Thailand Sets Out Plan to Make Longer Lives Better Lives as Ageing Accelerates

 

Public Health Ministry's Dr Ekachai Piensriwatchara outlines a five-year action plan on integrated primary care, long-term care and workforce development.

 

Thailand is committing to build a sustainable longevity society in which people live not merely longer but better, a senior health official told Nation Forum 2027: Thailand's Agenda on Tuesday (20 October 2026).

 

Dr Ekachai Piensriwatchara, deputy permanent secretary of the Ministry of Public Health, spoke in the second session, "Designing Your Health", of the fifth panel, "The 100 Year Life".

 

He said the ministry would pursue an action plan over the next five years, built on integrated primary care, long-term care and a larger care workforce, to support a fast-ageing society.

 

Thailand now has about 14 million people aged 60 or over, he said, and the figure is expected to pass 20 million within a few years, meaning roughly one in three Thais will be an older person.

 

 

Lessons from Japan

Ekachai, who studied in Japan 15 years ago and researched longevity, said the number of Thai centenarians has risen from about 8,000 to roughly 45,000, around 80 per cent of them women.

 

In Japan the figure has reached about 100,000, of whom 88 per cent are women. He said that a survey he conducted while directing the Department of Health's elderly office found that more than half of people over 60 did not necessarily want to reach 100.

 

They wanted a long life in good health. Most said that at 100 they would like to walk, socialise, earn an income, remain at home in their community, and feel valued. None wanted to be bedridden and dependent.

 

 

 

He recently attended a World Bank workshop on healthy longevity and ageing in Tokyo, one of 12 countries invited.

 

Participants agreed that a good old age rests on three pillars: good health, including preserved function and minimal dementia; economic security, including work beyond 60 to 65, supported by government policy; and dignity, meaning the ability to live as one chooses in a familiar home and community.

 

He said the chance of dementia beyond 90 is about 60 to 70 per cent, so the aim is to minimise it and reduce dependence.

 

A town ahead of its time Ekachai visited Minamiboso in Chiba prefecture, whose population has halved to 25,000 over a decade, with half now aged over 65, compared with about 40 per cent nationally.

 

Primary schools have largely closed. The mayor's goal is to keep older residents independent.

 

The town identifies those at risk of dementia or falls, which lead to bedridden status, and places them in a three-month rehabilitation programme run by several professions.

 

Care homes are almost full, so the emphasis is on enabling people to stay at home with caregivers.

 

Thailand has followed Japan in training caregivers and care managers for about 12 years but has not yet introduced a long-term care system, he said. He expects one to be introduced.

 

 

 

Eight habits of the very old

From a survey of just over 1,000 Japanese centenarians, mostly on Okinawa, he identified shared traits:

They eat quality protein, especially fish.

They keep at least 20 teeth, natural or artificial.

They sleep at least seven hours, going to bed early and rising early.

They stay active through daily life, with healthy ones walking at least 6,900 steps daily and some up to 19,000.

They have good eyesight, with cataracts or glaucoma treated.

They have never suffered a serious fall with fractures.

They do not smoke, though some drink alcohol.

They have a happy family or good neighbours.

 

One centenarian told him her motivation was not her descendants but neighbours with whom she had grown up and taken part in community activities.

 

 

Thailand's strengths and six priorities

Ekachai said Thailand has strong foundations: more than a million village health volunteers, a universal health coverage scheme that other countries praised, and nearly 20,000 nurses trained as care managers, though they are not yet a distinct specialism.

 

Volunteer nurses also support communities of all ages. Thailand adapted Japan's concepts rather than copying them, he said. After the Tokyo meeting, officials from the health, social development and national health security bodies set six priorities.

 

They are preventing loss of function and slowing ageing through screening for falls, dementia and non-communicable diseases; reaching older people who miss services, especially those living alone or as couples; integrating health and welfare, including home and community care; using digital tools and AI to find them; delivering medicines to homes; and promoting income and savings, in which the Finance Ministry is involved.

 

Ekachai noted that the state's monthly allowance for older people is small, making savings essential. He also said that the three pillars are supported by four sectors, namely family, community, government and business, which must be balanced.

 

Communities are increasingly stepping in as families shrink.

 

 

Action plan and technology

Thailand's five-year plan consists of two main parts. The first integrates primary care and welfare across the public and private sectors through early screening of at-risk older individuals, physical assessments, integrated care plans delivered by primary care teams and local authorities, and digital follow-up with data shared across ministries.

 

The second focuses on training and developing a sufficient long-term care workforce.

 

While regional neighbours like China pivot towards robotics to assist with housework and elder care, and Japan imports foreign care workers to plug demographic gaps, Thailand still has enough of its own people for the job, provided they are trained quickly.

 

Thailand’s immediate advantage lies in its human-centred community networks, but as Ekachai warned, state allowances and volunteer frameworks can only do so much.

 

Ultimately, as Thailand stands on the precipice of becoming a super-aged society, Ekachai’s closing remarks served as a compelling reminder that longer life must mean a better life.

 

Extending healthspan to match lifespan does not require expensive food, supplements or high-tech solutions but rather the accumulation of modest, daily habits cultivated long before retirement.

 

A century-long life, he stressed, should not be a distant prospect to dread, but a well-designed future to embrace—and it is never too late to start.