Stay true to health goals

The axe finally fell on the Thai Health Promotion Foundation (ThaiHealth), which has subsequently sparked public concern that it is a move by the military government to clip the wings of civil society.

The purge had been written on the wall for some time now. ThaiHealth has been under attack by the government for misuse of public funds. Allegations include budget use in avenues unrelated to health promotion and conflict of interest among some board members who were involved with organisations that received ThaiHealth grants. There have been several veiled threats of the possibility of dissolving ThaiHealth altogether.

ThaiHealth executives had been summonned to testify before the Centre for National Anti-Corruption (CNAC). ThaiHealth manager Krissada Rueng-areerat resigned. Justice Minister Gen Paiboon Koomchaya, despite his initial public frowns at ThaiHealth, announced in October last year that no irregularities were found in ThaiHealth's budget expenditure.

Yet the purge rumour continued. On Tuesday, Prime Minister Prayut Chan-o-cha ended it by using Section 44 to remove seven ThaiHealth board members. All of them are from civil society and supporters of ThaiHealth's pro-people programmes. 

The ThaiHealth budget comes from the extra 2% that the alcohol and cigarette industries must pay on top of its total excise taxes each year. The so-called sin tax is earmarked to reduce drinking and smoking as well as to promote other health issues, the environment and social well-being.

Founded in 2001, ThaiHealth was a model for independent state agencies with public participation. While 11 board members are from different ministries, eight are representatives from civil society. Many fund recipients are community organisations and non-government organisations. It is in line with the World Health Organisation's strategy to emphasise the roles of non-health sectors and a socio-ecological approach to public health. 

The government's unhappiness with ThaiHealth is understandable. Many of the state's megaprojects affect local communities' health and environment, which face opposition from several civic groups and some media outlets that are recipients of ThaiHealth funds.

Meanwhile, many government officials are also close to the alcohol and cigarette industries. Dissolving ThaiHealth will save the extra sin tax they have to pay. Civil society will be weakened subsequently, so hope state authorities.

Attacks on ThaiHealth are not an isolated attempt. Thai PBS public broadcasting service, another recipient of the sin tax, has also been targeted by the government for its reports critical of government development policies and projects. 

The ThaiHealth controversy is also rooted in fierce conflicts between the Public Health Ministry and public health reformists who are now running huge universal healthcare budgets and are the main drivers of ThaiHealth. 

Attacks by public health authorities on the universal healthcare system and ThaiHealth are viewed as attempts to bring the 141-billion-baht universal healthcare system now managed by the National Health Security Office (NHSO) and ThaiHealth's 5-billion-baht budget under their old bureaucratic control. 

Indeed, ThaiHealth must be subject to stricter financial monitoring. Any conflict-of-interest loopholes must be fixed. Whether ThaiHealth can move forward more transparently also depends on who will be handpicked as the ThaiHealth manager to replace the ousted representatives of civil society.

The government cannot go wrong if if stays true to ThaiHealth's original mission -  to strengthen people's participation and to promote well-being that goes beyond good physical health to include a healthy society.

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Position: Bangkok Post editorial column