Introduction

In an increasingly complex policy environment, many public sector challenges extend beyond the mandate of a single government entity. Issues such as public health emergencies, climate change, disaster management, and food security involve multiple institutions, policy instruments, and governance levels. As a result, Supreme Audit Institutions (SAIs) are increasingly required to conduct integrated and cross cutting audits that examine how government entities collectively address systemic challenges rather than assessing the performance of individual agencies in isolation.

Integrated and cross-cutting audits focus on evaluating the coherence, coordination, and effectiveness of government actions across sectors and institutions. This approach is particularly relevant when auditing programs linked to the Sustainable Development Goals (SDGs), where progress depends on coordinated implementation among multiple stakeholders. The INTOSAI Development Initiative (IDI) therefore introduced the SDGs Audit Model (ISAM) to guide SAIs in assessing government preparedness, policy coherence, and institutional collaboration.

Recognizing the importance of such an approach, the State Audit Office of the Kingdom of Thailand (SAO Thailand) conducted a performance audit titled “Enhancement and Preparation for Public Health Emergencies.” The audit examined how Thailand prepared for and responded to public health emergencies, particularly in light of global experiences during the COVID-19 pandemic. The audit also contributed to assessing national readiness in relation to SDG target 3.d, which aims to strengthen countries’ capacity for early warning, risk reduction, and management of national and global health risks.

Public health emergency preparedness represents a cross-sectoral policy area involving numerous government bodies responsible for disease surveillance, public health services, emergency response, border control, and strategic planning. The COVID-19 pandemic further highlighted that fragmented governance arrangements and insufficient coordination among agencies can undermine a country’s ability to respond effectively to emerging health threats. For this reason, auditing such a policy domain requires an integrated approach that examines how policies, legal frameworks, institutional responsibilities, and information systems interact within the broader governance system.

To address this complexity, the audit applied key principles of the ISAM framework, including the Whole-of-Government Approach, policy coherence, and multi-stakeholder engagement. These principles guided the auditors in identifying relevant institutions, defining audit scope, and examining the interaction between national policies and operational implementation across agencies.

Applying a Whole-of-Government Approach in Audit Design

A central element of integrated and cross-cutting audits is the Whole-of-Government Approach, which emphasizes coordinated governance across ministries, departments, and levels of administration. Rather than focusing solely on a single auditee, this approach examines how multiple institutions collectively contribute to achieving policy objectives.

In the case of Thailand’s public health emergency preparedness audit, the auditors recognized that effective pandemic preparedness depends on policy alignment, operational coordination, and information sharing among several government entities. Consequently, the audit design extended beyond a single agency and examined the roles and responsibilities of key institutions involved in disease prevention, emergency response, and health system preparedness.

The primary auditees were the Office of the Permanent Secretary of the Ministry of Public Health and the Department of Disease Control, which are responsible for policy coordination, disease surveillance, and national preparedness planning. However, the audit also considered the broader institutional ecosystem, including other agencies that play supporting roles in implementing strategic plans, managing resources, and responding to public health crises.

Applying a Whole-of-Government perspective enabled the audit team to identify governance gaps that may not be visible when auditing individual entities separately. For example, the audit examined the alignment of legal frameworks, strategic plans, and operational responsibilities among different agencies responsible for disease control and emergency management. This approach also allowed auditors to analyze how coordination mechanisms function in practice and whether existing institutional arrangements support timely and effective responses to health emergencies.

Integrated Auditing of Policy Frameworks, Planning, and Information Systems

The integrated audit approach also guided the selection of audit topics. Instead of focusing only on operational performance, the audit assessed multiple dimensions of preparedness, including:

• Legal and regulatory frameworks governing disease prevention and control
• Strategic planning and implementation mechanisms for public health emergency preparedness
• Coordination arrangements among government agencies
• Information systems and data integration for disease surveillance and response

The audit revealed that while Thailand has established legal instruments such as the Communicable Disease Act and several strategic plans related to disease prevention and emergency preparedness, gaps remain in policy coherence and institutional coordination. For instance, some legal provisions were not fully aligned with other disaster management laws, leading to uncertainty among responsible agencies during the early stages of pandemic response.

Furthermore, the audit found that several strategic plans addressing infectious disease preparedness contained similar objectives and indicators but were developed independently, resulting in overlapping targets and inconsistent implementation frameworks. This fragmentation limited the effectiveness of monitoring mechanisms and reduced the ability of authorities to assess overall preparedness at the national level.

Another critical issue concerned public health data systems, which were managed by different institutions and lacked sufficient interoperability. In a public health emergency, fragmented data systems can delay decision-making and hinder the government’s ability to monitor disease spread and allocate resources efficiently.

These findings demonstrate the value of cross-cutting audits, as systemic governance challenges often arise from the interaction between multiple policies, institutions, and information systems.

Contribution of Integrated Audits to Public Sector Accountability

By applying an integrated and cross-cutting audit approach, SAO Thailand was able to move beyond traditional agency-level accountability and assess system-wide governance performance. The audit provided insights into how national preparedness policies are translated into operational practices and how institutional coordination affects the effectiveness of government responses to public health crises.

The audit results contributed to strengthening public sector accountability by:

• Identifying policy and legal gaps affecting pandemic preparedness
• Highlighting the need for greater coordination among responsible agencies
• Recommending improvements in strategic planning and monitoring mechanisms
• Emphasizing the importance of integrated information systems for public health surveillance

These recommendations support the government’s efforts to enhance preparedness for future public health emergencies and improve policy coherence across institutions.

Lessons for SAIs

The experience of SAO Thailand demonstrates that integrated and cross-cutting audits are essential for addressing complex policy challenges that require coordinated government action. Applying a Whole-of-Government perspective enables auditors to identify systemic governance weaknesses and provide recommendations that strengthen institutional collaboration and policy coherence.

For SAIs in the ASOSAI region, adopting such approaches can enhance the relevance and impact of audit work, particularly when assessing issues related to public health resilience, climate change, disaster risk management, and sustainable development.