Project Background

The ASCC Research and Development Platform (Public Health Emergencies) is a newly developed project aimed at addressing the concerns raised at the high-level regional fora. The outputs of this ASCC Research and Development Platform will contribute meaningfully to more informed decisions that ASCC sectoral bodies could take in developing and implementing initiatives.

Project Findings

Healthy lifestyle relevant to ASEAN and AMS landscape and condition:

1. Noncommunicable diseases (NCDs) are the leading causes of mortality. Four major risk factors cause this: tobacco use, harmful use and consumption of alcohol, physical inactivity, and unhealthy diets
   
2. Following the ASEAN Post-2015 Health Development Agenda 2021-2025, ASEAN efforts to promote a healthy lifestyle include NCD prevention programs, tobacco control, reducing harmful alcohol usage, prevention of injuries, and promotion of mental health, healthy aging, and healthy diets.
   
3. Policy gap analysis indicates that a ‘hit-and-run’ intervention and rolling out regulation without an integrated multi-sectoral actionable framework are no longer enough to address this health risk. Therefore, ASEAN needs to strive toward designing a Healthy City that prioritizes health aspects in the development framework and includes integration of health promotion into the national health strategic plan

Notes: Please note that the information and finding in this report are extensive and detailed to every subject in the healthy lifestyle aspects stated in the previous cell. Hence, the finding stated here will only illustrate general information on NCD management in ASEAN:

Based on our analysis several actions may support NCD management and promotion of healthy lifestyles in ASEAN: Develop a Sustainable Funding Mechanism, Strengthen the Capacity of Health Systems and HCPs, especially in Primary Healthcare Facilities, Build a Community-based Behavioural change initiatives, and Enhance Surveillance System, and Monitoring and Evaluation Mechanism. Public health emergencies and public health security relevant to ASEAN and AMS landscape and condition:

1. The Association of Southeast Asian Nations (ASEAN) countries are known for their susceptibility to the emergence and re-emergence of infectious diseases (EIDs and RIDs).
   
2. Several risk factors related to health (e.g., high-risk health behavior and human susceptibility to infections) and non-health (e.g., ecological condition, urbanization, and conflict and famine) contribute to EID and RID
   
3. In ASEAN, diverse health system capacity and AMS’s fragmented data gathering and management standards impeded the regional implementation of this intelligent surveillance system.
   
4. Regionally, ASEAN has developed the ASEAN Strategic Framework for Public Health Emergency, which creates a strategic map to guide AMS in developing health security programs. The framework also supports ASEAN in efficiently preparing and mitigating future PHE and biosafety risks
   
5. Universal Health Coverage (UHC) is one of the ASEAN Post-2015 Health Development Agenda linked to the SDGs to address its regional health concerns. AMS has vowed to attain UHC through a variety of ways and programs
   
6. Due to high out-of-pocket expenditures and a lack of accessible treatments, poor and vulnerable households use health care at a low rate. In Malaysia, Cambodia, Myanmar, and the Philippines, out-of-pocket expenditure topped 50% in 2015, putting considerable financial pressure on many households

Notes: Please note that the information and findings in this report are extensive and detailed to every subject in the PHE aspects stated in the previous cell. Hence, the finding stated here will only illustrate general information on PHE management in ASEAN:

Digital health transformation relevant to ASEAN and AMS landscape and condition:

1. The penetration of technology in the region has been rapid, albeit at different rates, indicated by the swift adoption of mobile internet connections. Investment expansion in tech-enabled businesses supports digital health transformation
   
2. Telemedicine and other technology can extend the reach of high-quality healthcare into isolated communities, supporting the achievement of Universal Health Coverage (UHC), as shown by the Halodoc application in Indonesia
   
3. ASEAN has taken the step to further digital health transformation for PHE measures, such as Malaysia’s MySejahtera and Indonesia’s PeduliLindungi. At the regional level, ASEAN has established the PHE Portal and the BioDiaspora tools, including the ASEAN BioDiaspora Virtual Center (ABVC) initiatives
   
4. ASEAN established the ASEAN BioDiaspora Virtual Center (ABVC) to build regional capacity in big data analytics and visualization, strengthening ASEAN’s epidemic and pandemic preparedness and response capabilities.
   
5. In the ASEAN region, AI adoption is still in the nascent stages, with many companies at least piloting some AI initiatives. At the same time, some have started developing their AI strategies or investing, and only a few are in advanced stages of AI implementation, typically in more service-oriented sectors
   

Notes: Please note that the information and findings in this report are extensive and detailed to every subject in the digital health transformation aspects stated in the previous cell. Hence, the finding stated here will only illustrate general information in ASEAN.

Resilient Health System:

1. ASEAN is a hotspot for infectious diseases and is part of the region most vulnerable to climate change
   
2. ASEAN’s initiatives are in place to enhance factors relating to RHS. Several AMS also specifically included sectors relating to RHS in their adaptation to climate change plans (please check the policy brief for a detailed framework)
   
3. For essential healthcare, AMSs have rolled out initiatives to support resilience, including the ASEAN Comprehensive Recovery Framework (ACRF)
   many AMS still struggle with maldistribution and shortage of HRH, with rural areas often understaffed in delivering PHC-related services
   
4. AMS have many challenges in enhancing the health and welfare of its citizens, one of which is a reliance on household health spending
   
5. Global Food Security Index (EIU GFSI)’s ranking in 2019, within the ASEAN region, from the data available from nine out of ten countries, most AMS have a below-average rank out of 113 countries
   

Notes: Please note that the information and finding in this report are extensive and detailed to every subject in the food safety aspects stated in the previous cell. Hence, the finding stated here will only illustrate general information in ASEAN:

Food safety integration into food system:

1. FBDs have been a significant issue in Southeast Asia (SEA), with the second highest burden of FBDs among WHO regions
   
2. AMS are classified into two stages in food safety lifecycle: the transitioning stage (Indonesia, Cambodia, Myanmar, Lao People’s Democratic Republic (Lao PDR), the Philippines, and Viet Nam) and the modernizing stage (Brunei, Malaysia, Singapore, and Thailand)
   
3. High disaster occurrences pose another threat to ASEAN’s food safety. Disaster can directly or indirectly impact food safety. Food production in the affected areas will face the danger of microbiological or chemical agent contamination
   
4. Policies on FSCs are in place to integrate ASEAN’s market and ensure food safety, such as the ten key principles of the ASEAN Food Safety Policy (AFSP)
   
5. The structure of food industries in SEA is fragmented with a long food supply chain and dominated by small and medium-sized players with limited knowledge of complex food standards
   
6. The ASEAN region has achieved significant progress in improving WASH. However, the progress is varied due to the diverse capacity of AMS
   
7. Excessive usage of antibiotics and chemical substances in food production has increased AMR’s concern for foodborne pathogens
   
8. ASEAN does not have the power to force AMS to comply with food safety rules set by ASEAN as ASEAN practices consensus decision-making and non-interference in internal affairs
   
9. there are no substantive policies and legal procedures to encourage AMS participation in the exchange of information, causing less-than-ideal food surveillance system utilization
   
10. In light of the FSER plan development in ASEAN, there has not been any official regional framework to address it yet

Notes: Please note that the information and findings in this report are extensive and detailed to every subject in the resilient health system aspects stated in the previous cell. Hence, the finding stated here will only illustrate general information in ASEAN

Team Members:

Annisaa Indrarini, M.Sc., M. Adryan Sasongko, M.Sc.