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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.

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