1 Localizing Global Policy: The Experience of Primary Health Care in Thailand + Komatra Chuengsatiansup, MD. PhD  . Supattra Srivanichakorn, MD.   Abstract In the past three decades, Thailand was one of the countries in which serious attempts were made to implement primary health care (PHC) policy. Various measures and numerous efforts taken during mid 1970s up to late 1980s led to substantial improvement of health in rural area. Health situation as well as socio-political context has considerably changed since. This paper is an attempt to appraise the nation’s experience of primary health care movement from today’s vantage point. Combining critical review of studies on community health, various case studies on local health initiatives, and findings from a nationwide survey on the roles and performance of village health volunteers, this paper assesses the achievement, reviews lessons learnt, and suggests what the new health situations and the changing contexts mean to the renewal of primary health care. The study reveals that as PHC policy has created much needed spaces for community action for health. As PHC ran its course, however, the meanings of health and community actions have become more and more contested. What was needed at the local level was a more inclusive and more pluralistic health policy process in which various actors with their various identities could enter and openly negotiate their interest. At the global level, a shift of strategies among global health agencies toward a greater role in putting health in the global macroeconomic agenda was needed. The aim was to create a better global system of health governance by which political, social, and economic issues effecting health could be negotiated. Introduction: Primary health care as a social concept was historically contingent; it was a concept created within specific contextual circumstances and thus need to be understood and assessed within its politico-historical contexts. Although development has become the raison d’etre of the state, particularly for third world, or ―developing countries‖ since World War II and health featured prominently as an important domain of state intervention, it was within the context of the Cold War that the concept of primary care was conceived. Over the past three decades primary health care (PHC) has been one of the most important global health development strategies (WHO 1981). As an international health policy, it provided not only a set of clear directions but also a powerful guiding moral ideology to health policy and action (Cueto 2004: 1868). Health was not for the few, but for all. Thailand was unmistakably one of many countries to put in serious effort in the implementation of primary health care policies. Building on its experience in community-based malaria program in the 1950s, community health development in Sarapee project and the famous + Paper prepared for the Bellagio Workshop on five country case study on Primary Health Care, 17-21 November 2007, organized by Rockefeller Foundation, World Health Organization, the World Bank, Prince Mahidol Award Conference Committee, and Ministry of Public Health, Thailand.  Director, Society and Health Institute, Ministry of Public Health, Nonthaburi, Thailand   Director, Institute for Community Based Health Care Research and Development, Ministry of Public Health, Nonthaburi, Thailand.