Southeast Asian cooperation in health: a comparative perspective on regional health governance in ASEAN and the EU

Abstract

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

Trade and investment liberalization and Asia’s noncommunicable disease epidemic: a synthesis of data and existing literature

“…The potential opportunities at the regional level are under researched in the current literature. Despite the primacy they give to trade liberalization, ASEAN and the Asia Pacific Economic Cooperation forum have recently demonstrated increased commitment to addressing regional health issues, in particular infectious disease threats [ 148 , 149 ]. As others have noted, however, ASEAN member states have been resistant to attempts to develop regional policy mechanisms that impinge on their national sovereignty.…”

“…As others have noted, however, ASEAN member states have been resistant to attempts to develop regional policy mechanisms that impinge on their national sovereignty. Decision-making processes have been slow due to a ‘rule-by-consensus’ culture and their highly politicized nature (the ‘ASEAN’ way) [ 149 ]. The ASEAN Health Ministers Meeting is held every two years yet it has confined its work largely to infectious disease control and disaster preparedness, with agreements to date focused largely on sanitary and phyto-sanitary measures [ 150 ].…”

What is the relevance of policy transfer and policy translation in integrated care development?

“…It shows how policy-making can take place within the economic context of globalisation and the political context of global governance (Massey, 2010). Supranational forces such as the WHO thus constitute a form of global health diplomacy, and function as an interface between health, foreign policy and trade (Pang et al, 2010, Payne, 2008, where health is considered as both a global public good (Lamy and Phua, 2012) and a necessary focus for international policy development (Brown and Moon, 2012).…”

Strengthening Trade and Health Governance Capacities to Address Non‐Communicable Diseases in Asia: Challenges and Ways Forward

“…They have, however, been ineffective at generating regional consensus in other areas, including negotiations of the International Health Regula-tions and pandemic influenza response (Lee et al 2012). For historical reasons, WHO has divided East Asia into two regions, a significant challenge for building cohesion and coordination (Lamy & Phua 2012). Although ASEAN has played, at times, an important role in facilitating regional cooperation for health, its role has been hampered by the so-called ASEAN way, the predominance of national sovereignty over collective action and highly politicised decisionmaking processes (Fidler 2013).…”