This paper examines partnerships for health governance and health systems reform in complex developmental transitions, involving state health authorities, civil society and health consumers. Health systems reform analysis tends to ignore role of civil society (Patcharanarumol et al, 2011) but Thai health system reforms strongly highlight civil society (Chuengsatiansup, 2008). That paper’s starting point is the ‘Southern’ health consumer, taking a developing country perspective focused on health protection, environmental and public health hazards. Democratization has enabled civil society to drive consumer-society-state partnerships for health protection , starting with the constitutionalization of health system reform. The idea of health solidarities stands in the background, operationalized in terms of social infrastructure, extending the social determinants of health approach (CSDH 2008; Birn 2011; Friel et al 2011) towards health justice. This theoretical approach can incorporate the human development and capabilities approach by focusing on collective Health Capabilities. Following Deneulin (2014) health capabilities are incorrectly understood as consumer choices. Instead they form a frame for social and political action linking wellbeing to ‘affiliation’ (Nussbaum 2011), the transformation of unjust structures, and mutual responsibilities and justice (Deneulin et al 2006; Deneulin 2014) through public reasoning (Sen 2009; Ruger 2009). ‘Durable empowerment’ in this frame needs improved analysis (Volkert 2013). A health consumer protection alliance involving public awareness campaigning, policy influencing and interaction with the opportunity structure afforded by the People’s Constitution of 1997 and national Health Systems Reform Movement 2000-2004 yielded a dense civic participatory structures coordinated by Health Systems Reform Office and culminating in a Progressive National Health Act (2007). In this context, the 2010 National Heath Assembly proposed an asbestos ban and this was approved by Cabinet in 2011 (Sarnsamak, 2011). However conflicts between activists, Ministry of Public Health and Ministry of Industry have delayed progress and political turbulence and coup further delayed implementation of ban action, although they did not rule it out. In conclusion, democratization is a precondition for coordinated partnerships for health reform, but political uncertainty may delay action and affect the legitimacy and efficacy of system-wide reform .