Hanoi, Vietnam – Hanoi hosted the 12th ASEAN Meeting of the Ministers of Health in September, the title “Better Healthcare for the ASEAN Community after 2015”, where 2015 stands for the dealing on the Millennium Development Goals established by the UN in 2000. Delegates of Vietnam, Cambodia, Lao PDR, Malaysia, Indonesia, Brunei, Singapore, Thailand, Myanmar and the Philippines (joined by auditors from China, Japan and South Korea, ASEAN+3) met to talk about health: how to protect and it and how to improve it.
In a region that grows, becomes richer and therefore older, the management of old age can’t be underestimated. Globalization means more economic exchange, but with trade and global transport come diseases, with richness and new opening to a new world come new habits and more sexual freedom, used by HIV/AIDS and STIs to move across countries. Speaking of health, being blunt about it even, is not a mere health priority anymore: it has become a political one too.
And Asian politicians, from the representatives of Islamic countries (like Indonesia) to the ones of Catholic nations (the Philippines), face with scientific accuracy and bravery themes that would make the legs of many western politicians shake. The Philippine delegate for instance, talks with great precision and competence about the Klinika Bernardo of Quezon City, a suburb of Manila. The clinic, free of charge and open 24/7, it’s a center where men can get tested for HIV anonymously and where doctors and psychologists offer counseling to those who have contracted the virus by having sex with other men, even though not necessarily homosexual (men who have sex with men – MSM).This happens in Manila, but in the cradle of eastern Islam, Jakarta, ten years ago talking of key population (IV drug users, commercial sex workers and MSM), reduction of stigma and awareness among prostitutes and waria (transsexual prostitutes) was not too big of a deal. Even Vietnam, hosting the event, benefited from years of prevention and focused action which contributed to bring the average HIV rate down to 0.45%. Of course there are exceptions, like Hanoi’s prostitution scene where the prevalence is well above 20%, the prison population of Lao PDR and Thailand or the IV drug users communities of countries that have no needle exchange programmes, but on a general basis HIV is not endemic in any South East Asian country.
During the Conference several themes have been discussed, including the more political ones, like the need of having all workers currently employed in informal economic activities on health insurance. Dr Somanthan (Senior Economist at the World Bank), and Dr Evans, WHO representative, have underlined how Governments have the moral obligation to step in when individuals cannot afford healthcare. Of course the issue of sustainability and cost effectiveness was raised, and the response brought up the example of the Philippines where extra taxation has been imposed on alcohol and tobacco in order to prevent a harmful behavior and, at the same time, collect part of the funds needed for health insurance subscriptions for the poor.
Another interesting theme is that of emerging infectious diseases: the ASEAN region was the set for almost 65% of cases and of 80% of casualties occurred during the avian flu epidemics (H5N1). This became a further motivation to improve the prevention and control systems which were already in place. In the region the major authority on the subject is the Institute Pasteur, with labs in different countries across South East Asia, and in Vietnam the focal point for pandemic control and monitoring is the Centro Carlo Urbani, financed by the Italian Development Cooperation. At regional level, the Asia Pacific Strategy for Emerging Disease (APSED) was established in 2005 and updated in 2010. The strategy is based on several criteria to evaluate the likelihood of new epidemics and on parameters that have to be met in order to ensure safety. Should a parameter not be met all resources will be focused on repairing the protection net and keeping infections contained. To date nine out of ten countries have a compliance level between 75 and 100%.
Too such high and participating involvement of politicians, but also of scientists, journalists, civil society organizations gives a lot of hope: Asia is indeed a difficult continent, morphologically and culturally diverse, where a lack of coordination would mean a substantial failure in implementing effective and efficient health policies. During the Hanoi Summit it was clear that the continent is growing, evolving and following a definite direction. Of course, this does not erase inequalities and social differences, but it surely is a step towards a better quality of life for all Asians.
About the author: Elisabetta Borzini works as an UN Fellow since January 2014, seconded to the Italian Development Cooperation office, where she has taken the lead in designing and launching a child protection programme that addresses the identification, assistance and repatriation of minors victims of traffic in Vietnam, Laos and Cambodia.
She has been working on gender, child protection and public health since 2011. Her first assignment was on a women’s economic empowerment project set in a prison in northern Ethiopia with the Italian Development Cooperation where she also represented at the donors’ coordination group on HIV/AIDS.
She has also worked in India for an NGO based in Mumbai –CORP, Community Outreach Programme- that provides shelter, education and healthcare for children and elderly. And as she says it , “ The time in India allowed me to experience first-hand what the lives of those we call “beneficiaries” are like, in all their complexity and harshness.”
On twitter @Malawi_butterfl
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Editor’s Note: This is a guest post and the views expressed in the article are solely that of the author. Information about the meeting is as per the author.
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