Integrating Kidney Health into Universal Health Coverage Beyond Dialysis: Lessons from Thailand for Southeast Asia

Purpose Chronic kidney disease (CKD) represents a growing health and equity challenge in Southeast Asia; however, kidney care remains insufficiently integrated into universal health coverage (UHC). This policy brief examines how countries in Southeast Asia can translate growing policy recognition of kidney health into financed and measurable healthcare system action, drawing primarily on Thailand’s experience. Policy Context WHO Resolution WHA78.6 has recognized kidney disease as an NCD priority requiring prevention, management, and surveillance at the national level. In Southeast Asia, its implementation faces existing barriers, including late diagnosis, high treatment costs, and a shortage of nephrologists. Thailand’s experience illustrates the potential role of UHC benefit packages for dialysis provision in the region, as well as the need to align dialysis coverage with service capacity and to invest in earlier care that prevents progression to kidney failure. Policy Recommendations Health ministries and other partners should prioritize four actions. First, develop a minimum package for kidney health that will strengthen early detection and effective treatment. Second, integrate stronger CKD screening, treatment, and follow-ups into routine diabetes and hypertension services. Third, expand the non-specialist workforce (i.e., task-sharing, standardized protocols, and specialist support). Finally, improve the routine surveillance of CKD burden, access, and outcomes. Conclusions Kidney health should be treated as an integral component of UHC rather than limited to dialysis coverage. Sustainable progress may require coordinated investments in primary care, workforce capacity, financing, specialist support, and measurable accountability.