Dr Vichai remembers the urgency that fueled those early days. “There was no infrastructure,” he says. “The poorest of the poor were suffering, and no one seemed to care.”

Out of sheer desperation, a group of doctors banded together. Their goal was to provide immediate medical relief and transform healthcare policy at its core. What began as a loosely connected network of volunteers evolved into a far-reaching movement that continues to advocate for the rights of Thailand’s rural poor.

The Rural Doctors Movement’s persistent advocacy eventually led to one of the most transformative moments in the country’s healthcare. In 2002, after years of lobbying, Thailand implemented a universal healthcare programme covering more than half of the population. “We started with a budget of just 1,202 baht per person—about US$30 a year,” recalls Dr Supat Hasuwannakit, president of the Rural Doctor Society. “To most, it seemed impossible. But we had already spent decades making the impossible happen in rural hospitals.”

Universal healthcare didn’t come without challenges. Political opposition and widespread doubt clouded the early years of implementation. “It didn’t just happen,” says Dr Vichai. “We had to fight for it—resist corruption, and build alliances with people willing to listen.”

While today, Thailand’s universal healthcare system is hailed as one of the most equitable in Southeast Asia, its roots lie in the dogged determination of rural doctors who saw healthcare not as a privilege, but as a right.

But even after the introduction of universal healthcare, rural communities faced significant hurdles. Thailand’s healthcare system was still reeling from decades of neglect. While the cities experienced rapid growth, rural areas remained in the dark—literally and figuratively. Public hospitals in these regions were crumbling, overcrowded, and chronically underfunded. Medical equipment was outdated, and the nearest doctor could be a two-day journey away. “We had people dying of treatable conditions,” recalls Dr Supat. “The inequality was staggering.”

In this bleak scene, the RDM doubled down. Their work ensured that even the poorest, most isolated communities would benefit from the government’s new healthcare policies. But as the system evolved, so did the challenges. Political instability, corruption, and an ageing population threatened to unravel years of progress.

Read more: Talk about fishermen, not melting icebergs: How to make people care about ESG

Today, Thailand faces new healthcare challenges. With over 70 per cent of rural residents now aged over 60, the healthcare demands have shifted. “Older people need more care several times a year,” explains Dr Choochai Supawongse, current president of the Rural Doctors Movement. 

Complicating matters further is the growing impact of climate change. Droughts, floods, and extreme temperatures are becoming more frequent, making rural communities increasingly vulnerable to heat-related illnesses, food insecurity, and disease outbreaks. 

“Another problem is that we are challenged with new technology. This is always very, very expensive, and we have limited resources. So, we need to cautiously choose new technology for the benefit of our people, with an affordable price,” Dr Vichai says. “Our healthcare system needs to adapt, and quickly,” warns Dr Supat. “But we’re already stretched so thin.” Still, the doctors remain undeterred. “We’ve always fought uphill battles,” adds Dr Choochai. “This is no different.”

For more than five decades, the Rural Doctors Movement has worked toward a singular mission: ensuring that even the most disadvantaged communities in Thailand have access to healthcare. This mission has seen them implement rural hospital development, advocate for policy changes, and provide care in the most remote corners of the country.

Their influence has extended far beyond healthcare. By advocating for the rural poor, the movement has contributed to broader social justice efforts in Thailand. The doctors have tirelessly campaigned for civil liberties, fought against corruption, and made a lasting impact on public health policy.

Today, their work continues, not because they have to, but because they believe in the fundamental right to healthcare. “We do this because healthcare is a human right,” says Dr Vichai. “And as long as people are still suffering, we will keep fighting.”

The fight for healthcare equality is far from over, but the groundwork laid by the Rural Doctors Movement provides a strong foundation for whatever comes next. Its legacy will continue to shape the country’s healthcare system for generations to come. 

Thailand’s grassroots activism transformed its healthcare system, achieving near-universal coverage. The landmark introduction of universal healthcare in 2002, the result of decades of persistent advocacy, stresses that comprehensive reform is attainable through collective effort. 

As the Philippines advances its own reforms, building a robust network of rural healthcare workers committed to advocacy could pave a similar path. Despite progress under the Universal Health Care Law, there are still valuable lessons to be drawn from Thailand’s experience—particularly its recognition of healthcare as a fundamental right. Embracing this perspective can ensure that no community, however marginalised, is left behind.

This is not just about healthcare—it’s about hope. Despite odds, these doctors remind us that true change rarely comes from top-down policies but from the tireless efforts of those on the ground. Their fight was not merely about curing the sick; it was about healing a fractured system. 

The Rural Doctors Movement’s lessons ultimately leave a profound truth: a nation’s strength is not measured by the wealth of its cities but by the well-being of its most vulnerable. It proves that even in the most neglected corners of society, justice and dignity can take root and flourish.

This article is part of Business of Good, the series that explores how global leaders work to drive change through philanthropy and positive action.

OTHER ARTICLES IN THIS SERIES

Talk about fishermen, not melting icebergs: How to make people care about ESG

L'Occitane en Provence CEO Adrien Geiger on finding creative, practical ways to fight plastic waste

Cartier's Cyrille Vigneron on championing global change through culture, philanthropy and leadership