Since 2000, Thailand has made significant progress in reducing its malaria burden. In 2016, Thailand committed to achieve zero local transmission in more than 95% of Thailand’s 928 districts by 2021 and achieve national elimination by 2024. As part of the Greater Mekong Sub-region, Thailand is receiving Global Fund support under the Regional Artemisinin-resistance Initiative RAI2E grant until 2020.
Malaria services are being integrated into general health services under the responsibility of Thailand’s Provincial Health Offices (PHOs) and decentralized as more budgetary resources have been allocated to local administrative authorities. In the context of integration and decentralization, and with a view toward preparing for a successful transition from donor financing after RAI2E, the BVBD, UCSF/MEI, and other partners are working together on strategies to increase local ownership and resource mobilization for malaria elimination.
Two case examples documented instances where local administrative organizations (LAOs) worked collaboratively with public health entities in their areas to access funding for malaria elimination through sub-district health funds. From 2015 to 2017, USD 214,000 was approved by LAOs for malaria activities out of nearly USD 187 million available nationwide to support local health interventions. Lessons learned from the case studies appear in a “Guide to Malaria Elimination for LAOs,” which will be presented during an upcoming training for Provincial Health Officers (PHOs), select LAO representatives, and civil society from Thailand’s 42 provinces with indigenous malaria. Geo-referenced malaria data will be utilized to target specific sub-districts and develop costed activity plans. The training will subsequently cascaded to LAOs nationwide and plans will be submitted to local decision-makers in time to influence the 2019 budget cycle.
The process is expected to build capacity of PHOs/LAOs to increase the amount of funding available for elimination activities in villages with active malaria foci, ultimately bolstering program sustainability in endemic areas.