vector Borne Disease Units (VBDUs) supervise GHS staff to ensure high-quality malaria case detection, surveillance, and response.

Day 1 malaria cases could be found and notified by staff from MCs, MPs, or border posts or by general health facility clinicians. Day 3 case investigations are conducted by MC staff or sometimes by public health workers at hospitals or MP staff with additional follow-up from SRRTs. Day 7 foci investigation and response largely relies on district-level SRRTs, a national system of epidemiology and investigation teams established in 2004 [ 18]. SRRT members include staff of both the vertical and GHS programmes.

Both the DVBD and BOE remain committed to building skills and updating training materials and guidelines for effective implementation of the elimination programme and the 1-3-7 strategy. The training package targeted epidemiologists, malaria surveillance focal points, and entomologists and was complemented by annual refresher training [ 13]. Public health workers trained all epidemiologists as part of the SRRT launch in each province to integrate malaria elimination activities into their work, including the 1-3-7 strategy and other public health responses. The training, comprising both workshops and on-the-job coaching, covered MIS data monitoring for timely action to correctly identify malaria infections and disrupt transmission. Since the launch of the 1-3-7 strategy, the DVBD has conducted annual trainings, resulting in 719 trained epidemiologists in Thailand. At the subdistrict and community levels, training for healthcare providers included VHVs. Entomologists were trained on vectors present in each subdistrict or VBDU area, a collection of mosquitoes for polymerase chain reaction (PCR) testing to rule out indigenous transmission in new B1 areas prior to their designation, and insecticide resistance monitoring for endemic areas.

Allocating budget and resources

Costs for surveillance and response activities, including required equipment, internet connectivity, and labour are supported through the MOPH budget, the health security budget, and local budgets. This domestic funding is enhanced by support from the Global Fund to Fight AIDS, Tuberculosis, and Malaria and additional external support from partners such as the United States President's Malaria Initiative. The MOPH also works with other agencies to coordinate malaria activities in their relevant domains and identify efficiencies, prioritize tailored activities, and maximize available funding. For example, shared information technology and systems resources across the government support malaria surveillance efforts.

From 2017 to 2020, the MOPH supported the malaria elimination strategy with Thai baht 2.8 billion (USD $88.5 million), which does not include budget spent for health infrastructure and human resources [ 5]. The Malaria Elimination Steering Committee, comprising members from several ministries and the WHO, develops an integrated budget. Of this budget, 11% is allocated to surveillance activities.

At the local level, PHOs and Local Administrative Organizations (LAOs) in areas with malaria transmission may allocate their own funds to malaria elimination projects. LAOs have subdistrict-level responsibility for public health and welfare issues, including malaria [ 5, 17]. The 2015 Infectious Disease Act also stipulates that LAOs must conduct malaria surveillance and liaise with district health authorities. LAO committees that prioritize malaria as a community issue are empowered to design projects on disease control and response, based on hyperlocal malaria epidemiology and surveillance data. They also prepare and approve annual budget plans, and they manage funds for emergencies like disease outbreak response or natural disasters.

Comparisons between the Thailand experience and the China experience

The DVBD adopted the 1-3-7 strategy from China but tailored the strategy's activities to suit Thailand's requirements, available resources, and surveillance infrastructure. China included all suspected malaria cases in surveillance activities, which required substantial resources despite the country's low caseload at rollout in 2012 [ 19]. In Thailand, because all suspected malaria patients can access blood tests and results within the same day of visit, only confirmed positive cases trigger the 1-3-7 strategy. This not only promotes accurate management of fever patients and efficient use of commodities but also increases the quality of surveillance data by reducing reporting requirements.

Microscopy examination remains the most widely used diagnostic tool for laboratory confirmation of malaria both in Thailand and China. However, with declining incidence, practitioners' skills in performing and reading blood smears may decrease [ 9], so RDTs have recently become available in primary health care centers and communities in Thailand. This will allow VHVs to play a greater role in Thailand's malaria elimination strategy compared with China and also supports Thailand's system based on confirmed cases rather than suspected cases [ 20].

