Abstract
Since 2005, a national strategic plan aimed at controling and preventing a future avian influenza (AI)
pandemic and/or outbreak of influenza in Thailand was established as a policy measure to tackle these
public health threats. The objective of this paper is to study the formulation process of two policy measures
for AI: vaccination of poultry and stockpiling of antiviral drugs for humans.
We used a qualitative approach with in-depth interviews of 38 key stakeholders from many organizations.
In addition, a literature review was carried out along with the interviews. After collecting data
from the literature and the in-depth interviews, we analyzed the emerging themes relevant to the policy
formulation process in Thailand.
We found that policy formulation concerning poultry vaccination is a very complex and politically
driven process since many stakeholders are involved with different special interests and powerful influences.
Small-scale poultry producers representing rural people are the ones who would rather use vaccine,
because non-vaccine measures, such as culling or using bio-security buildins and measures, are against
their rural culture. However, the majority of key stakeholders were against the use of poultry vaccine.
There are four major reasons: (a) evidence of vaccine effectiveness is not convincing and thus a public
health threat remains possible; (b) the government has confidence in the infrastructure needed to fight AI
outbreaks with non-vaccine measures; (c) the management system of vaccination (acquisition of goodquality
vaccine, finance, logistics, monitoring and exit program) is not fully effective; and (d) the government
implicitly wants to protect the poultry export industry. Thus, the government decided not to use
poultry vaccine.
Contrary to the poultry vaccine policy, building stockpiles of antiviral drugs for use in humans is
determined primarily by experts at the Ministry of Public Health, following World Health Organization
guidelines, but under budget constraints. Other factors relevant to policy analysis are: government leadership,
budget constraints, animal and human health co-ordination, scientific evidence and risk communication
for the public.
