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Success has too many
fathers to allow us to ascribe parentage to a few institutions, but
without claiming that Thailand’s accomplishments in economic policy
making and public health spring directly from its premier universities
in those fields, Thammasat and Mahidol, it may be useful to consider
some of the ways they contribute to national achievements and then to
focus on how these institutions developed.
Our purpose is to
concentrate not on what is unique to the Thai experience, but on what
has been done that could perhaps be done elsewhere, both through foreign
assistance programs and through wise domestic policies. We are
interested in identifying the ways in which Thai leaders were able
utilize resources available domestically and through foreign assistance
mechanisms to build strong institutions, and especially in how they have
succeeded in sustaining and enhancing the institutions after the
assistance programs phased out. We also wish to consider the need to
define new mechanisms for future cooperation if maximal mutual returns
on these achievements are to be gained.
II.
BACKGROUND
Although respect for
modern knowledge has been widespread since Meiji times, opinions about
the means of acquiring and using this elusive commodity have changed
frequently over the intervening years. The Japanese relied more upon
translations than do later day developers, but virtually all serious
attempts to modernize begin with a substantial investment in overseas
education.
Overseas education for
a time plays the R&D role for a developing country; it is a primary
source of new methods and technologies. Reliance upon the direct
transfer of knowledge and techniques from industrial to developing
countries has familiar hazards, however, and the necessity for field
research and the adaptation of knowledge to local conditions has been
recognized at least since Walter Reed braved Panama.
The discoveries of
high-yielding varieties of cereal grains and of oral rehydration therapy
(ORT) conclusively demonstrated the value of conducting high-quality
research on location in developing countries, but these successes for
the most part occurred within the confines of enclave research
institutions controlled by scientists from abroad. The Rockefeller and
Ford Foundations set up and ran CIMMYT and IRRI before the Consultative
Group for International Agricultural Research (CGIAR) shared the burden
among a variety of donors, and the US Navy supported much of the field
research which culminated in the discovery of ORT at the Pakistan/SEATO
Cholera Research Laboratory in Dacca.
A case could be made,
perhaps, for the industrialized countries to conduct the bulk of the
research needed on Third World food production and disease problems
under some sort of international division of labor, but this would fail
in practice even if it were somehow accepted in principle. The world’s
largest medical research budget, that of the US National Institutes of
Health (NIH), devotes no more than 5% of its funds for maladies
primarily of concern in the tropics.
Even if budgetary
limits were overcome, understanding the social and cultural settings for
illness can be as critical as mastering its biological aspects. Even
simple and effective remedies such as ORT require adaptation to fit the
cultural and social context of dealing with diarrheal illnesses.
The need for each
country to have its own health research system has recently been defined
and affirmed by an International Commission on Essential National Health
Research, and the case for creating indigenous capacity for analyzing
and dealing with national problems in other fields is no less accepted.
The development of
local problem-solving capacities in health, agriculture, economics and
other dimensions of national action would seem to be an obvious arena
for international cooperation, and so it is, but just how this capacity
can be created remains a challenge in many countries. The role of
universities continues to be controversial among development
strategists. Universities can be and often are remote from the realities
of poverty and disease, expensive purveyors of higher education of
doubtful relevance and merit.
Without suggesting
that universities need be the primary research institutions in a
country, or that Mahidol and Thammasat are the only successful
universities in Thailand, the experience of these two institutions in
developing high-quality research and teaching capacities, and the part
played in their success by foreign assistance, seems worthy of
attention.
III.
WHY THAILAND?
Thailand’s economic
and social success is particularly encouraging for other countries
because the Thais have demonstrated that it is possible to succeed
without massive external assistance or the discovery of oil riches.
Thailand has benefited from enlightened and effective foreign assistance
in institution-building from both private and public sources, as these
papers are intended to demonstrate, but foreign aid played a relatively
minor role in the overall success of the economy.
By comparison with
Taiwan, where US aid averaged $10 per capita for many years and made up
34% of gross investment, assistance in Thailand was seldom more than $1
per capita and averaged less than 1% of total investment. Whereas US aid
averaged 6.4% of Taiwan’s GNP between 1950-1970, and was 10% in the
initial years, in Thailand during that period it averaged 0.7%.(1)
The Thai economic
achievement as not been as spectacular as that of Taiwan, Korea, or the
other Asian Tigers, Singapore and Hong Kong. Indeed, in 1965 Thai per
capita income exceeded that of Korea, and in 1985 it was only a third of
Korea’s(2), but the rate of growth has been impressive, relatively
constant, and healthy in terms of diversification.