Foci classification also varied between the two countries, with four categories in Thailand and three categories in China. In China, areas with at least one confirmed malaria case are classified into three foci categories:

"Inactive focus" is an area that is unlikely to support transmission because of an absence of vectors;

"Active focus" is an area with suitable vectors; and

"Pseudo focus" is a malaria-free area with a case classified as imported [ 9, 20].

Thailand has been using a foci classification system for several years, throughout both the malaria control and malaria elimination phases, based on malaria source (i.e., indigenous or imported), entomological factors, and environmental characteristics (i.e., unsuitable or suitable for transmission) [ 7]. Whereas in China both active and pseudo foci prompt RACD, in Thailand RACD screening is carried out only in foci with an index case (A1, A2, or B1).

Recording and reporting requirements were also slightly different because Thailand looked for efficiencies to maximize limited resources. In Thailand, to meet the criteria for foci reporting within 7 days, MIS users may input data through the end of the subsequent week that the case was reported. For example, if the case was identified on Monday of week 1, the VBDU can respond on any day starting on Monday of week 1 through Saturday (i.e., the last day) of week 2. As long as there were no other cases occurring in the same sub-village that week, the MIS will count that case as responded to within 7 days. Because workload for subnational officers can often be a bottleneck to timely surveillance and response, the DVBD applied a workload reducing strategy based on the number of cases in a province. For example, in a high-prevalence province like Tak, which reported 1,685 malaria cases in 2019, only one RACD was required even if more than one index case was reported at the same week in the same sub-village. Because each RACD targets 50 people per index case, coverage was adequate to maintain high-quality surveillance.

Success factors to Thailand's 1-3-7 surveillance strategy

The DVBD has heightened the visibility of malaria in Thailand by coordinating a Malaria Steering Committee and working across various government agencies including the Ministry of Interior, Ministry of Foreign Affairs, and Ministry of Defense. To engage policymakers, the team outlined a convincing argument that focused on the benefits of malaria elimination for the development of the country-for example, the DVBD published a cost-benefit analysis that found that every Thai baht invested in malaria elimination can return up to 15 Thai baht to Thailand's health system, households, and economy [ 21]. The DVBD also partnered with neighboring countries to share data and policies; this regional approach opened new funding opportunities through the Global Fund Regional Artemisinin-resistance Initiatives. More internally, the DVBD has prioritized malaria surveillance, including the 1-3-7 strategy, in its strategies and budgets, creating an enabling environment from Thailand's public health leadership. Supporting digital transformation policies have simultaneously catalyzed malaria surveillance infrastructure and success, including developing dashboards that facilitate review of 1-3-7 metrics and catalyze subsequent actions.

At the operational level, Thailand's malaria officers also have a mobile chat application that is a unique factor in the success of 1-3-7 surveillance. The chat group has over 400 malaria members from across the country and at every level of the health system. The group chat enables continual communication with peers to monitor the malaria situation, exchange experiences, seek recommendations or troubleshooting support, share press releases, and provide fodder for new strategies. Participation of the DVBD and national-level partners also supports more effective monitoring and evaluation. The active members respond to notifications, ask questions and provide answers, and offer motivation and support, making it an efficient platform for monitoring and communication among malaria workers.

A final success factor in Thailand's implementation is the flexibility of implementing budgets and activities at very local levels. Even though annual budgets are calculated based on the previous year's activities and unexpected situations often occurred, LAOs were able to work with provincial authorities to revise their local budgets to fit needed activities for the current situation. Because these local authorities know the community situation, this microplanning has been a successful strategy for organizing targeted response even in situations with unanticipated spikes in malaria caseload.

The future road to elimination

The 1-3-7 strategy has been successfully implemented, and results suggest it has contributed to Thailand's decline in malaria burden from 14,948 cases in fiscal year 2017 to just 4,421 in fiscal year 2019, representing a 70% reduction in incidence. The DVBD continues to adapt its programme to ensure prompt and high-quality case management, capacity maintenance, and adequate supply of lifesaving commodities. It is also continuing routine data monitoring and wider assessments as needed to verify that the time-bound targets of the 1-3-7 strategy are sustained over time. Senior staff are expanding technical discussions and resources to include prevention of reintroduction. However, the DVBD may also need to consider potential challenges that may emerge as provinces approach very low prevalence.

