From Toon's super-marathon to the 'sugar tax', we look at the big issues of the past year concerning Thailand's healthcare.
Mr Wonderful
No one has been more of the talk of the town now than Artiwara "Toon" Kongmalai of the rock band Bodyslam, now on the road in the longest run of his life -- 2,191km from Betong district of Yala province heading up north to the finish line in Chiang Rai's Mae Sai district -- to raise funds for the procurement of medical equipment for 11 state hospitals nationwide.
Before he started this cross-country run, Artiwara aimed for 700 million baht. As of now, the donations exceed 845 million baht and the frontman shows no sign of stopping. Last December, Artiwara also ran 400km from Bangkok to Bang Saphan, raising 63 million baht for medical equipment for Bang Saphan Hospital in Prachuap Khiri Khan.
Wherever Artiwara ran to, he was welcomed warmly by locals. People want a selfie, a handshake, his signature on a guitar and more. The excited crowds, in part, were said to be the cause of Artiwara's injury, which required him to take an interval break days longer than usual on the advice of his doctor.
Artiwara's mission is definitely for a good cause. But it has also raised a lot of controversy -- from the choice of hospitals to bigger things, like the country's healthcare-budget management. Adding to the drama was the Ministry of Public Health itself, which came out and donated one million baht to Artiwara's project -- a donation laughed about by many because Artiwara was running for hospitals under the Ministry of Public Health.
Dengue vaccine fiasco?
After years of promotion and advocacy, all of a sudden the vaccine against dengue fever, Dengvaxia, has been put on hold in Thailand following a decision by the Philippines Department of Health earlier this month to suspend the programme.
It's been reported that the world's first dengue vaccine could worsen symptoms for people not previously infected. The Philippines quickly froze its public dengue immunisation programme, in which more than 733,000 children were reported to have received the shot. The Filipino authorities have now ordered a blanket suspension for private use as well, according to international news reports.
The World Health Organization has supported the decision by the Philippines government to suspend its mass-immunisation programme and said it has begun reviewing safety data.
Meanwhile, the Paediatric Infectious Disease Society of Thailand has advised people to stop receiving the vaccine, provided mostly in private hospitals.
In response to this, the Asian Dengue Vaccination Advisory last week issued a statement, saying that while test results showed people previously infected by the dengue virus would benefit from the vaccine, those with no previous infections tend to have higher hospitalisation rates (an additional five hospitalisations per 1,000 vaccines in five years), but with no reported shock, bleeding or mortality. So this should not cause undue panic among individuals who have already received the vaccine.
Students at a Phitsanulok school are treated by paramedics after they developed breathing difficulty following an HPV shot. Photo: Chinnawat Singha
Another vaccine pain
In August, a group of students at a Phitsanulok school was reported to suffer breathing difficulty after receiving the human papillomavirus (HPV) vaccine provided on the school premises. As part of Thailand's National List of Essential Medicines, which has just included the HPV vaccine last year, the vaccine was given for free beginning in August to 400,000 fifth-grade students across the country.
The news suddenly sent the public into complete shock, fearing that the vaccine would do more harm than good. After the news broke, the Department of Disease Control was quick to come out and say that the vaccine was likely not responsible because some of the students had reported breathing difficulties even before receiving the shot.
The Department of Disease Control also clarified the vaccine's side effects, stating that common symptoms are usually minor, such as redness and swelling at the site of injection. Some would develop fever and headache, while severe side effects were very rare.
Thailand is not the only country that faces public controversy regarding the vaccine against cervical cancer. Since 2013, the Japanese government has stopped recommending the HPV shot for schoolgirls, following reports of side effects among almost 3,000 cases, who were found to have headaches, nausea and fatigue, loss of memory and numbness in their hands and legs.
Inthira 'Sai' Charoenpura. Photo: Tawatchai Kemgumnerd
The anxiety queen
This is indeed a very tough year for actress Inthira "Sai" Charoenpura, who many years ago suffered post-traumatic stress disorder (PTSD) following a severe car accident, which led to significant depression. She later picked up and is now getting back on track. With her experiences dealing with mental illness that plagued not just herself but her mother, Inthira has acted as an advocate on behalf of the issue, raising public awareness regarding mental health and emphasising the importance of visiting psychoanalysts. This year she has been especially active, publishing a book on depression, and has been constantly addressing the issue on social media.
But doing good is not easy. Last month, Inthira made headlines after she was offended by a Thai newspaper that reported she had sent her mother for hospitalisation at the Srithanya mental hospital for treatment of depression and Alzheimer's. Inthira said in news reports that this time it's gone over the top and she would take it to court, as she has been defamed.
Despite all the circulated drama and offensive comments in the online world, Inthira is without a doubt an icon of strength and courage for people suffering mental disease. She is still on medication to keep her sickness at bay, and in the meantime she continues sharing stories and experiences from the perspective of a patient, allowing the public a clearer understanding.
The new excise tax on drinks with high sugar content was launched in September. Photo: Patipat Janthong
Will the 'sugar tax' help?
In the end, the long-discussed new excise tax on drinks with sugar content has been implemented, starting on Sept 16. As part of the amended excise tax act, the new "sugar tax" allows a lower tax rate for drinks that contain less sugar than the Finance Ministry's threshold sugar per 100ml. The rates are divided into three categories: 10-14% sugar, 14-18% and 18% or higher. Less sugar means less tax burden on the manufacturer.
The new excise tax on sweet beverages will have a two-year incentive period. This means that two years from Sept 16 is the duration manufacturers have been given to change their products. During these two years, they will pay pretty much the same tax rate, but from Sept 30, 2019, onwards, is a "penalty period" during which, if they still put the same amount of sugar in their goods, their products will be levied with a progressive tax rate.
Although the new tax rate is thought to have been designed for manufacturers to reduce sugar quantity in their products, which would be beneficial to consumers, health advocates underline the importance of non-tax measures, too, because in the long run people's awareness is equally essential to helping them cut their sugar intake.
Prognosis for 2018
Dr Thidakarn Rujipattanakul, anti-ageing specialist and founder of Pleasehealth Books, predicts health and exercise trends that might rule next year.
1 Fitness gamification
The new exercise challenge for 2018 is fitness gamification, wherein game rules and principles are applied to non-game contexts. This can mean group exercises that involve competitions, speed or endurance challenges, score-collecting, or other fun game elements. This way, the exercise not only improves health but encourages friendships.
2 Edible flowers
Flowers have been incorporated in food for quite some time, but it is predicted that this culinary trend will turn into a health trend, given that petals from some certain species are rich in antioxidants. Dishes with flowers can also be photogenic, which is particularly important to people in the age of Instagram.
3 Source-specified ingredients
Supermarkets in the United States, such as Whole Foods Market, have implemented a new policy to state how their products are sourced, which has garnered positive feedback. Some supermarkets in Thailand, such as Lemon Farm, also have such a policy. More fresh-ingredient market sellers are expected to declare not just their sources, but their distributors as well as providing a short story on how they are produced, to help ensure safety and add value to their products.
4 Genetic medicine
Technological advancement will certainly allow diagnosis and treatment at the genetic level, which will also become more affordable. One day, genetic screening will be part of a basic physical examination.
5 Telehealth
The proliferation of health-tech start-ups in Thailand is a force for the possibility of telemedicine, wherein a doctor's visit doesn't necessarily mean an in-person examination. It's healthcare from a distance. Despite certain limitations, in the future networks of health data will be built, allowing doctors to assess a patient's body temperature, blood pressure, body mass index, etc, more deeply and accurately.