In the 1950s, when
Thailand’s national income accounts were first being estimated, its
per capita income, as in many developing countries, was well under $100
per year. During the 1950s, the Thai economy grew by a respectable rate
of over 5% annually, and this increased in the 1960s to an 8.4% annual
average. The oil price shocks of the 1970s hit Thailand relatively hard,
but the economy still grew by an average of 7% per year during that
decade.(3)
Much of this early
success was due to a continuous expansion of agricultural exports, some
of which took a heavy toll of tropical forests, and import-substitution
manufacturing. During the first part of the 1980s, oil and commodity
price shocks set the economy back, slowing growth and leading to rising
debt and austerity. In the second half the of l980s, however,
Thailand’s performance has been spectacular, including a 40% annual
increase in manufactured exports, a 30% annual growth rate in total
exports, and an overall double-digit GDP growth rate.(4)
The shift in export
composition is particularly significant. The Thai economy was initially
dependent upon a narrow range of primary commodities, chiefly rice,
rubber, teak and tin. In 1971 manufactured goods accounted for only 10%
of exports, and as recently as ten years ago, primary products
constituted two-thirds of exports. Now over 60% derive from
manufacturing.(5)
A recent analysis by a
team of economists at TDRI goes in some depth into the sources of the
recent export-led growth, its effects on the economy, and prospects for
its sustainability. Of interest to us here are less the factors that
caused the growth than those that did not. Contrary to what one might
expect, neither increases in world demand for traditional Thai products
nor a growth in foreign investment provides the explanation for the Thai
success, although both were positive factors. The authors credit instead
the Thai ability to take advantage of favorable domestic and
international economic circumstances (such as slowing of the expansion
of extensive agriculture, developing the manufacturing sector, producing
a skilled workforce, and creating economic infrastructure), and
responsive macroeconomic management (a reasonable exchange rate,
responsible fiscal and monetary policies, etc.).
In other words, the
Thai economic success over the years, and particularly recently, is
home-grown. It is less the product of natural or donor benevolence, or
of fortunate shifts in the terms of trade of its traditional products,
than of local abilities and sound policies. Our interest here is to
learn what we can about how those local abilities and sound policies
came into being.
In the population and
health sector, Thai accomplishments are no less outstanding. The rapid
reduction in fertility rates accomplished in the course of three decades
is regarded in the literature as a demographic revolution(6). The annual
population growth rate declined from a peak of over 3% in the early
1960s to around 2% at the end of the 1970s, and is expected to reach
1.6% by the end of the century.(7)
Similarly, the health
status of the Thai people has improved greatly as evidenced by available
indicators of health status: life expectancy at birth, infant mortality
rates, nutrition status of infants and children under five, and leading
causes of death and illness.
Life expectancy at
birth has increased by five years since 1965 and is projected to
increase another five years, to over 65 for both male and female, for
the generation that will be born after the year 2000. Infant mortality
rates have dropped by half or more since 1965 to a national average of
45 per 1000, although regional disparities persist. Leading causes of
death have shifted in twenty years from diarrheal diseases, tuberculosis
and pneumonia to accidents, heart disease and cancer. These statistics
compare favorably with countries at the same and, higher levels of per
capita income.(8)
These achievements,
too, have many fathers, including an unusually effective Ministry of
Health, an outstanding population and family planning program, and
strong medical education and research institutions. Although it is not
possible or even desirable to try to allocate credit for improved health
status among the participating institutions, it is more plausible to
credit research and training institutions with success if their
societies are doing well in the areas in which the institutions
specialize than if they are not.
Nor are Thailand’s
successes in economic growth and health status improvement cause for
complacency. Income distribution is seriously skewed, particularly by
region, and many people in rural areas have scant access to health care.
The point is not that all problems have been solved; it is that solid
institutional capacity for analyzing and dealing with problems has been
created from a relatively rudimentary base in a remarkably short time.
We need to learn what we can about how it was done, under what
conditions it might be replicated elsewhere, and what future linkages
between Thai and US institutions would make sense in the post—aid
period.
IV.
ORGANIZATION OF THE INQUIRY
The topic is, of
course, unmanageable. But since our purpose is to learn what we can
about how institutional research capacity was successfully created in
Thailand, with US assistance, and what avoidable mistakes may have been
made in the process, we invited two senior researchers, and research
administrators, to discuss the evolution of their institutions and the
part played in it by US assistance.
This initial paper is,
then, devoted to defining our purpose and describing some of the
mechanisms through which assistance contributing to research
capacity-building has been channeled to Mahidol and Thammasat
Universities over the past thirty years. The description is not
encyclopedic, nor is it evaluative; it is meant to provide a backdrop
for the other papers in this series.
The author of the
second paper, Professor Natth Bhamarapravati, has been Rector of Mahidol
University since 1979. He is a pathologist with a D.Sc. from the
University of Pennsylvania and was the first chairman of the Department
of Pathology in the Faculty of Medicine at Ramnathibodi Hospital. He
served as Dean of the Faculty of Graduate studies at Mahidol from 1973
to 1980. He has remained active as a researcher throughout his
distinguished career in academic administration and continues to be a
leader in the field of dengue vaccine research. Dr. Natth’s
observations on strategies for institutional development that have
benefitted Mahidol University are thus based upon a wealth of first-hand
experience.
Professor Praipol
Koomsup has been Vice-President for Academic Affairs of Thammasat
University since 1988. He is an economist with a Ph.D. from Yale
University in 1978, He served as Chairman of the Research Committee of
the Faculty of Economics at Thammasat from 1979—82, and was Dean of
the Faculty from 1986-88. Dr. Praipol publishes extensively in the areas
of energy policy and economic development. His observations on
strategies for institutional development benefiting Thammasat University
are similarly based upon long personal experience.
