Expanding capacity of non-communicable disease research and training in Thailand

Cases of non-communicable diseases (i.e., illnesses such as diabetes or cancer – NCDs) are growing worldwide, and are responsible for an increasing number of mortalities each year. This growth coincides with rapid globalisation and urbanisation in developing countries, which have brought about changes in lifestyles and eating habits: from traditional food and high levels of physical activity to western-style foods and lower levels of physical activity. The growing rates of NCDs pose a threat to the global population. In Thailand, non-communicable diseases have become the leading cause of morbidity and mortality. Yet most NCDs are preventable or treatable, which strongly indicates a need for improved healthcare and improved NCD training and research for healthcare professionals, such as nurses.

Dr Kathleen Potempa’s research background and collaboration with Thailand’s public health services in managing HIV/AIDS and their policies for NCD management led to the collaboration for this current project with Thai collaborator Dr Benjaporn Rajataramya. The project aims to provide a five-year training program to enhance the NCD research capabilities of Thai scientists including nurses and other health professionals. Additionally, the programme supports translation of NCD research into practice, enabling better care for people with NCDs and reduction in the incidence of NCDs in Thailand.

Growth of NCDs is occurring globally, causing an increasing number of mortalities every year

Past successes
As is the case with many developing countries, HIV/AIDS is a significant cause of mortality. However, the Thai government was one of the first to significantly advance their control of this disease. In 2003, a collaboration between Thai and American academic institutions was formed to manage the expansion of HIV/AIDS into more populations as well as to provide the opportunity to treat HIV more widely because of a new government policy instituting a universal health plan. This effort aimed to empower nurses within the country’s health infrastructure, ultimately expanding the capacity of the public health service to manage the rising number of cases of HIV/AIDS. This collaboration was successful – by 2009 it had expanded the capability of Thailand’s healthcare system to cope with the challenges created by infectious diseases, particularly HIV and AIDS. The infrastructure created an opportunity to consider other projects that would leverage this expanded capacity such as the rising occurrence of NCDs.

Rising NCDs
In 2011, Thailand’s public health landscape was shifting towards a growing incidence of NCDs, with a concomitant increase in mortality. As with other developing countries, this rise in NCDs was associated with urbanisation and globalisation, which promote a shift from traditional, high activity/low calorie lifestyles towards more western lifestyles, which are associated with lower physical activity and higher calorie intake. Along with this shift comes increasing risk of developing chronic diseases, such as heart disease, cancer and diabetes, which are some of the illnesses categorised as NCDs. Prior to 2012, training for treating NCDs had not been emphasised because of the primary focus on infectious diseases, injuries and other more prevalent causes of illness at that time. A study by Dr Potempa and Thai collaborators, however, found that nurses and other health professionals were not confident in their ability to care for those with cancer and heart disease, and less than half of the nurses surveyed were confident in their ability to treat more common NCDs like hypertension and diabetes. The need for more information about how to prevent and treat NCDs in Thailand was apparent.

For nurses and other health professionals, the need to refocus their research on NCDs was of increasing importance to provide evidence-based guidance to clinicians and public health policy makers in the new era of NCD prevalence. Because nurses and other health professionals with PhDs were an important part of the research workforce in Thailand, Dr Potempa and Dr Rajataramya embarked on this current programme to advance research training for expanded NCD research.

The global community will benefit from countries working together to share knowledge and effective practices

NCD research and training
To ameliorate the threat of NCDs, Dr Potempa and Dr Rajataramya’s work aims to improve the research training of nurses and other scientists by proposing a five-year post-doctoral training programme. The programme aims to provide two years of post-doctoral NCD research training for ten PhDs, offer short term NCD training for 20 investigators, and provide forums for researchers and administrators to discuss and identify ways to further NCD research in Thailand, thus strengthening the existing foundation for NCD research. This project will increase the capacity of the Thai health infrastructure to manage the increasing burden of NCDs and promote efforts to reduce and prevent their growth, ultimately improving the prevention and treatment of these diseases in the long-term.

Conclusion
Growth of NCDs is occurring globally, causing an increasing number of mortalities every year. This growth is influenced by a shift in many developing countries, associated with urbanisation and westernisation, from high activity-low calorie intake to low activity-high calorie intake lifestyles. To address this, improved training and research into NCDs needs to occur, which would allow countries to refocus their health systems and health policy on the prevention and treatment of such diseases.