Funding health promotion and disease prevention programmes: an innovative financing experience from Thailand.

Sustainable sources of funding for health programmes have been explored by many countries. In Thailand, the Health Promotion Foundation (ThaiHealth) was established in 2001 as an innovative state agency for funding health promotion from the 2% surcharge on alcohol and tobacco excise tax. ThaiHealth is governed by a Board chaired by the Prime Minister. It is not part of the conventional health services. ThaiHealth explicitly pursues a "socio-cultural" rather than a "biomedical model" of health. It has fostered strategic partnerships with government, private sector, nongovernmental organizations, and communities to implement health promotion plans. In 2010, its budget was 3700 million bahts (119 million US dollars). Since ThaiHealth plays a catalytic, coordinating, empowering and enabling role, its impact can only be assessed "collectively" with all partner organizations. ThaiHealth contributed to development of several policies that led to enactment of laws and building the capacity of organizations, communities and individuals in planning and carrying out health promotion activities. The "Collective impact" includes decline in smoking among the more-than-15-year-olds from 25.47% in 2001 to 20.7% in 2009; harmful alcohol drinkers from 9.1% in 2004 to 7.3% in 2009; death rate from vehicle accidents from 22.9 per 100 000 in 2003 to 16.82 per 100 000 in 2010. The main factors leading to achievements of ThaiHealth are: flexibility, financial security and effective strategy. However, inadequate understanding among public and stakeholders about the philosophy, governance and operation of ThaiHealth is reckoned as a huge challenge.