The fourth paper, by
Dr. Charles Myers, Jr., provides a contextual perspective to these
accounts of institutional development by discussing changing labor and
employment patterns, the structure of the education system, and policies
through which the Thai authorities dealt with pressures for rapid
enrollment increases in a period of budgetary constraint. Dr. Myers is
an economist with a Ph.D. from Princeton University, who is currently
Acting Director of the Health Office at the Harvard Institute for
International Development. He is a frequent consultant to TDRI and was a
resident researcher there from 1985 to 1987.
Part V will eventually
contain a summary of lessons gleaned from the preceding papers that may
be of use to other countries trying to strengthen their economic and
health research systems, and a discussion of bilateral and international
linkage mechanisms that will continue in the post—aid era, or which
might need to be created. This concluding section will be prepared
following the Princeton Conference. In the present version, some
preliminary ideas along these lines are put forward for discussion by
Conference participants.
V.
MECHANISMS OF COOPERATION
In choosing to look at
the development of institutional research capacity in Thailand, we are
fortunate that so much evaluative literature already exists. Among the
sources drawn upon most extensively for this paper are the following:
1.
Thailand and the United
States: Development, Security and Foreign Aid by Robert J. Muscat.
This book, published in 1990 by Columbia University Press, contains a
full account of the US contribution to Thai development through the
development assistance program.
2.
“Thailand,” a chapter from an unpublished review by the late
James Coleman of the University Development Program of the Rockefeller
Foundation, written in 1984.
3.
“Thailand: Evaluation of USAID’s Centrally-Funded Science and
Technology Grants Program,” prepared for USAID by William Krebs,
Anthony San Pietro, and Jaroon Kumnuanta in June 1989.
4.
“Mid-Term Evaluation of the USAID/Thailand Science and
Technology for Development Project (STDP),” prepared for the STDP,
Ministry of Science, Technology and Energy of the Royal Thai Government
by Ronald Black, Albert B. Van Rennes, Burapa Atthakor, and Suchitra
Punyaratabandhu-Bhakdi, in March 1990.
A.
The University Development Program of the Rockefeller Foundation
For nearly two
decades, beginning in 1963, the Rockefeller Foundation invested
substantial resources in seven universities on three continents,
certainly the most ambitious higher education development program by a
private institution since the Foundation’s major effort at the Peking
Union Medical College. Three of the seven beneficiary institutions were
in Thailand, and they received a total of $28 million, or 24% of the
total expenditures.
The Foundation
didn’t intend to invest in three Thai institutions; it held to the
notion that synergetic gains were available from the creation of strong
faculties of agriculture, life sciences, humanities and the social
sciences in a single institution, and its officers tried in vain for a
year and a half to bring about the amalgamation of Kasetsart, the
University of the Medical Sciences (which became Mahidol in 1969), and
Thammasat into a single university. The circumstances in Thailand did
not meet the UDP criteria in other ways as well: sound and effective
academic leadership with which to cooperate was not evident at two of
the institutions, disciplinary strength was lacking in key areas of
concentration, and, in two cases, no other donor was available to share
the financial burden.
In the end, the
Foundation overrode its own misgivings and made major investments in the
Thai institutions. In part, perhaps, its flexibility reflected the long
history of the Foundation in Thailand, extending from a campaign against
hookworm and environmental sanitation which began in 1916, through nine
years of support for the Siriraj Medical School at Chulalongkorn
University beginning in 1923, and continuing support for agricultural
research and education at Kasetsart University, which had begun in 1955.
Thailand’s proximity to the turbulence in Indochina and Red China, and
its pro—Western orientation, may have added a geopolitical
consideration, but that hardly seems necessary to justify the choice.
Interestingly, when
Coleman and others came to review and evaluate the UDP investment in
Thailand, they found that solid academic leadership was in fact present
when the program started, and that the absence both of other donors and
of disciplinary traditions on which to build were factors contributing
to the program’s success. Starting nearly from scratch at Thammasat
and the University of Medical Sciences (Mahidol) had its advantages.
1. The
Faculty of Science, Mahidol University.
The initial RF commitment at Mahidol was to train preclinical and basic
scientists, not to train physicians, although the end result was hoped
to be better-trained physicians in other Thai schools. When the program
began, there was no medical school at Mahidol, but in 1966 a Faculty of
Medicine was established next door to the Faculty of Science at
Ramathibodi Hospital. Even within the Foundation, there was debate over
whether the American model of research tied to medical schools was
appropriate for a developing country institution such as Mahidol.
When the Faculty of
Medicine at Ramnathibodi was established, the RF expanded its commitment
to include responsibility for introducing community medicine into the
curriculum. In a sense, the Foundation was then straddling the
appropriateness issue by supporting both the development of a strong
science faculty in the Western tradition and the practice of community
medicine in rural areas.
The RF investment in
Mahidol was massive in its day, as it would be now. Thirty promising
candidates were initially selected by a Thai dean and awarded doctoral
fellowships in American universities. Twenty-seven of these completed
their training.
