Globalization has led to new health challenges for the twenty-first century. These new health challenges have transnational implications and involve a large range of actors and stakeholders. National governments no longer hold the sole responsibility for the health of their people. These changes in health trends have led to the rise of global health governance as a theoretical notion for health policy making. The Southeast Asian region is particularly prone to public health threats such as emerging infectious diseases and faces future health challenges including those of noncommunicable diseases. This study looks at the potential of the Association of Southeast Asian Nations (ASEAN) as a regional organization to lead a regional dynamic for health cooperation in order to overcome these challenges. Through a comparative study with the regional mechanisms of the European Union (EU) for health cooperation, we look at how ASEAN could maximize its potential as a global health actor. Our study is based on primary research and semistructured field interviews. To illustrate our arguments, we refer to the extent of regional cooperation for health in ASEAN and the EU for (re)emerging infectious disease control and for tobacco control. We argue that regional institutions and a network of civil society organizations are crucial in relaying global initiatives, and ensuring the effective implementation of global guidelines at the national level. ASEAN's role as a regional body for health governance will depend both on greater horizontal and vertical integration through enhanced regional mechanisms and a wider matrix of cooperation. At the turn of the twenty-first century, the concept of Global Health (Woodward et al. 2001) beyond the traditional World Health Organization (WHO) definition of health as "a state of complete physical, mental and social well-being" (World Health
This article revisits the conceptualisation of pharmaceutical regulation. While States and multilateral organisations play a central part in devising rules, regulation as a social practice extends beyond their role. Domestic and international interests, geopolitics and spatial configurations, commercial and health considerations, governmental policies and individual behaviours and legal and illegal transactions all contribute to regulating the pharmaceutical milieu. This consideration expands the epistemological range of pharmaceutical regulation, which then appears as the assemblage of heterogeneous laws, rules and codes of conducts. The way in which these layers are connected forms what regulation actually is in practice. Regulation multiple thus appears as the product of tensions between harmonisation efforts and persistent diversity, as well as the result of interactions and overlaps between official regulation and unofficial regulatory practices. This article explores these tensions in the Southeast Asian pharmaceutical market along three themes: circuits and logistic regimes; control and attention to quality; bridges and harmonisations. The globalisaTion of pharmaceutical markets which has been taking place over the last 30 years is marked by deep transformations in the geographies of production
The wide circulation of substandard medicines in Southeast Asia is a serious public health concern. Substandard medicines may contain none, or inadequate quantities of the active ingredient, or may contain harmful ingredients. This poses a considerable threat to human lives and an obstacle to infectious disease control at the national, regional and global level, also due to the associated risk of antimicrobial resistance. As trade liberalisation in the region intensifies, moreover, there are concerns that reduced custom controls and higher mobility of people and goods may increase the illicit trade in falsified medicines. In this context, crucial is the ability of governments to develop adequate regulations and capacities as well as enforcement measures to tackle these issues. Given the transnational nature of the problem, the establishment of effective mechanisms for cross‐country surveillance, information exchange and coordinated action is also necessary. In this article, we provide an overview of national responses, reflecting on strengths and limitations of past interventions. We then examine existing institutional frameworks for regional health cooperation, particularly the Association of Southeast Asian Nations, and their potential to support enhanced capacities and cooperation to address this challenge.
As malaria cases continue to decline in Asia, an integrated service delivery approach is ever more urgent to ensure that no malaria and fever cases are missed, and that malaria health workers continue contributing to broader infectious disease control efforts. However, despite its perceived merit, translating integrated surveillance into practice poses several systemic challenges. This article aims to identify what is hindering improved processes for integrating diagnostic and surveillance services for febrile illnesses. Data from peer-reviewed and grey literature were reviewed using a systems approach based on the World Health Organisation health systems building blocks to fully understand the connections between different elements and system implications of integration. We include snippets from Sri Lanka, Myanmar, Malaysia and Nepal, highlighting expanded diagnostic integration best practices. This review provides a foundation for 'integration roadmaps' that can be adapted to different contexts and guide national stakeholders on the operational and political steps for a successful integration model. Such a model
Le monde du travail associatif est marqué par la précarité et l’exploitation. Pourtant, malgré ce constat, les salariés semblent, plus qu’ailleurs, motivés et satisfaits de leurs emplois. Les co-auteures de cet article, membres du Mouvement associatif – fédération des fédérations associatives –, soulignent que les associations sont aussi un lieu de réinvention d’un travail non-instrumentalisé par la recherche du profit, motivé par la recherche de bénéfices sociaux.
This article explains how making a disease notifiable by law is a core component of a robust and well-functioning health system. Mechanisms to rapidly detect and report existing or emerging infectious diseases in a timely manner are key to disease control and elimination. Using malaria in Asia-Pacific as a case in point, we explore different policy considerations involved in making malaria a notifiable disease. These include the timing of legislative changes at different stages of elimination, investing in adequate infrastructure for a robust surveillance system that can support targeted interventions, and the importance of involving all sectors in the delivery of malaria services to detect, report and respond to every case. The article explains how frameworks to report on notifiable diseases, in this case malaria, contribute to improved regional health security. | INTRODUCTIONResilient and responsive health systems are key to effectively preventing, detecting and responding to global health threats. This has been further demonstrated by global efforts to tackle the COVID-19 pandemic and ongoing efforts to control and eliminate long-existingThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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