Technical Collaboration to Strengthen and Expand Capacity to Detect, Prevent, Respond and Mitigate the Effects of Public Health Threats of National and Global Importance with the Ministry of Public Health (MoPH) in the Kingdom of Thailand

and treatment of existing diseases, and strengthened the capacity to collect and use surveillance data. Despite advances, major challenges still persist. 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. The top three causes of deaths (cardiovascular disease (CVD), cancer, and injury) in Thailand are all NCDs. Infectious diseases continue to be serious public health issues impacting Thailand and the Mekong region-extending globally as more people travel. Overall HIV incidence has decreased, but incidence and prevalence remain high among key populations, particularly men who have sex with men (MSM) and transgender (TG) women and sex workers in larger urban areas. An estimated 2.4 million migrants live in Thailand. Migrants and other mobile populations have less access to healthcare and bear a higher burden of diseases of public health importance such as TB and malaria, posing increasing strain on health systems. Emerging infectious diseases such as COVID-19 can easily spread across international borders, with continued efforts needed to enhance early detection and support control measures to prevent pandemics. The ability to achieve HIV epidemic control in Thailand is constrained by a health system that does 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) such as, MSM, TG and and People Who Inject Drugs (PWID)) and their partners. Overcoming this requires implementation of standards for innovations in HIV prevention, same-day, high-quality, patient-friendly HTC including offline to online HTC, index testing and self-testing, with immediate referral of PLHIV and priority populations to care and initiate same-day/rapid ART, promote retention to treatment and continuity of care, targeting PPs in priority provinces, accompanied by greater capacity of health care workers (HCWs) and laboratory staff to implement, monitor and continuously improve these HIV services. In addition, systemic public health responses should be established to control new infections in priority areas where PLHIV with recent infections are identified. Reducing the burden of disease and improving public health in Thailand requires a multifaceted approach. In the next five years, this umbrella cooperative agreement will facilitate collaboration within CDC and across the Thailand MoPH, emphasize the critical role of multi-sector and regional collaboration in core domains of public health to avoid duplication of effort and produce sustainable improvements in areas of public health importance for both the United States and Thailand.