The MOPH is working toward an integrated system of health services by phasing out vertical VBDUs, VBDCs, and MCs. As staff in these facilities retire, the MOPH is not recruiting replacements so that future patients are directed toward GHS facilities, including health promoting hospitals [ 13]. The new structure of GHS's malaria programme is semi-vertical, with the DVBD's expertise guiding the development of high-quality malaria services across facility types. This guidance includes incorporation of malaria case management into GHS pre-service training, mechanisms of in-service training and professional support through VBDU, and an encouraging career path for GHS trainees [ 5, 8]. The DVBD will remain involved in the integration process to ensure the high quality of malaria case management and surveillance is maintained through elimination and prevention of reintroduction.

When areas reach very low prevalence, the DVBD may consider supporting provincial authorities to take a stronger role in quality assurance. Additional online training and standard operating procedures could support a more decentralized system to fortify comprehension of protocols despite current challenges caused by the coronavirus disease. An annual online training with certification could be one way to maintain knowledge and skills, share updates, and review surveillance data as fewer health staff interact with suspect malaria cases and have robust malaria case management experience.

As the DVBD's efforts reduce malaria burden, advocating for necessary funds becomes more challenging. Thailand's budget for malaria surveillance has changed over time. However, the technical malaria community knows that malaria elimination programmes are more resource-intensive than malaria control, with increasing cost per case. The current global funding landscape is shifting, and external funds available to Thailand are shrinking. This challenge requires the DVBD to be more creative and strategic with identifying sources of financial support. Especially in the described climate of integration, domestic fund-raising is also a challenge because it requires that malaria be prioritized over all other diseases Thailand is working to address.

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Implementation and success factors from Thailand's 1-3-7 surveillance strategy for malaria elimination - Malaria Journal

# data[].attributes.attachment_link.description
Thailand's National Malaria Elimination Strategy 2017-2026 introduced the 1-3-7 strategy as a robust surveillance and response approach for elimination that would prioritize timely, evidence-based action. Under this strategy, cases are reported within 1 day, cases are investigated within 3 days, and foci are investigated and responded to within 7 days, building on Thailand's long history of conducting case investigation since the 1980s.

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CDC Thailand Division of Global HIV and TB

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CDC Thailand Division of Global HIV and TB

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Centers for Disease Control and Prevention (CDC)

# data[].attributes.attachment_link.title
CDC Thailand Division of Global HIV & TB

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FHI360 provides technical assistance to the Government of Thailand and community based organizations. FHI360 provides clinical research services and established the Product Quality and Compliance (PQC) lab in Bangkok.

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This is a case study that goes over the solutions that Thailand has created to battle HIV/AIDs. Although, prevention programs have been on a rise, and the response to these programs has been good there are still new problems that need to be addressed. The support of the King and Prime Minister have influenced the country greatly which is why Thailand continues to be successful.

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Centers for Disease Control and Prevention (CDC)

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The Ministry of Public Health is an organization that educates the public on diseases. They provide health tips and applications for registering for vaccines.

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The Ministry of Public Health serves to improve the health of the population of Qatar with its many advanced protection, promotion, prevention, diagnosis, treatment, and rehabilitation services.

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Centers for Disease Control and Prevention

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Centers for Disease Control and Prevention

# data[].attributes.body
The CDC prevents and controls infectious diseases such as HIV/AIDS, tuberculosis, and influenza. The CDC played a major role in minimizing the impact of COVID-19, and implemented a AIDS Relief plan. With the help of the CDC Thailand was the first Asian country to receive WHO certification for the elimination of mother-to-child transmission of HIV and Syphilis.