The number of
scholarships awarded to prospective Mahidol Faculty members by the
Foundation eventually reached 80, but only the original 30 were for the
life sciences. Six went to other departments in the Faculty of Science,
22 to nursing, 10 to the Ramathibodi Medical Faculty, 5 to the Institute
of Population and Social Research, and 7 to social sciences and the
humanities.
While the first group
of scholars was in training, 22 members of the Foundation field staff
were assigned to six life science departments. Those selected to head
departments were asked to make a commitment to stay until qualified Thai
scientists were available to replace them. In all, the 22 scientists
served a total of 120 years in Thailand, five as acting department heads
for periods of six to nine years until the return and full integration
of Thai successors.
The Foundation spent
twice as much on resident staff as on foreign training, which might be
considered disproportionate, but Coleman found their contribution to
setting the pattern for teaching courses and organizing curricula to
have justified the heavy investment. By 1975, the academic staff of
Mahidol was entirely Thai, and by 1978 all of those who had returned
were still in their departments, three as chairmen. They were highly
productive, world-class scholars, averaging more than 50 papers per year
in international professional journals.
The cost of the RF
effort at Mahidol under the UDP was $13 million, around 10% of the total
program worldwide. In addition, RF continued to support research at
Mahidol at an annual rate of $80,000 after the UDP phased out in the
mid-1970s. In today’s dollars, the investment would be equivalent to
slightly over $40 million, based upon the consumer price index as
reported in the US Statistical Abstracts.
The achievements of
the program have been impressive. As planned, the Faculty of Science
serves as a national center for graduate studies and cadre formation in
the life sciences. Coleman found that a substantial majority of Thai
scientists serving in provincial Thai universities received their
graduate training in life sciences from Mahidol. Research output remains
prodigious, and the Faculty attracts funds from more than 20
international funding agencies.
The one major
objective not reached is that of establishing Mahidol as a regional
center of excellence in the life sciences for Southeast Asia. After the
UDP phased out, external scholarships were abolished and Thai
increasingly became the language of instruction. The few non-Thai
students in the Faculty diminished to none.
Coleman identifies the
following principal ingredients of success:
a.
A concrete, detailed plan of action, with specific measurable
objectives and carefully scheduled activities, was mutually agreed
before the program was launched and was adhered to at every step.
b.
The Thais scrupulously fulfilled all of their undertakings in the
collaboration. Two successive Thai rectors, spanning the 15-year period
1964-79, gave the program strong support. Buildings and physical plant
were provided on schedule, appropriations for recurrent budgets were
dependable, and the University library budget was significantly
augmented as Foundation support phased out.
c.
The RF provided full funding for fellowships, field staff,
scientific equipment, and library equipment. A senior RF scientist
served in Thailand for 13 years as RF representative, helping with the
planning and implementation of the program.
d.
The Thai authorities provided attractive and competitive working
conditions for returning scientists. Each had an established position to
return to, salary supplements were available for meritorious teaching
and research, research opportunities were abundant, and the research
environment made the meaningful pursuit of a professional scientific
career both possible and rewarding. On average, the returning scholars
were able to spend half time on research.
The level of commitment brought to the enterprise by both the
Thais and the Foundation was if anything more impressive than the
magnitude of the funds provided.
2. Thammasat
University. Although Thammasat University is Thailand’s
second oldest, the RF program there, which came to be centered on the
Faculty of Economics, also began largely from scratch. When the program
began in 1964 there were almost no full time faculty members. The
institution was, however, already in the midst of a transition from an
open-admission “people’s university” to a quality institution with
reduced enrollments and higher standards, under the leadership of a
dynamic Secretary-General.
As with Mahidol, RF
was the only donor on the scene for much of the life of the program. The
initial approach to institution-building differed from the Mahidol case,
however, in that the Foundation had no predetermined disciplinary
preferences. Fellowships were awarded to the most promising candidates
from wherever they could be found in the humanities and social sciences.
No step—by—step university development plan was devised, nor were
field staff appointments made to coincide with overseas fellowships.
Some of the early fellowship awardees later became noted in the fields
of drama, poetry, and the philosophy of science. Many became leaders in
the governance of the University.
To some, Thammasat may
have been a surprising choice for work in humanities and the social
sciences. The older Chulalongkorn University was more prestigious, and
Thammasat had a reputation for social commitment and volatility, often
in its history having been at the center of political activity, which
could have put the Foundation off. Foundation executives decided,
however, that Chulalongkorn was too traditional and conservative to
respond well to external stimuli, and Thammasat’s role in producing a
majority of the country’s higher civil servants and teachers in other
Thai universities made it a particularly attractive institution with
which to work.
Not long after the
program commenced, it gravitated increasingly towards a focus on the
Faculty of Economics, and within five years that became its singular
area of concentration. The main reason was the appointment as dean of
Dr. Puey Ungphakorn, former Governor of the Bank of Thailand and a
charismatic intellectual. Dean Puey had a clear vision of the future of
his Faculty and he worked closely with RF field staff to plan and
schedule a long-range program for carrying it out.
