Abstract
Thailand has entered an aging society ahead of its economic readiness, with demographic pressures outpacing the capacity of existing health and social systems. Although the universal coverage scheme and the national long-term care (LTC) initiative provide an important policy foundation, elderly care remains fragmented across ministries, unevenly implemented, and heavily reliant on unpaid or undertrained community caregivers. This commentary synthesizes current evidence through 2025 and identifies key system gaps, including low utilization of local-level funds, shortages of trained personnel, and weak inter-ministerial coordination across the health, welfare, and local government sectors. Recent developments, such as community-based LTC models, expanded telehealth services, and Thailand's emerging regulatory framework for advanced therapy medicinal products (ATMPs), illustrate the country's growing innovation readiness, though major challenges remain. Digital platforms for chronic disease monitoring and post-stroke rehabilitation show early promise, whereas ATMPs require careful evaluation through health technology assessment, ethical oversight, and long-term cost-effectiveness considerations. As Thailand moves toward becoming a super-aged society, strategic reforms in financing, workforce development, digital infrastructure, and ATMP regulatory preparedness are essential. Without coordinated efforts, the country faces the risk of "aging before prosperity" and increasing care disparities. However, with strengthened collaboration and the careful implementation of existing initiatives and emerging technologies, Thailand can build an elderly care system that truly supports healthy and dignified aging.