When Professor Sir Nick White arrived in Thailand from Oxford University 40 years ago to join a small medical research unit, his duties included treating malaria and milking venomous snakes. Today, from his base at Bangkok’s Mahidol University, he leads an international team conducting a worldwide COVID-19 drug trial.

During Sir Nick’s four decades in Thailand, the Mahidol Oxford Tropical Medicine Research Unit (MORU) – a collaboration between Oxford and Mahidol Universities and the London-based Wellcome Trust -- has grown from three researchers to 600. And its activities have spread far beyond Thailand to countries across Asia and Africa. Now, having pioneered treatments to combat deadly tropical diseases, MORU is enrolling 40,000 frontline healthcare workers as far away as Europe and South America in the only large-scale global clinical trial to test whether the drugs hydroxychloroquine and chloroquine can prevent COVID-19.

“We are doing this from Thailand because we have the experience here to conduct large multinational trials,” Sir Nick, who holds professorships at both Oxford and Mahidol and was knighted in 2017 by Britain’s Queen Elizabeth for services to global health, said in an interview. “Thailand punches above its weight in clinical medical research. It has very good academic standards and has created a milieu that prizes innovation, creativity and knowledge.”

Thailand has long been internationally acclaimed as a destination for so-called medical tourists lured by Bangkok’s world-class hospitals. Less well known is an underlying healthcare ecosystem that is helping transform Southeast Asia’s second largest economy into a much broader medical hub, attracting investors and researchers in biotechnology – including vaccines, genomics and biopharmaceuticals -- as well as high-tech medical devices.

Even as the COVID-19 pandemic has crippled industries in other parts of the world, it has actually raised investor confidence in Thailand’s health care sector. In the first half of 2020, 52 medical-related businesses with projects worth 13 billion baht (more than $400 million) sought approval from Thailand’s Board of Investment (BOI) – a rise of 170 percent in project numbers and 123 percent in value over the same period last year.

Since the pandemic began, Thailand has won international praise for the very low infection rate among its 70 million population. Over the same period, Thailand has also become one of the first middle income nations to begin clinical trials on a home-developed COVID-19 vaccine.

Separate from the Oxford-Mahidol global trial on hydroxychloroquine and chloroquine, Thai universities and biotechnology companies are working on at least three vaccine candidates.

In the most advanced of the vaccine studies, Chulalongkorn University’s Chula Vaccine Research Center is about to begin human trials on a vaccine that has already been tested successfully on mice and monkeys.

Since its founding 15 years ago, Chula VRC has quietly worked on vaccines to combat health scourges such as HIV and dengue fever, forging collaborations with several U.S. government and academic institutions including the National Institute of Health and the University of Pennsylvania.

Now its COVID-19 vaccine, based on a technology known as mRNA, has attracted international media attention. And if the upcoming human trials prove successful, the team led by Dr Kiat Ruxrungtham hopes to work with manufacturers in Thailand, North America and Germany to produce 30 million vaccine doses to supply Thailand and six other Asian countries.

Dr Kiat says his team is also collaborating with a second Chulalongkorn study in which Dr Thirivat Hemachudha of the Thai Red Cross Emerging Infectious Disease Health Science Center, working with Baiya Phytopharm, a spinoff from the university’s faculty of pharmaceutical sciences, has developed a potential vaccine that uses a different technology derived from plant protein. “It is great to have more than one vaccine candidate in Thailand among 180 candidates globally,” Dr Kiat says.