The plan had five
chief objectives, which were tackled in sequential but overlapping
stages. The objectives were to dramatically improve the quality of the
undergraduate curriculum in economics, to establish a Master of
Economics program in English, to engage the faculty in policy-oriented
research both to enrich its teaching and to contribute to national
public policy formulation, to strengthen the University as a whole
through the leadership of the Faculty, and to make the graduate program
into a regional resource.
First priority went to
accelerated staff development, and for that good candidates needed to
acquire fluent English and a grounding in economic principles before
being sent abroad. The Foundation consequently brought in a number of
resident staff to strengthen the undergraduate economics program and set
up an English-language program to serve all Thai universities preparing
staff for overseas training. Economist field staff gradually built up to
a peak of nine in 1971-2, and then declined fairly sharply to phase out
entirely in 1981. A total of 64 person-years were devoted to the
Faculty, with 14 more serving in the English-language project, and nine
in non-economic social sciences and the humanities.
The issue of relevance
or the appropriateness of the curriculum was complicated in the case of
economics because neither the expatriate field staff nor the returning
Thai PhDs knew much about the real economic conditions and problems of
Thailand. This lack added to the motivation of faculty members to engage
in applied research and the development of indigenous teaching
materials. In the later years of the program, RF supported research
through the Thai Studies Program (Thai Khadee), the Economic Research
Unit, a political science research center, and a University—wide
research institute.
Most of Dean Puey’s
and the Foundation’s program objectives were achieved, although some
more so than others. The undergraduate curriculum was upgraded until it
was sometimes under fire for being too rigorous, and hence
“elitist,” but returning Thai scholars affirmed that it was on a par
with that offered in institutions where they received their doctorates.
The MA program in English, the first full-time graduate-level program in
a Thai institution, produced high-quality people and a good source of
economic research materials resulting from second year theses. Some RF
staff anticipated a natural decline in the standards of the program as
field staff departed and the availability of scholarship funds
diminished, but later evidence indicated that the decline failed to
occur.
The
institutionalization of the applied research activities of the Faculty
was more in doubt at the time of the Coleman evaluation, but has since
then gained in importance. Among the problems were noncompetitive
salaries and rigidities concerning the allocation of paid time for
research, apart from the Economic Research Unit. No special endowment to
supplement salaries was made available by the Government as it was for
Mahidol scholars, with the result that good economists could earn five
or six times their University salaries in the private sector. In
addition, political turbulence in which Thammasat staff and students
were deeply involved racked the campus in 1976, leaving a residue of
Government suspicion of the purposes of research, and increased faculty
caution in undertaking it. The 1976 upheavals also led to the expulsion
of Dr. Puey, then Rector of the University, from the country.
Opinions were divided
as to whether the administration of the University improved through
Economics Faculty example, but Dr. Puey’s selection as rector in 1974
doubtless led to the further application of the Faculty’s experience.
The aspiration to make the Faculty a center of excellence for Southeast
Asia failed to be realized for some of the same reasons that kept
Mahidol from that role.
3. Kasetsart
University. The third leg of the UDP in Thailand was support
for the development of the agricultural university, Kasetsart. Unlike
Mahidol and Thammasat, the RF was not alone as the principal donor to
this institution; it had received substantial USAID support since 1952.
Moreover, the RF itself had supported activities at Kasetsart since 1955
under its Conquest of Hunger Program.
The Foundation made
major contributions to staff development and to the quality of
instruction through long-term field staff assignments, as with Mahidol
and Thammasat, but one function it undertook differed from other cases
and deserves special mention. One senior field staff member, a former
president of an American land—grant university, served as
Vice—Rector for Development for four critical years during which a new
Kasetsart campus was planned and a World Bank loan negotiated. The loan
covered not only campus development costs but also funds for graduate
study abroad for more than 100 Thais drawn from all faculties of the
University. This was a case of what foundations think of as
“leveraging,” the investment of a relatively small sum to influence
the quality of the application of much larger sums. The concept is
understandably more popular with the leverager than the leveragee, in
this case the Bank, but it is one that may be worth returning to in Part
V when we consider the need for new mechanisms for cooperation.
To conclude this
abbreviated account of an extraordinarily successful exercise in
institution-building, it is worth noting the flexibility and persistence
which marked the effort. Not only did the Foundation override some of
its predetermined criteria in selecting these Thai institutions for
assistance, it did not pull out when things went seriously awry.
On two occasions, in
1971 and 1976, military coups occurred, the latter involving the killing
of students, the intimidation of faculty members, and the forced
political exile of RF’s close and esteemed collaborator, Dr. Puey. On
another occasion, an experimental rural development project, designed to
involve the three universities and the Foundation in a comprehensive
interdisciplinary effort and to expose the students to concrete
development problems, was abruptly terminated by the Government after
the military coup of 1976. The Foundation did, in other countries,
abandon university programs under adverse circumstances where eventual
success was not as legibly written on the wall.
Even more important
than the willingness to persist despite adversity was the initial
recognition that building strong institutions would take 12 to 15 years,
and the ability to plan for a program of that duration.
B.