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CDC Thailand provides technical expertise on a number of critical noncommunicable diseases including cardiovascular disease, cancer and road traffic injuries. CDC supports the Global Hearts Initiative, which focuses on cardiovascular health, the number one cause of mortality in Thailand. Additionally, CDC collaborates with the National Cancer Institute of Thailand to evaluate the National Cancer Prevention Program.

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How the Department of Disease Control (DDC) makes  Decisions on Public Health by Democratizing Analytics

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How the Department of Disease Control (DDC) makes  Decisions on Public Health by Democratizing Analytics

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The DDC democratizes analytics to help prevent diseases using data from multiple sources. They rely on data to publish information on their website to inform the public of how to prevent/handle diseases.

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Democratizing analytics capabilities across the organization

The Department of Disease Control (DDC) is an important government department under the Ministry of Public Health in Thailand responsible for the public health of the Thai people through disease prevention and control. To achieve this mission, they have tapped on data as a strategic asset. Using Tableau, the DDC was able to efficiently work with large sets of data to understand the healthcare situation amongst the Thai population to guide policy working. Complicated data sets were also broken down according to common disease types such as dengue, malaria and food poisonings and regularly published on its website to inform and educate the public.

Traditionally, data analysis had been a very manual process. When dealing with data from multiple sources and in various formats, the DDC often had to rely on a small group of skilled programmers to clean and prep the data for analysis. This process took a lot of time. To improve its operational efficiency, the DDC wanted to democratize analytics to more of its employees who are medical professionals so that they can benefit from the data insights directly.

One of Tableau's greatest strengths is the way it allows us to quickly and easily connect with our data. As an analytics tool, it also helps people to understand their data better and make decisions.

This was made possible by using Tableau - even with just basic computer skills, DDC employees were able to create their own visualizations within one to two days, hugely reducing the reliance on IT teams. This marked improvement from the past, when employees can take more than ten days to gain enough confidence with business intelligence tools. Extracting data from complex data sets also became much faster; instead of an overnight process, this can now be done in just two to three hours.

"The learning curve with Tableau is very short compared to traditional business intelligence tools, and it makes it easier for our business users to interact with and make sense of their data," said Yongjua Laosiritaworn MD, MPH, PhD who is the Information Centre Director at DDC." One of Tableau's greatest strengths is the way it allows us to quickly and easily connect with our data. As an analytics tool, it also helps people to understand their data better and make decisions."

Mapping the pandemic

Democratizing analytics capabilities across the organization afforded the DDC a critical advantage in managing the Covid-19 crisis. When employees in the field responsible for disease control are equipped with the skills needed to work with data insights, they can plan in advance knowing where, which group and when there might be an outbreak. For instance, following a recent outbreak, DDC was able to identify a specific region of concern and create a control zone to minimize the spread.

During the pandemic, the DDC relied heavily on Tableau to inform its response. They have had to maintain oversight on the situation over the whole of Thailand and leveraged Tableau to consolidate information from various regions in the country. By developing real-time visualizations to understand the impact of Covid-19 in different regions, they could remain agile to make real-time public health decisions.

Data has also been a critical asset to support the efficient allocation of resources. The DDC collates data from 500-600 hospitals in their data warehouse - ranging from the number of available hospital beds, availability of medicine and vaccinations and number of patients serving quarantine. Combining all this information in a central place like Tableau empowered the DDC to better manage their resources in line with the most immediate priorities.

It has also been crucial for the DDC to maintain public trust and confidence. They rely on data as a single, objective source of truth and frequently publish visualizations on their website to keep people informed of the ongoing situation. As the situation continues to evolve, the DDC is able to maintain this an effective channel of communication with the public.

One of the Department of Disease Control's major missions is to protect Thai people from sickness. Accurate and easy to understand data in the form of Tableau visualizations will help the department to achieve this mission.

The future of healthcare

The pandemic has cast a spotlight on the need for the DDC to rely on data-driven decision-making. Still, they must be intentional about maintaining a data-first approach even beyond Covid-19.

"One of the Department of Disease Control's major missions is to protect Thai people from sickness. Accurate and easy to understand data in the form of Tableau visualizations will help the department to achieve this mission," said Dr Laosiritaworn.

