Thailand - Stop TB Partnership

Laboratory network
Thailand has relatively well-equipped laboratories with few supply and maintenance problems.
In addition to the National Central Reference Laboratory (NRL), there are 167 provincial
and 678 district laboratories, all of which are equipped to perform smear microscopy,
while approximately 85 percent are capable of performing mycobacterial cultures. 133
The NTP is planning to improve the availability of TB diagnostic services by
increasing capacity to conduct cultures in provincial hospitals and by strengthening culture
facilities in regional TB reference laboratories. External Quality Assurance (EQA) activities
cover all TB laboratories in MoPH facilities, and efforts are being made to include the private
sector in the quality assurance scheme. In addition to developing laboratory capacity,
the NTP is expanding its training activities to enhance the performance of TB control and
laboratory staff in technical areas.
Drug distribution systems
Responsibility for procurement and distribution of TB drugs has been decentralized to the
provincial and district levels, 134 raising some concerns about capacity to ensure proper quality
control and effective management of drug stocks.
Procurement and quality control
Anti-TB drugs are manufactured in Thailand, but at higher cost than the drugs available on
international markets. 135 The WHO has recommended that the government should renegotiate
drug prices with the Government Pharmaceutical Organization (GPO) or explore
alternate procurement channels to make local funding for drugs more viable, and to free up
more NTP funding for other activities such as training and supervision. 136 NGOs may have a
role to play in building public support for this message through media outreach efforts.
Second-line drugs produced in Thailand are available free of charge to patients
diagnosed with MDR-TB at provincial hospitals; cases diagnosed at the district level are
referred to the provincial level for treatment services. However, international agencies have
not formally assessed and approved these drugs, which raises concerns about quality control
and requires donors to continue purchasing more expensive second-line drugs from quality-assured
sources outside of Thailand.
PUBLIC HEALTH WATCH MONITORING REPORTS 59