The USAID Program
1. Training.
USAID, and its predecessor organizations, have been active in Thailand
since 1951, and the experience must be counted among their most
successful. The depth and breadth of the assistance program could not be
captured in a brief treatment such as this, but fortunately the recent
book by Professor Robert Muscat provides an excellent account and
analysis of the achievements of the program, and of the Thai
institutions it was designed to assist. The following information was
derived primarily from Muscat's book.
From the outset, the
foreign assistance program emphasized training, much of it in the United
States, and a sizable proportion at the graduate level. This paper is
concerned with a more narrow focus, primarily the strategies for
developing indigenous research capacities in the fields of health and
economics at Mahidol and Thammasat Universities, but it is worth noting
in passing the extent to which senior Thai academic, Government, and
private-sector figures have been exposed to American education. The
significance of their studies, for our purposes, is that they helped to
create a receptive environment for change, including a willingness to
accept and act upon research results.
Overseas training
began with 14 participants in 1951 and 77 in 1952, reaching cumulative
totals of 8,000 by 1970 and nearly 11,000 by 1980. About a quarter of
these people were on long-term courses of study. The perceptible
slowdown in numbers sent abroad in the 1970s was importantly due to
increased capacity for offering high-quality education and training in
Thailand, but it also reflected changing emphases in the foreign
assistance program towards activities perceived to affect the basic
human needs of recipients more directly.
Interviewing Thais in
business, Government and academia, Muscat found near unanimity in the
belief that training has been the most important contribution of the US
aid program to the country’s development. The Thai—American
Technical Cooperation Association in 1986 determined that of 411 senior
administrative and decision-making officials in the Government,
excluding military and security related positions, 162 had been
participants in US official overseas training programs.
This proportion is
doubtless far short of the total number who received American training.
In addition to Rockefeller Foundation fellowships for post-graduate
study in the United States, which totaled 378 between 1951 and 1985, the
Ford Foundation awarded 111 fellowships in this period, the Population
Council 43, and the Agricultural Development Council 38.
Dwarfing all sponsored
education in US institutions, privately-financed Thai students comprised
about 90% of the Thai student body in the US from the mid-1950s to the
mid-1970s. According to statistics compiled by the Institute of
International Education, Thai students have numbered around six to seven
thousand per year in the US since the mid-1970s, comprising about 2% of
the total foreign student population. Most of these are in undergraduate
institutions.
To put this massive
exposure to foreign training into perspective, it should be remembered
that virtually no graduate education was available in Thailand in the
1950s, and as recently as 1967, Thai institutions were graduating only
about 150 master's level students per year, a third of them medical. The
ability of the Thai society to accept this massive foreign exposure, to
put the technical knowledge to good use and not be seduced or
overwhelmed by it is extraordinary testament to the strength and
resiliency of the Thai culture. Almost no Thai participants failed to
return home after their training, and dependency upon foreign
institutions did not occur, as evidenced by the rapid decline in numbers
sent abroad when high-quality graduate education became available in
Thai institutions.
2.
Transition program. By 1983, the assistance program in
Thailand was justified mainly by its proximity to the continuing
turbulence in Indochina rather than by Thai poverty, and the AID Mission
Director undertook a study of future options for the program. The views
of 40 to 50 prominent Thais were obtained in lengthy interviews. The
predominant views of these individuals were that the most useful roles
for USAID in the future lay in education and manpower development,
science and technology, management, public-private cooperation, and
agriculture. The US was highly regarded as a leading source of advanced
technology, and more open to sharing it than most alternative sources.
The alleviation of poverty was not considered an area in which US aid
had particular relevance or leverage.
Assistance programs
don’t change directions overnight, nor are the priorities seen from
the field always persuasive with Washington, but in the time between the
options report and the shutdown of the AID program in March 1991, the
program moved a considerable distance in the directions favored by the
Thai respondents. Two substantial initiatives can be briefly mentioned
here: Emerging Problems of Development, and Science and Technology. In
addition, participation in centrally-funded scientific research
competitions by Thai scientists was effectively encouraged and supported
by the Mission.
The Emerging Problems
of Development Program was scheduled to run from 1985 to 1992 with an
authorized funding of $18 million. Its intent was to identify
significant problems where policy choices will be required and to
stimulate high-quality research and analysis on them. Some advanced
professional training was funded, but the largest single allocation went
to support policy research at TDRI. The TDRI experience, not restricted
to the AID project, is discussed in Part V.
The Emerging Problems
program also instituted a process that solicits the policy concerns of
Government agencies, invites proposals, and funds studies, with
decisions jointly taken by the Thai planning board (NESDB), the
Department of Technical Cooperation (DTEC), and the Mission. Studies and
pilot activities funded under this program have led to major new
projects in science and technology and in natural resources and the
environment.
The Science and Technology Program was also intended to last from
1985 to 1992 with an authorized USAID budget of up to $35.4 million plus
$15 million in Thai funding. A semiautonomous Science and Technology
Development Board (STDB) under the Ministry of Science, Technology and
Energy has been created to administer the funds. On it sit businessmen,
scientists, and Government officials. The objective of the STDB is to
improve the utilization of Thai science for economic activities. Apart
from the medical field, scientific capability is perceived to be
under—utilized by private industry, and resources devoted to research
by the private sector have been low by comparison with more advanced
economies in Asia and elsewhere.