At the same time, the healthcare industry as a whole has become more mature in their understanding and advocacy of data-driven decisions. They have a responsibility to make accurate and timely decisions that have profound implications on their broader community. They must continue to invest in strengthening their data competencies - both with regard to data tools and upskilling - to deliver quality care experiences.

For one, the DDC plans to mature its use of analytics with machine learning and AI. This will allow them to better leverage data analytics as a tool to not only streamline their operations but also turn to more granular data insights to support efforts to diagnose, develop treatment plans and predict future diseases.

BAC (Business Applications Company Limited) is a pioneer of the proficient software distributor and support provider company in Thailand since 1994. We provide Business Intelligence solutions to serve your best need. Our key performances and commitments are to improve customer business performances with data. We bring the concept of analytics which everyone can use with our best support to guarantee our customer satisfactions. Our solutions are not one size fit all, we have many customer solutions including data preparation, data integration, cloud data integration, data analytics along with data visualization and dashboarding, we also help customers building data culture in their company using Tableau Blueprint and extend the use of analytics with Tableau Embedded Analytics solution.

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Thailand's Department of Disease Control Democratizes Analytics to Make Better, Faster Decisions on Public Health

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The Department of Disease Control (DDC) is an important government department under the Ministry of Public Health in Thailand responsible for the public health of the Thai people through disease prevention and control. To achieve this mission, they have tapped on data as a strategic asset.

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This is a prevention program that provides treatment to highly affected areas for HIV/AIDS. They treat patients through events and promote the use of contraceptives. They also hold community based HIV rapid testing.

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Looking For HIV Testing in Thailand? Find HIV Center
AHF Thailand was established in 2014 with support from international, governmental, and local organizations. The program focuses on HIV/AIDS prevention and treatment/care for key affected populations (KAPs) including men who have sex with men (MSM), transgender people (TG), sex workers, and migrant workers in Bangkok, Maesod/Tak, Chonburi, Ratchaburi, Samutsakorn, Nonthaburi, Khon Kaen, Udon Thani, Ubon Ratchathani, Rayong and Ranong through special/thematic events, condom/lube promotion and distribution, community-based HIV rapid testing services, and linkages to appropriate medical care. In addition, care and treatment such as ART, treatment of opportunistic infections and tuberculosis, home-based care, and nutrition support are provided for free and co-share particularly for poor migrant workers.

Key partners include Planned Parenthood Association of Thailand (PPAT) in Bangkok and Maesod/Tak, Bamrasnaradura Infectious Diseases Institute, Taksin Hospital, Lerdsin Hospital, Bang Na General Hospital 1, Glove Clinic and The Poz Home Center in Bangkok, Banglamung Hospital in Chonburi. Sairoong Ratchaburi Group and Ratchaburi Hospital in Ratchaburi, Samut Sakorn Hospital, Khon Kaen Hospital, Udon Thani Hospital, Sunpasitthiprasong Hospital, Rayong Hospital, Ranong Hospital, Sisters Foundation, M-Can Group, Health and Opportunity Network and Bangkok Rainbow.

The Thai government has committed to ending the AIDS epidemic by 2030 with a National AIDS Strategic Plan. While the number of adults infected has slowly declined, substantial progress has been made in eliminating HIV infections among children; Thailand saw a 41% reduction of HIV child transmission from 2010-2014.

In 2018, an estimated 480,000 of Thai people are living with HIV, out of the 68 million total population. An estimated 6,400 new HIV infections occurred in 2018. Gender prevalence amongst adults (15-49) shows women at 1% compared to men at 1.2%. Out of the 450,000 of Thai people living with HIV, approximately 360,000 are on treatment.

Sources www.unaids.org/en/regionscountries/countries/thailand
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AHF Thailand - HIV/AIDS Testing - AIDS Healthcare Foundation

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Looking For HIV Testing in Thailand? Find HIV Center AHF Thailand was established in 2014 with support from international, governmental, and local organizations.