Definition of health promotion fund
Health is a fundamental human right. The concepts and principles of health promotion initially discussed in 1984 have been developed throughout the years. Many countries are struggling to preserve the healthy lives and well-being of their populations, facing an increasing burden of healthcare costs due to the escalating number of non-communicable diseases (NCDs).
Globally, the human toll of non-communicable diseases (NCDs) is on the rise due to changing lifestyles and aging populations. It is responsible for 41 million (71%) of all deaths worldwide annually. More than two-thirds of these deaths (77%) are in low- and middle-income countries (LMICs). NCDs are the leading cause of preventable death and disability with enormous costs, causing significant losses in human capital (health, education, skills) development. This undermines workforce productivity, perpetuates poverty and inequalities, and threatens the development of national economic growth.
Public health is about more than focusing on health care; prevention and health promotion are important components of improving and saving lives. Health promotion is the process of enabling people to increase control over their own health. It covers a wide range of social and environmental interventions that are designed to benefit and protect individuals’ health and quality of life by addressing the root causes of ill health, not just focusing on treatment and cure. These include community development and mobilization programmes, advocacy for healthy public policies, programmes supporting healthy individual behaviors, and reorientation of health services to better address health challenges. These are the basic principles of health promotion programmes consistent with the 1986 Ottawa Charter for Health Promotion.
Health promotion programmes are recognized as cost-effective interventions to diminish the impact of all major NCDs and mitigate economic and social burdens. However, the escalating prevalence of NCDs often outweighs the preventive health measures taken by most countries.
Health promotion services and programmes require durable, dedicated and sustainable funding. It has been a less-than-promising journey as most health promotion budgets are solely dependent on the annual government budget allocations that are often limited, vary from year to year, and cut when resources are constrained. Government funding for health promotion initiatives often pales in comparison to that provided for curative acute health care. As a result, health promotion programmes are inadequately staffed and severely under-resourced in most countries. And setting up a health promotion fund or foundation is not a magic bullet; it can pose coordination and public sector stewardship challenges.
An effective way to generate a sustainable stream of revenue using fiscal measures (not necessarily limited to or originating from the health sector) is raising tobacco excise taxes or introducing a surcharge tax, and dedicating some of that revenue to a health promotion fund or foundation.
The Thailand Health Promotion Foundation (ThaiHealth) acts as a catalyst for accelerating innovative ideas with proactive and flexible grants and a diverse multi-sectoral network of government, public and private sector, and civil society partners. ThaiHeath has adopted three approaches to leverage its fund:
the power of knowledge where activities create evidence in health promotion.
ThaiHealth funds a number of semi-autonomous institutes under the Ministry of Public Health, which produces evidence for health policies and economics.
- the power of politics where activities develop laws, policies and regulations in health promotion.
- ThaiHealth funds government committees to accelerate their policy development process, an example being the national health assembly which is an alternative mechanism to discuss health issues and provide recommendations directly from civil society to the cabinet.
- the power of social movements where activities empower civil society to promote health.
ThaiHealth provides grants to civil society organizations and mass media, in addition to owning 30 resource centres that assist civil society in applying, using and accounting for its funds efficiently and appropriately.
References
World Health Organization (1984). Health promotion: a discussion document on the concept and principles: summary report of the Working Group on Concept and Principles of Health Promotion, Copenhagen, 9-13 July 1984. Copenhagen : WHO Regional Office for Europe. Available at: https://apps.who.int/iris/handle/10665/107835
World Health Organization. (2021). Noncommunicable diseases (Online). Fact sheet, 13 April 2021.
Schang L K., Czabanowska K M., Lin V. (2011). Securing funds for health promotion: lessons from health promotion foundations based on experiences from Austria, Australia, Germany, Hungary and Switzerland. Health Promotion International, Vol. 27 No. 2. doi:10.1093/heapro/dar023
World Health Organization. (2010). The World Health Report: Health Systems Financing. Geneva, World Health Organization.
Carroll A., Wood L., Tantivess S. (2007). Many Things to Many People—A Review of ThaiHealth. Thai Health Promotion Foundation, Bangkok, Thailand.Watabe A, Wongwatanakul W, Thamarangsi T, Prakongsai P, and Yuasa M. (2017). Analysis of health promotion and prevention financing mechanisms in Thailand. Health Promotion International, 2017;32:702–710. doi: 10.1093/heapro/daw010