The STDB seeks to
strengthen the technical infrastructure supporting industry by improving
industrial standards, testing, and quality-control capabilities. It also
seeks to promote R&D on commercially promising products and to
improve access to international technological information. STDB can also
support studies on policy constraints in these areas. Technical
assistance to STDB is supplied through the National Academy of Sciences.
What distinguishes the
S&T project, in Muscat’s view, is its focus on applications in the
private sector, its concern for S&T policy as a broad developmental
issue, and its objective to help fix deliberate attention to S&T in
effective institutional settings. For the purposes of this paper, what
distinguishes STDB is the support it offers for applied research and
development in the areas of bioscience and biotechnology, further
strengthening the contributions of Mahidol, Kasetsart, and other
universities to Thai development.
3. PSTC. In 1979, President
Carter announced the establishment of a Foundation (later Institute) for
Scientific and Technological Cooperation (ISTC) with developing
countries. The idea was to take responsibility for research and
technological collaboration out of AID, where it fared poorly in the
atmosphere created by the “basic human needs” orthodoxy, and place
it in a new Federal institute that would facilitate relationships
between the US scientific community and institutions in developing
countries, particularly the middle-income countries no longer served by
the foreign assistance program.
The announcement
proved premature. Although the idea was hailed as a breakthrough by
scientists in Asia, Africa and Latin America, the US Congress had little
enthusiasm for creating another Federal agency. The ISTC was authorized
by the Congress, but funding was rejected by the appropriations
committee of the Senate. As a compromise, the authorities designed for
the new agency were vested in AID, which set up the Office of the
Science Advisor to administer the resulting Program in Scientific and
Technological Cooperation (PSTC).
PSTC has been
administered quietly but effectively since being launched in 1981.
Research capacity building has not moved to center stage in AID as a
whole. Recent policy pronouncements stress building democratic
processes, strengthening the family, and partnership with the private
sector, but not building the problem-solving capacities of nations
through universities. The budget of PSTC has declined from $12 million
in 1981 to around the $8 million level, not accounting for inflation.
For Thailand, and
Mahidol University in particular, the PSTC has been a boon. Thai
scientists have won 53 grants over the years, more than twice as many as
any other country. Indeed, Mahidol University alone has captured more
grants than any country total other than Thailand.
Mahidol’s success is
testimony not only to the quality of the institution, but also to the
emphasis placed by the USAID Mission in Bangkok on strengthening
scientific and technological capacity in the transition program. Perhaps
the most effective action by the Mission for PSTC was the appointment of
a Thai scientist, Dr. Jaroon Kumnuanta, to its staff to help scientists
prepare and submit proposals to the program. The year after his
appointment, Thai scientists won 12 awards, triple the number of the
previous year and a quarter of all PSTC grants awarded that year. PSTC
soon began attracting upwards of 100 proposals per year, and the Science
Advisor had to ask the Mission to limit submissions to 50 in order to
give the rest of the world a chance.
Another international
research competition funded through the Office of the Science Advisor
was administered by the Board on Science and Technology f or
International Development (BOSTID) of the National Academy of Sciences
(NAS). The BOSTID program initially concentrated on six research areas
chosen by a committee of distinguished scientists from the US and
developing countries. Special workshops on each topic were held to
determine what research was needed and which developing country
institutions were best able to do it. Proposals were then solicited from
those institutions and reviewed and revised before funding. The BOSTID
program lapsed in the late l980s due to a reduction in funding available
to the Science Advisor.
A third international
research competition, funded through the Office of the Science Advisor,
in which Thai institutions have impressive success is the US-Israel
Cooperative Development Research Program (CDR). This program seeks to
increase the access of developing countries to Israeli scientific,
technical and development expertise. It funds joint research on
significant development problems by Israeli and developing country
scientists. Proposals are subjected to objective peer reviews and
awarded on a competitive basis.
By the end of 1988,
when the impact on Thailand of the three centrally-funded research
competitions was evaluated, PSTC had made 40 grants to Thai institutions
totaling $5,622,164; CDR had made 20 grants totaling $3,094,098; and
BOSTID had made 11 grants totaling $1,547,970. Of the total funds
available worldwide, Thailand received around 20%.
As might be
anticipated, the findings of the evaluation were highly positive as
reflected in the following summation:
The centrally-funded
projects have been producing scientific information
that is of immediate relevance to development in Thailand as well as
other developing countries. The overall quality of research is high,
with few exceptions. The impact of these grants on Thai institutions,
primarily the universities, is substantial: strengthening their capacity
in science, increasing their ability to attract and hold qualified
staff, serving as magnets to talented students, equipping their
laboratories, improving research management, and expanding institutional
capability to acquire funding for research from other sources.
Centrally funded
research programs, while strengthening AID’S overall impact in a
country, are not free goods for the AID Mission. The Thai Mission
devotes two person-years of staff time annually to centrally funded
research. The AID Mission was due to phase down to one or two persons on
the Embassy staff in the early 1990s even before the recent coup forced
a more abrupt cessation of activities, and the PSTC and CDR
responsibilities will probably be transferred to the STDB, assuming that
institution survives the funding cuts. For other missions, where science
and technology are not prominent elements of the program, the burden of
supporting and monitoring centrally funded projects can be considered
onerous.
