Technical Collaboration to Strengthen Bangkok Metropolitan Administration Capacity to Detect, Prevent, Respond, Monitor, and Mitigate The Effects of Public Health Threats In The Kingdom of Thailand.

health behaviors, health care services and systems in Bangkok; (b) design, development, and implementation of standard procedures and practices for high-quality services by BMA health facilities and laboratories; and (c) capacity building and mentorship of BMA health care workers, laboratory staff, strategic information (SI) experts, and program managers to implement, monitor, and continuously improve the quality of those procedures and practices so as to enhance prevention, detection, response, and preparation for public health threats. Achieving those goals in Bangkok requires a multifaceted approach that embraces all partners. For more than 20 years, BMA and CDC have collaborated to strengthen public health infrastructure and capacity in Bangkok. These efforts have helped control the spread of HIV and other infectious diseases, increased access to quality diagnosis, care, and treatment for communicable and non-communicable diseases, and strengthened surveillance and use of evidence to guide public health decision-making and financing in the Bangkok area. Over the past four decades, Thailand has undergone significant social, economic and demographic changes. Demographic changes have resulted in an increasingly aging population structure, as well as increased exposure to non-communicable disease (NCD) risk factors, such as poor diet, sedentary lifestyle, tobacco consumption and harmful use of alcohol. Infectious and emerging infectious diseases continue to be serious public health issues impacting Thailand and the Mekong region - extending globally as more people travel. Antimicrobial resistance (AMR) is a rapidly growing public health threat in Thailand. Rising gram-negative bacterial resistance and antibiotic overuse have led to development of a National Strategic Plan to prevent and control AMR. Thailand has identified AMR as one of the national public health priorities. In 2019, the estimated number of people living with HIV (PLHIV) in Thailand is 470,000, with approximately 17% (78,866) of them living in Bangkok. Overall HIV incidence in Thailand has decreased, but incidence and prevalence remain high among key populations, particularly in larger urban areas such as Bangkok and among men who have sex with men (MSM), transgender (TG) women, and sex workers. Among MSM, HIV prevalence in Bangkok declined from 20% in 2014 to 10% in 2018. Based on the Asian Epidemic Model, the estimated number of new HIV infections in Bangkok were 1,063 (22%) of the 4,855 new HIV infections in Thailand in 2020. The ability to achieve HIV epidemic control in Bangkok is constrained by multiple health systems (e.g. several public entities, private health care service providers) that do not provide an integrated continuum of HIV prevention, HTC, care, treatment of HIV and co-infections (tuberculosis, sexual transmitted infections, hepatitis infections), and support services that respond to the needs of PLHIV including priority populations ((PPs) men who have sex with men (MSM), Transgender (TG) women and their partners and People Who Inject Drugs (PWID). Overcoming this requires implementation of standards for same-day, high-quality, patient-friendly HTC including online to offline testing, index testing, and self-testing, with immediate referral of PLHIV and PP to care and initiate same-day/rapid ART, promote retention to treatment and continuity of care, , accompanied by greater capacity of health care workers (HCWs) and laboratory staff to implement, monitor, and continuously improve these HIV services. In addition, systematic public health responses should be established to control new infections in priority areas where PLHIV with recent infections are identified. By improving the BMA’s capacity to respond to HIV/AIDS, influenza, and other public health challenges, this NOFO will emphasize the critical role of multi-sector and regional collaboration in core domains of public health, produce sustainable improvements in areas of public health importance for both Thailand and the United States, and enable CDC to execute its global health strategies and other public health priorities in Thailand.