Post COVID-19 Thailand needs power decentralization for national reform

                         The health crisis resulted from the coronavirus disease 19 (COVID-19) is a great challenge of humanity including Thai people. The best thing that we should do now is to try to survive this crisis and not let the economic damage and the troubles we are facing go to waste. We should learn, look forward to the Post COVID-19 era and find opportunities in this crisis to develop a better society.

                         As all Thai people are concerned about the grave health crisis, the National Health Commission Office (NHCO) would like to share a viewpoint from Dr. Prateep Dhanakijcharoen, Secretary-General of the commission, who leads the organization that has been tasked with promoting a process of participatory public health policies based on wisdom for over 10 years to create a “well-being society”.

                         NHCO together with many organizations have been following up the COVID-19 crisis and drawing lessons from it. Dr. Prateep has spoken of the evaluation of the COVID-19 situation and the work of NHCO to support government measures and relieve people’s hardships. It has drawn lessons and looked forward to applying them for the implementation of public policies in the future.

Great negative impacts – years of economic slowdowns to come

                         Giving the overview of the situation, Dr. Prateep said that the COVID-19 crisis created enormous impacts because it was a pandemic. Both negative and positive impacts are noticeable. The negative ones are as follows.

                         1. Regarding health impacts, the number of patients and the death toll are huge and medical personnel have to work harder.

                         2. As for social impacts, people panicked and created disunity and discrimination at the beginning of the pandemic.

                         3. Economic impacts are great because Thailand depends on exports and tourism. The International Monetary Fund predicted the gross domestic product of Thailand would plunge by 6.7%, showing a serious economic downturn.

 

                         This shows that the COVID-19 crisis affects national security. The impacts can last 2-3 years, or even as long as a decade for some sectors. Fortunately Thailand is a food source of the world and will not suffer starvation. This is its advantage compared with situations in many other countries.

There is a wide range of positive impacts. People’s empowerment can proceed.

                         Dr. Prateep said there was a light in the dark as there were also the positive impacts of the COVID-19 crisis.

                         1. The COVID-19 crisis has proved that the health and public health systems of Thailand are capable of defense, proactive work and epidemic control. In urban areas, we have strong medical personnel. In remote areas, infection prevention is highly effective. Communities have strong public health fundamentals comprising 1 million health volunteers in villages, nearly 10,000 sub-district hospitals, and 700-800 hospitals ready to treat patients.

                         “If lessons are drawn from the positive impacts, there will be huge investment in enhancing the capabilities of primary health care and community health systems. Conventionally our resources have gone mainly to large-scaled hospitals in Bangkok and major cities. The COVID-19 crisis shows that there is health capital in communities. If more investment goes to a community level, the Thai health and public health systems will considerably benefit in the future.”

                         2. The COVID-19 crisis lets us see people changing from “Fright to Fight”. People make great learning to cope with the pandemic, take care of themselves and practice social distancing. If this continues, people will be empowered, their networks of volunteers will be strengthened and their measures will be scaled up and used to take care of each other in the future.

                         3. The COVID-19 crisis results in a creation of “people’s charters” for their fight against the virus. People create their own measures under the name “people’s charters” which correspond to government measures to handle the pandemic. Their measures give importance to public health and social measures. Vulnerable people in communities such as elderly people, young children and people suffering chronic diseases are well concerned to prevent from the virus.  Food donation and food security are also thought-out. These charters can be developed into other charters, for example, natural disaster responses and other epidemics control. This is a very important step of community empowerment.

                         4. The COVID-19 crisis raises more public awareness of the importance of “power decentralization”. Provincial governors and local administrative organizations have been authorized to introduce their own measures that accelerate the implementation of the measures which the government initiated under the executive decree on public administration in emergency situations and the Communicable Disease Act of the Ministry of Public Health. Local authorities can speed up measures’ implementation because they are able to mobilize people. If the government had centralized power, it could not have been able to solve problems so swiftly. This is an obvious change.

                         “Therefore, these situations have positive impacts. People are active and have initiated their own measures. The society realizes the importance of power decentralization which may lead to national reform in the future,” the Secretary-General of the National Health Commission spoke of his hope.

From the “Active Citizens” project to power decentralization

                         On the roles of NHCO in implementing the “Synergy of Active Citizens to Support Country against COVID-19” project together with partners, Dr. Prateep mentioned the idea that led to the project and expectations. He said that it was aimed at complementing the government’s main measures for COVID-19 control and rehabilitation of people’s living and economy, so that the government measures would be brought into effective implementation, reach out people and gain tangible results.  NHCO and partners work at a sub-district level as it is an efficient strategic location where the government and people sector work interlinked.

                         On the synergy-of-active-citizens project, Dr. Prateep said it integrated the tasks, networks, instruments and budgets of key organizations on health sector, social sector, administrative sector, mass media and Buddhist monks to help local networks and support people in villages and sub-districts in reaching agreements or “Charters to fight COVID”. This is aimed at empowering people to make decision and take action on COVID-19 control and prevention and relief of COVID-19 impacts.  People are expected to improve their understanding about power decentralization and political reform will follow COVID-19.

4 lessons Thai society draws from the COVID-19 crisis

                         Asked finally what the Thai society learned from this crisis and how it can cope in the future, the Secretary-General of the National Health Commission gave quick and serious answers as follows.

                         1. The society is aware of risks. Both the rich and the poor face the same degree of present and future risks. Various, serious and life-threatening risks can emerge anytime. The impacts of COVID-19 are widespread. Therefore, the Thai society must be ready to cope by developing good systems and ensuring public participation.

                         2. The society has learned that health, social, economic and political problems are not separate but are interconnected. When an epidemic breaks out, impact is arisen in all dimensions. Investment for health is consequently as important as economic investment. Only economic investment is not sufficient anymore.

                         3. The society has learned that centralized solution making is unable to tackle both health and economic problems. Provincial governors and local organizations must have power to ensure swift and efficient solutions.

                         4. The society has learned from the crisis that there is income inequality and clearly divided opinions. The urban middle class wants strict control and curfew because they can afford to comply. Meanwhile, another group of people want to continue with their work; otherwise, they cannot survive. The gap between these two groups of people is clear and there should be a compromise to prevent their confrontation.

                         “Personally I think that although the pandemic will be alleviated, people of the new generation will not let adults deal with problems alone as they did. They want to solve problems and participate in decision making. I believe that the Thai society will change in the Post COVID-19 era because Thai people have learned a lot from the crisis.” Dr Prateep concluded.

                         In the complete darkness amid the COVID-19 crisis, everyone feels impacts. The perspective of the Secretary-General of the National Health Commission lets us see the opportunities of positive changes. If today’s lessons are recorded and systematically drawn, it will become evident that power decentralization and the right allocation of resources will lead to national reform.