C.
The National
Epidemiology Board of Thailand (NEBT).
The rapidly changing requirements for health services in
Thailand, resulting from economic growth and national accomplishments in
combating infectious diseases and negotiating the demographic
transition, place a considerable burden on policy makers in the Ministry
of Public Health (MOPH). The pace of change puts a premium on the
ability of the health system to identify priority problems, to mobilize
resources, and to assess the effectiveness of alternative courses of
action.
Recognizing the
potential value of the knowledge and experience of medical scientists in
the universities for analyzing national health problems, the MOPH in
1986 set up the National Epidemiology Board of Thailand as a mechanism
for mobilizing academic resources for public health purposes. The idea
evolved from discussions engaging officials of the MOPH, Thai
academicians in the health field, and a representative of the
Rockefeller Foundation. The Foundation provided initial funding for the
activity.
The NEBT consists of a
Board of Trustees, the National Epidemiology Board (NEB), an Executive
Committee of the Board, five program units, and an administrative
section. The NEB is the policy-making body, guided and supported by the
Board of Trustees. Twenty senior Thai academicians and health executives
serve on the NEB. The Board of Trustees consists of 35 persons, most of
them serving ex officio as representatives of departments of the MOPH,
universities, and bilateral and international donor organizations
interested in public health activities.
The Executive
Committee is the key body for identifying priority issues and
formulating plans of action. It consists of ten qualified health
professionals who utilize a Technical Advisory Group and special
problem—oriented commissions to assist in information-gathering,
planning, and analysis.
The four main program
areas of the NEBT, each of which is the focus of a scientific commission
serving the Executive Committee, are:
-
Communicable disease control;
-
Non-communicable disease control;
-
Environmental health; and
-
Health systems research.
In addition, an office
of Special Programs is available to deal with issues not covered by the
four Commissions.
This rather elaborate
structure is remarkable for its ability to link sources of technical
information with policy-making executives and those who control domestic
and external resources available for dealing with health issues. It also
encourages a broad problem orientation, transcending disciplinary and
departmental boundaries.
The creation of the
NEBT has facilitated much closer interaction between decision-makers in
the MOPH and leading academicians, and a joint approach to problems. For
example, the Commission on Environmental Health determined that there is
a high incidence of water—borne diseases despite the increasing
availability of safe water supplies and latrines. The NEBT provided
research grants to examine the issue, considering socio-cultural and
behavioral factors as well as environmental and medical. The annual
meeting of the NEBT offered a forum for policy—makers and academicians
to discuss research findings and recommendations, and jointly to
consider further action.
The opportunity for academicians to interact with experienced
health workers from the field, created through the scientific working
groups sponsored by NEBT, has proved beneficial in fostering
interdisciplinary approaches to complex problems. Combining behavioral
and social science research with clinical and biomedical approaches has
increased the applicability of research results in some case.
A number of cases can
be cited to demonstrate the value of the NEBT to the Ministry. NEBT was
instrumental in organizing meetings of experts to consider means of
preventing encephalitis. The groups designed appropriate educational
materials and vaccine schedules for use by the Ministry, which used the
recommendations in conducting a large-scale vaccination program in the
northern provinces.
NEBT also initiated
sentinel surveillance of HIV infections in 14 provinces, a system that
has been adopted and expanded by the Ministry as its major source of
information on HIV transmission.
In another case, NEBT
worked closely with the Ministry to design an action research program on
means of controlling iodine-deficiency diseases. The National Medical
Research Council supplied funding for studies. The NEBT supported a
national seminar on iodine deficiency diseases, organized by the
Nutrition Division of the Department of Health, which led to changes in
strategies and programs in this field.
VI.
CONCLUSION
Our principal focus in
this series of papers is on the external assistance strategies and local
policies that help to explain the emergence of two remarkably successful
research-oriented universities in Thailand. Our brief review of two
other institutions established in Thailand with external assistance, the
STDB and the NEBT, is intended to illustrate the value of creating
special mechanisms for linking university research capacities in the
health field to both private and public sector agencies dealing with
health problems. This institutional articulation is particularly well
developed in Thailand.
VII.
NOTES AND REFERENCES
1. Muscat, Robert, Thailand
and the United States: Development, Security and Foreign Aid,
Columbia University Press, 1990. p. 8.
2. Muscat, p. 2
3. Muscat, pp. 1-2
4. Akrasanee,
Narongchai, David Dapice and Frank Flatters,
“Thailand’s Export-Led Growth: Retrospect and Prospect,” TDRI,
February 1991. p. iv.
5. Akrasanee, p. 5
6. Muscat, p. 272
7. Sussangkarn,
Chalongphob, Teera Ashakul, and Charles Myers,
“Human Resources Management,” paper prepared for the 1986 TDRI
Year—End Conference, December, 1986. p. 16
8. Sussangkarn, pp. 167-8
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